Displeased with the results of your gynecomastia surgery? You are not alone. Gynecomastia surgery, like all surgery, is all about attention to detail. The details, in this case, are identifying and treating each component of what comprises gynecomastia. Gynecomastia, or enlargement of the male breast typically has three major components.
The first is the fatty component. This is typically approached effectively by the surgeon with liposuction. A small incision is made, fluid containing local anesthetic and a vasoconstricting agent is injected into the area, and a cannula is used to remove the fatty component of the gynecomastia and contour the chest to a masculine appearance. The second component, which is often overlooked or undertreated by surgeons, is the glandular component. The glandular material cannot be treated adequately with liposuction alone, whether it be conventional suction assisted liposuction or ultrasonic or laser liposuction.
To adequately address the glandular component, the gland must be removed. This means separating the gland from the skin above it and from the pectoralis major muscle beneath it. The goal of surgery is to remove the fat and the glandular material between the skin and the muscle and then encourage the skin to redrape over the muscle properly. This is typically achieved with a compression vest and foam material to compress the skin on to the muscle. This also helps prevent complications such as hematoma or fluid collection under the skin.
The final component of gynecomastia is the diameter of the areola. In most cases of gynecomastia, the areola is enlarged and puffy. By thinning the sub areolar tissue, the puffiness will be addressed and typically the areola will shrink. If you think you may have gynecomastia or are displeased with the results of previous surgery, call to schedule a complimentary consultation.
Gynecomastia revision surgery is performed as an outpatient procedure under a general anesthetic. and takes 1-1.5 hours in experienced hands. Recovery time is usually 3-4 weeks with restriction of arm movement for the first week.
Being a parent, it is my responsibility to teach my kids to be confident and that confidence isn’t all about outward appearance. I am personally not a proponent of aesthetic plastic surgery for minors. But as a father of boys, I feel very empathetic towards boys and young men with gynecomastia. Breast reduction surgery is the only plastic surgery I perform on minors. If my boys are ever candidates for this procedure and have the desire, I would fully support their decision, even as teens, to have gynecomastia surgery.
About Gynecomastia
Gynecomastia, sometimes referred to derisively as ‘man-boobs’, is endemic in the United States. While gynecomastia can be associated with excess body fat and obesity, many males I see for gynecomastia reduction surgery are not overweight. They simply have experienced the spontaneous proliferation of fibrous breast tissue on one or both sides of their chest, for reasons that medical science currently cannot fully explain. It has been found that some medications such as anti-anxiety medications, some antibiotics, certain heart medications, cancer treatments, anabolic steroids (which can lead to hormonal imbalance), and more. In these cases, the dosing of the medication may need to be adjusted or the medication stopped altogether.
For younger boys and teens that are living with gynecomastia, the issue of excess breast tissue can create a vicious cycle of self-consciousness and social withdrawal. With breast area enlargement due to excess glandular tissue, a boy can gradually become insecure about his appearance without a shirt or even in tighter clothing (such as workout clothing). In these situations, I have seen males begin to avoid social situations in which their chest appearance is obvious (the gym, the pool, pickup games), and sometimes come to avoid sporting activities altogether. This can potentially damage their psychosocial development and has a profoundly negative effect on their sense of well-being and quality of life.
An Increase In Gynecomastia Cases
There are many theories as to why there has been such a dramatic increase in the incidence of gynecomastia over the last few decades. Some believe it is because of the increase of pro-estrogenic hormones and chemical compounds such as antibiotics in meat and dairy products, and/or chemicals that we are exposed to in the environment (building materials, flame retardants, pesticides, etc.). No one can be absolutely certain what has caused the significant increase in gynecomastia, but I see enough gynecomastia patients with a normal body weight to know for certain that it is not simply due to the rising incidence of obesity.
As a board-certified plastic surgeon, I have experience performing many different plastic surgery procedures. I have noticed that Gynecomastia patients are among the happiest with their results. They are not only pleased with their more masculine chest appearance after male breast reduction surgery but also become more confident socially. The outcome of gynecomastia surgery can be truly life-changing, with young men immediately more socially confident and more socially active.
One very grateful set of parents recently shared with me that their son, who would never even remove his shirt around his family in the privacy of their home, was so happy with his improved appearance that he was frequently shirtless around the house, was back to hanging out with his buddies at the pool and was thinking of trying out for soccer for the upcoming school year. This kind of story is very typical of an adolescent male patient who has undergone gynecomastia surgery.
Gynecomastia Treatment
If you or your son is struggling with the excess tissue on his breasts, please do not hesitate to reach out to me today. I have ample experience performing minimally invasive male breast reduction surgery as well as other gynecomastia surgery techniques to correct the symptoms associated with gynecomastia. During this procedure, I will remove the enlarged male breast glands, as well as contour the chest area to achieve a more masculine-looking, sculpted chest.
Schedule a Gynecomastia Surgery Consultation
If you are interested in learning more about gynecomastia surgery (male breast reduction surgery) to improve the appearance of the male chest, contact my office today. I will be happy to speak with you about your male breast concerns and goals during a male breast reduction surgery consultation.
