Avoiding complications after gynecomastia surgery is a goal of all surgeons. With careful planning, most complications can be minimized or avoided altogether. Most gynecomastia surgeons believe in the use of drains and the wearing of a compression vest after surgery.
Drains are an effective measure against the accumulation of fluid in the “dead space” left from the excision of breast tissue. The accumulation of clear serous fluid is referred to as a seroma. If left untreated, a seroma can interfere with healing and possibly lead to an infection with swelling and can be painful. Drains collapse the “dead space,” evacuate the fluids and create a negative pressure to the cavity encouraging it to close down.
The drains have tubes that carry the fluids from the surgical site through a tiny incision in the armpit and empty into a small plastic bulb by negative pressure. Then dressings are applied and the placement of a compression vest. Usually within 2 to 3 days will be the first post-operative visit and at that time the drains most likely will be removed. The compression vest is only to be removed when the patient takes a shower and is to be kept in place for 6 weeks. The use of drains reduces the chances of a seroma greatly by removing fluids as they collect.
If drains are not used, needle aspiration will need to be done every few days until the cavity is collapsed, but the healing will be prolonged and is very inconvenient for the patient. Dr. Miguel Delgado has been using drains for his gynecomastia patients for over 25 years with minimal incidence of complications. Dr. Delgado has designed a compression vest that has built-in pockets for the bulbs to rest in, instead of being attached with safety pins.
Deciding to proceed with male breast reduction surgery is an exciting time(Season For Gynecomastia Surgery). It also presents with many arrangements that you will need to make; such as, having someone care for you for at least the first 24 hours, transportation home after surgery, getting lab tests done, filling prescriptions, getting time off work…and when will you have the surgery?
After surgery, you will most likely be wearing a compression garment for 6 weeks. Wintertime is more comfortable for the additional layer of clothing as you can wear thicker shirts and jackets.
By having your surgery in the wintertime allows your recovery to be complete before summer when most people want to enjoy the outdoors. However, be aware that you still need to protect your young scars from the sun to prevent hyperpigmentation (turning dark brown). As long as your incisions remain pink in color, you need to be very careful of the sun, use a sunblock of at least 30 SPF, complete healing can take several months.
It is important to note that you will need to refrain from any type of formal exercise for about 4 to 6 weeks. Outdoor activities such as jogging, bike riding, volleyball, basketball, etc. may be easier to give up when there is inclement weather, than a beautiful sunny day.
With all this being said, if your schedule doesn’t allow you to plan your surgery during the winter months, anytime you can schedule is the right time. Remember it is only a short time to be inconvenienced compared to a lifetime of freedom from your man boobs.
Asymmetry and Gynecomastia, When a man has too much estrogen stored in his body, female type breasts may develop. In most cases when breasts develop, they are mostly the same size and shape. However, it is possible for breasts to be different sizes or possibly only one breast will develop. Asymmetric breast development can cause even more distress for men than symmetric gynecomastia.
It is normal to have some asymmetry, but when it is obvious, it may cause shame and embarrassment. A gynecomastia specialist can correct asymmetry with liposuction and removal of some breast tissue.
Asymmetry can happen during male breast reduction surgery if complications should arise, or lack of experience by the surgeon. Unfortunately, this will require revision surgery, but in the right hands, the result can be very satisfying.
About 40% of Dr. Delgado’s gynecomastia practice is revision cases where the patient had surgery by another surgeon. Most revisions are a correction of “crater deformity” where too much fat and/or tissue was removed. Some revisions are because not enough fat/or tissue was removed.
In the before and after pictures below is a 43 year old man who was not satisfied with his original surgery done by another surgeon. Dr. Delgado removed 350cc’s of fat on the right side, and 375cc’s of fat on the left side to obtain a symmetric chest.
Gynecomastia and Parabens, For many years it was believed that parabens as a preservative were safe. Manufacturers loved parabens because they are cheap, stable, and effective. Parabens have been used for decades and give products a long shelf life. They have been used extensively in toiletries and in food. In the late 1990’s new data was beginning to surface showing negative reactions to parabens.
