Surgical Procedures

 
 
   

Male Breast Reduction

 

"My doctor told me to ignore the problem because it would go away. I never uncovered my chest and I was embarrassed to wear any fitted clothing.

Though some drugs and medical conditions have been linked with male breast enlargement or Gynecomastia; in most cases there is no known cause for this condition  whose name derives from the Greek word for "women-like breasts." An embarrassment  for many males, it affects 40 to 65 percent of adolescent males and approximately 10 to 15 percent of adult men.

Fortunately, with the advent of Liposuction, this is now a more readily treatable problem.

There a number of classifications of gynecomastia  used to  determine treatment options. They are, however, not generally useful in determining treatment.


Primary gynecomastia usually develops during puberty. There is no known underlying cause for primary Gynecomastia. It often resolves without treatment over a period of a year. If this does not occur then treatment can be considered.

Causes of secondary gynecomastia include obesity and the use of certain drugs such as steroids, alcohol,marijuana or any substances that alter  normal testosterone/ estrogen levels. In most cases no definitive cause can be found.
Obviously If a patient is significantly obese, drinks alcohol in excess, smokes marijuana or takes medications known to cause breast growth , they will be discouraged from having surgery, as the condition will likely recur. Causative factors should be eliminated to see if breast fullness is reduced.

In the treatment of Gynecomastia, once your surgeon knows how much fat and
glandular tissue is within the breasts then the appropriate surgical approach
to best suit your needs can be determined.  

Glandular (or duct) tissue is woody and firm in nature and cannot be treated with liposuction. It presents as a firm nodule directly behind the nipple. It requires direct excision.

Fatty tissue compromises the bulk of the enlarged breast and is usually treated with liposuction.

Most men have a combination of both so a small incision plus liposuction are required.
The best candidates for this surgery have firm, elastic skin that will reshape itself
to a new contour after surgery. 

Gynecomastia Surgery: How It Is Done

Correction of enlarged male breasts is under general anesthesia . The Centre only uses fully trained and experienced certified anesthetists. All of our procedures are done in our private accredited and inspected operating facilities.  Isolated duct tissue behind the nipple can be removed with local anesthetic. Surgery for gynecomastia is most often performed as an outpatient procedure. The surgery itself takes about an hour to perform.  The purpose is to remove excess fat and/or glandular tissue from the breasts. We do not shave the chest.   The surgery involves making a "nipple splitting incision" which is a small incision across the nipple to the edge of the areola that permits the excess duct tissue to be removed. Liposuction is then performed around the edges of the breast to ensure a smooth, natural-
looking final result. This involves one or two entrance points on the chest to allow insertion of the liposuction cannula. This is usually done first.

The areolar incisions are then closed with dissolving sutures and small dressings are applied. We do not wrap the chest as this prevents proper airflow to the lungs.

You will then recover in the recovery room for 1-2 hours. A responsible adult is required to accompany you home.
You can expect to be back to normal daily activities within a few days but you will be
restricted from heavy physical activity for about a month. It will take about 3
months before you see the final result of your surgery as this is how long it takes normal skin to shrink following liposuction.

Questions about:

General anesthesia is required for the 1 hour procedure. If you are not healthy enough for an anesthetic we will not proceed. Anesthesia standards require that you are seen by an appropriate medical doctor prior to the procedure. All of our anesthetists are fully trained and certified.

Bleeding can occur after any operation. If it happens it will occur in the first 24 hrs. It is important to stop taking any medication (aspirin!) or supplements ( green tea!) at least 10 days prior to any surgical procedure as many of these products act as blood thinners. Pre operative control of abnormal blood pressure is also important. Bleeding is very rare following our male breast surgeries.

Infection can occur after any operation. A surgically clean environment, careful surgical technique, healthy patients and suitable antibiotic coverage will minimize the risk of infection. There have been no infections following this procedure.

Blood clots can form in the deep (not varicose) veins of the legs and pelvis during any operation. This is called a deep vein thrombosis (DVT). It occurs 72-96 hours after the operation when you are at home and may be asymptomatic. This is rare  with male breast surgery. These clots may grow and a portion may break off and travel to the lungs (Pulmonary Embolus). This is a potentially serious problem that may require emergency treatment and hospitalization. Fortunately, there are a number of ways to minimize this risk. At the Centre we use all known methods to decrease this unusual problem to its absolute minimum. We use TED stockings, Sequential Compression Devices, adequate hydration, intraoperative warming and early mobilization. At home you will continue with the TEDS, movement and use additional treatments if required. This is very rare.

Scars are a necessary part of any surgical procedure. The incision is placed across the areola as this tissue heals much better than the adjacent skin. It usually heals extremely well so that it is not visible when not wearing a T-shirt. This may take 3-4 months. We work hard to give you the very best outcome.

Numbness in the treated area typically lasts for 2-3 months. It is usually not a concern.

 

From Initial Phone call to Post Op Visits: How it Works

Your initial contact with the office will be with Trish, our Patient Coordinator. She will guide you through the process. You will then meet with Dr. Weiglein to determine the best solution to your particular problem. This initial meeting is designed to be an information and educational meeting. It is actually a time when you "audition" us and we "audition" you. With your input a recommendation will be made and all questions answered. We have numerous pre and post operative photos for you to see. There are always former patients available to speak with you about their experience. We welcome friends / husbands/ others to this meeting.

You will then meet with Trish again to discuss costs, scheduling and logistics. If you require more time to consider your options, or wish another appointment, we will arrange it. If you wish to finance the procedure we will assist you.

We encourage you to see us as a second opinion.

If you elect to proceed you will then meet with one of our nurses for your pre operative visit. She will review the procedure and expectations. Any necessary lab reports will be reviewed. Anesthesia standards require a pre operative physical from a family doctor.

We will provide you with full written post operative care instructions, your prescriptions, follow-up appointment dates, contact telephone numbers and instructions for care-givers at your pre operative appointment. No question will be unanswered.

Need more information?
Please contact us if you have questions. 

We are one of the leading cosmetic surgery practices in Canada so you can rely on our expertise.