Dr. Miguel Delgado and his staff recently welcomed Dr. Ivan Puah from Singapore to Marin Cosmetic Surgery Center, to further hone his surgical skills in gynecomastia surgery.
Dr. Miguel Delgado shared clinical and surgeries cases with Dr. Ivan Puah. Both doctors exchanged experiences on cases they have seen and performed, including post-surgery complications, surgical approaches, and more.
It was rewarding for Dr. Ivan Puah to receive one-on-one mentorship from Dr. Miguel Delgado in gynecomastia surgeries as well as observation of liposuction and a tummy tuck procedure. At the clinic, Dr. Ivan Puah had the opportunity to observe consultations, pre-operative patients, and management of post-operative patients who were having drain and suture removal.
Dr. Ivan Puah has been practicing medicine for more than 20 years with training in various disciplines including general surgery, orthopedic surgery, urology, dermatology, and many more. Since the establishment of his medical aesthetic practice, Amaris B. Clinic in 2004, Dr. Ivan Puah has been performing various types of surgical body sculpting procedures such as laserlipolysis, liposuction, VASER® Lipo, fat grafting, and gynecomastia.
Dr. Ivan Puah is a certified VASER® practitioner, obtaining his VASER® Body Sculpting training in Colorado and Argentina. In Singapore, he is accredited and recognized by the Ministry of Health to perform surgical body sculpting procedures.
“Gynecomastia is the top main concern for male patients in Singapore. As a doctor, it is important to provide patients with honest, ethical advice, as they put their trust in you; while managing their expectations realistically, working with them on achieving the results they want,” explains Dr. Ivan Puah.
We asked Dr. Ivan Puah on his key takeaway from the training, and he stated, “It was a very fruitful trip. Although I have been performing gynecomastia surgery for years, I am extremely humbled to have the opportunity to receive further training and to be mentored personally by Dr. Miguel Delgado, who is an expert in this field. He is very approachable, yet professional, and always ready to give advice. I look forward to more learning opportunities with Dr. Miguel Delgado in the near future.”
Gynecomastia.org, a popular educational online site, set up by Dr. Miguel Delgado and his team, is dedicated to providing comprehensive information for males who are facing issues with manboobs.
“I am glad that gynecomastia.psstage.com offers a platform for patients to share their experiences, research for the right information for their specific concerns and treatment options. To be listed on the doctor’s panel provides physicians like myself another useful channel to communicate and offer appropriate advice,” says Dr. Ivan Puah.
Visit https://www.gynecomastia.org/ to learn more about gynecomastia.
Gynecomastia specialists’ see too often the cases of male breast reduction done by less experienced surgeons. Many gynecomastia revision cases are necessary because the primary surgeon removed too much fat and tissue leaving a “crater deformity,” or in some cases, not removing enough tissue. A large percentage of revision cases are due to liposuction alone being performed, and there is breast tissue left behind.
How many cases does the surgeon do in a year? It should be in the hundreds.
There should be available an extensive photo gallery of before and after surgery.
Custom Plan For Your Body Type
Gynecomastia surgery is very complex; each patient needs to have a surgery plan based on their unique case. For example, bodybuilders do not need removal of excess fat or skin. However, they can be at a higher risk for bleeding due to an increase in blood flow in the chest muscles that are highly developed.
What to Avoid
Beware of advertised discounts and specials on surgery fees. Specialists have devoted many years to perfecting their skills. Specialists are in high demand; they do not need to “reduce” their fees to attract new patients. Unless they should get an unavoidable cancellation, you may find that you have to wait a few months to get on their surgery schedule. But it will be worth the wait, avoid the possibility of gynecomastia revision surgery which will compromise your results and add additional fees. Remember you get what you pay for.
Surgical Vs. Non-Surgical Body Contouring and Liposuction Procedures
The Myths And The Myth Busters
• What Is Coolsculpting / Non-Surgical
The Myth:
The makers of CoolSculpting State That This Procedure Freezes & Eliminates Stubborn Fat.
The information provided by the company states that this procedure will safely deliver precise, controlled cooling to gently target the fat cells underneath the skin. The information also states that the treated fat cells will crystalize (freeze), then die. Over time, your body is to process the cells and eventually eliminate the dead cells, leaving a more sculpted you. It is stated that while some patients may see results as early as 3 weeks following the first treatment, the most dramatic results are usually seen between 1 and 3 months following a series of treatments along with diet and exercise.
Myth Buster:
Anyone that is committed to following a diet and exercise program for 3 months, will likely lose weight and contour their body naturally. This can also be the case for those who are 3 weeks into their diet an exercise program.
• What Is Liposonix / Non-Surgical
The Myth:
Liposonix states that this procedure reduces fat using ultrasound technologies. Like Coolsculpting, Liposonix is also marketed as a non-invasive fat reduction procedure. They state that Ultrasound energy can be used to penetrate through layers of skin to target fat tissue without harming the skin or other surrounding tissues. Fat is then naturally processed through the body. The Liposonix system informs consumers that the procedure uses high-intensity focused ultrasound wave of energy that can destroy targeted subcutaneous fat therefore delivering a more precise result. It is stated that results can typically be seen within 8 to 12 weeks with a healthy diet and exercise.