Parabens mimic estrogen, the female hormone. Men who get high concentrations of parabens may find their muscle mass is lower, and that they gain more body fat, and develop breasts. Research in Japan has shown damage to men’s reproductive system, low sperm count, and a reduction in testosterone levels. More disturbing is that damage was noted at doses much lower than the accepted daily intake.
Scientists in Denmark discovered that propylparaben and butylparaben have estrogenic properties as potent as bisphenol-A, a petrochemical that is used in making plastics.
In 2006, Europe outlawed the use of parabens in food, on the other hand, it is found today in over 50 snacks in the United States.
Reading labels for what you put in your body is important, but also what you put on your
body, such as deodorants, lotions, shampoo, shaving cream, anything that is applied to the skin.
Parabens are easy to identify when reading labels, all of them end in “paraben” some of them are:
• Methylparaben
• Propylparaben
• Ethylparaben
• Butylparaben
• Benzylparaben
To avoid exposure, one of the easiest steps you can take is to read the labels of all personal products and choose all-natural toiletries. A little more difficult to avoid are parabens in food. Whenever possible, you should select whole foods and reduce the amount of processed food like cured meat and packaged pastries.
Should I Worry About my Male Breasts? Dr. Miguel Delgado, M.D. recommends that men seek a professional evaluation from a Board Certified Plastic Surgeon who specializes in gynecomastia if they feel tenderness, pain or have swelling of their breasts. If it is determined that the patient has gynecomastia, caused by fat and breast tissue, no treatment will be required unless the condition is causing psychological distress, in which case surgery may be recommended.
When the surgeon is trying to find the cause of male breast abnormalities some questions asked will be:
• What age did your breasts first develop?
• Are your breasts tender or painful?
• What, if any, supplements do you take?
• Are you now or ever have been on steroids?
• How much alcohol do you consume per day?
• Are you taking any legal or illegal drugs?
Further questioning might be:
• Does anyone in your family have or had breast cancer?
• Do you have Hodgkin’s Lymphoma or Klinefelter’s Syndrome?
• Do you have prostate cancer being treated with estrogen?
Depending on your surgeon’s assessment, he/she might want you to see an endocrinologist for further testing.
Both men and women have male and female hormones with their own gender dominate. However, if men should have an increase in estrogen throwing their hormones out of balance, they might start to develop breasts.
The incidence of breast cancer in men is about 1 out of 1,000, and while it is rare, it can occur. The onset of breast cancer in men is usually between the ages of 60 and 70. Symptoms you need to watch for are:
• A lump or fast growing mass on either breast
• Nipple discharge
• Rash on either nipple
If breast cancer is not detected early enough, it can spread to the lymph nodes. Men are less likely than women to get an early diagnosis and therefore when it is discovered it usually is much more advanced and serious.
The Silent Condition Gynecomastia, and I think that’s the biggest challenge. Those who suffer from it often hide it from the rest of the world, even from their closest family members. The symptoms can start as early as puberty. This leaves young men, maybe as young as adolescents, battling the condition on their own without much knowledge of what it is and how it can be treated.
The Silent Condition Gynecomastia: Silent Symptoms
In some cases, gynecomastia can be accompanied by mild breast pain and discomfort, but more often the symptoms are silent. Gynecomastia, on its own, it’s not life threatening unless it’s connected with other underlying health issues.
However, living with gynecomastia can have a strong, and often dangerous, psychological effect on the individual. This could be living with an unhealthy body image and the extreme measures that accompany it, social alienation and, in most cases, depression.
The Silent Condition Gynecomastia: Seeking Treatment
I can only treat those who walk into my clinic, but I hope to take my reach further and help other men suffering from gynecomastia. I hope when they search for advice online, these type of blogs help answer their questions. Ultimately I want to empower them to contact a doctor and ask about treatment options.
I know men with gynecomastia dread the idea of walking into a clinic for a gynecomastia consultation. It’s often the one thing that keeps them from seeking treatment – the idea of speaking to someone else about their condition.
What Happens During a Gynecomastia Consultation
The first goal is to confirm whether or not you have gynecomastia and try to pinpoint the cause. It’s a relaxed and confidential chat with the surgeon, at the clinic. After that, we will talk you through the treatment options, what to expect, recovery time and aftercare.
For personalized information about gynecomastia plastic surgery procedures, please complete Dr. Delgado’s inquiry form.