Myth Buster:
Liposonix states that results can be seen with only one treatment. However, it is more often recommended that the patient may receive 2 to 3 treatments to achieve desired results. Again, like Coolsculpting, anyone that is committed to following a diet and exercise program for 8 to 12 weeks, will likely lose weight and contour their body naturally.
• What Is SmartLipo / Non-Surgical
The Myth:
The makers of Smartlipo state that this procedure is a minimally invasive, laser-assisted procedure that will target troubled areas like the abdomen, arms, buttocks, thighs, and neck, and will permanently eliminate fat. The manufacturer states that for the stubborn areas of your body that does not respond to diet and exercise, this procedure will provide dramatic improvements. They state minimal downtime with less pain than traditional liposuction.
Per the information provided, the technique has three wavelengths to provide targeted treatments that will disrupt the fat, coagulate blood vessels as well as stimulate collagen to improve the elasticity and texture of the skin.
This procedure is performed using local anesthetic to numb only the specific areas that are being treated. What this means, is that you are awake during the procedure.
The Smartlipo laser cannula is inserted through a small incision in the skin, the laser will then rupture fat cell membranes and destroy fat cells permanently. It is stated the fat will liquefy and then gently suction out.
The Myth Buster:
Be careful of fancy marketing words such as “Laser” Liposuction and “minimally invasive”. Fact, the only fat that is responsive to any liposuction procedure is the fat directly beneath the fascia. This is the fat that can be pinched directly underneath the skin. The procedure is performed to address the fat just beneath the skin. Having said that, all liposuction procedures can be considered “minimally invasive”. What this means is, the procedure is performed just below the surface of the skin through a small incision (approx. size of a pencil eraser). Over the years, the word “laser” has become somewhat of a great marketing word. There are always factors to consider prior to having this procedure, as well as any procedure (surgical or non-surgical). Lasers in any form, produce heat, therefore can burn its surroundings. Complications that are often seen with this procedure, can range from cosmetic dissatisfaction to permanent internal damage. These complications are often due to heat from the laser, combined with friction of the technique. This combination can burn the underneath portions of the skin causing a visually wavy/lumpy appearance at the treatment site. Other complications from lasers can also be as severe as an internal burn or injury.
***Lasers have become a great option for external resurfacing such as scar treatments, and hair removal. Lasers have also evolved in technology for anti-aging purposes. When lasers are used in this capacity, the provider can be much more precise in the treatment as well as visibly see how the individual is reacting to the heat. ***
• What Is The Ultrasonic Liposuction Procedure / Surgical Procedure
• What Is Traditional Liposuction Procedure / Surgical Procedure
Ultrasonic Liposuction:
The ultrasonic liposuction procedure is very similar to a traditional liposuction procedure, with one major exception. A sound generator is connected to the cannula, which then generates ultrasonic waves through the tip of the cannula. These waves cause fat cells to dissolve and liquefy, and the liquefied fat is then easily suctioned from the body.
Ultrasonic liposuction can greatly benefit patients that are not the perfect candidate for traditional liposuction. Ultrasonic liposuction uses sound waves to first break up and liquefy fat, which is then removed via suction. Because the fat is liquefied before removal, there is far less blood loss than with traditional liposuction, and can also be effective in areas that tend to be more fibrous.
Depending on the individual needs of each person, a more traditional liposuction may be performed directly after the ultrasound procedure in order to better shape the body. Having a Board Certified Plastic Surgeon perform the Liposuction procedure is the safest way of having ANY procedure done. When having a Board Certified Plastic Surgeon perform the procedure, you will have options available that will deliver the best results for you and your body type.
Traditional Liposuction:
During liposuction, a cannula is inserted – or surgical metal tube – through surgically created entrances in your skin. Fat is then sucked through the cannula into a container by the power of a vacuum pump. The experience and skills of our board certified plastic surgeons allows them to act as body sculptor, leading to more proportional and attractive results.
Although liposuction is not intended as a weight-loss technique, this procedure is commonly used to remove fatty areas for body contouring and sculpting. Suction-assisted lipectomy, or lipoplasty, more commonly referred to as liposuction, can be used to improve various areas of the body. Individuals who choose to have liposuction often target their abdomen, hips, thighs, and knees. Men generally target love handles, lower abdomen and enlarged male breasts.
Following any Liposuction procedure, you will be fitted with elastic bandages or compression garments while your skin shrinks to fit your new body.
Your Safety:
*** FOR YOUR SAFETY, IT IS HIGHLY RECOMMENDED THAT WHEN HAVING ANY PROCEDURES PERFORMED, THAT THE PROVIDER BE LISENCED IN THE SPECIALTY AND THE PROCEDURES ARE PERFORMED IN A STERILE ENVIRONMENT AT A LISENCED SURGICAL FACILITY. ***
Do extensive research on the provider as well as the facility itself. Your life and your body are not worth bargaining.
Note: In most cases, if a procedure is not being performed in an Operating Room setting, this will often mean that the provider performing the service does NOT have Operating Room privileges. This can mean that the provider is not licensed to perform the procedure.
