Male Breast Reduction Surgery
Adrian Lo, MD, FACS, FRCS (C), recognizes that gynecomastia Philadelphia men each have a unique physique and expectations for surgery. Men undergoing gynecomastia correction surgery also vary in the source and extent of their enlarged breasts. With this in mind, Dr. Lo stays abreast of advanced liposuction methods and other male breast reduction surgical techniques, so he can treat your enlarged breasts effectively no matter what the cause or how extensive the condition is. The following is an overview of the techniques that Dr. Lo may use during male breast reduction surgery, depending on the cause and complexity of your gynecomastia. Together with Dr. Lo, you will decide on the best course of action during your consultation. Liposuction to treat pseudogynecomastia. Pseudogynecomastia describes a condition in which adolescent or adult men have excess fat in the breast area. Stubborn deposits of fat in this area make these men look like they have true gynecomastia (i.e., enlarged glandular tissue instead of fat tissue) or “manboobs”. The fatty tissue that accumulates in the chest is different from fat in other areas of the body. Once it accumulates, it stays there and does not go away with losing weight, diet or chest exercises. If you have pseudogynecomastia, Dr. Lo may recommend liposuction to remove excess fat in the breast area. Dr. Lo is highly trained and experienced in three sophisticated liposuction techniques, so he is able to treat a variety of pseudogynecomastia patients. With all liposuction techniques used for male breast reduction, Dr. Lo makes an incision that is one-third of an inch long in each armpit. Using each armpit cut, Dr. Lo suctions out the excess fatty tissue. Once the incision heals, it will be hidden in the natural contour of the armpit and will not be seen over time.
Tumescent liposuction. Dr. Lo routinely uses tumescent liposuction to minimize bleeding, swelling and pain. Before performing liposuction, Dr. Lo injects tumescent fluid into the area to be treated. Tumescent fluid is a sterile solution made of saline (i.e., sterile salt water solution), a local anesthetic called lidocaine and a vasoconstrictor called epinephrine. As a vasoconstrictor, epinephrine constricts blood vessels, greatly reducing bleeding during surgery and bruising following the procedure.
Power-assisted liposuction (PAL). Additionally, Dr. Lo offers power-assisted liposuction (PAL) which is another liposuction method that can be used to achieve maximum contouring of the chest region.
Ultrasonic liposuction. The Philadelphia plastic surgeon is an expert in ultrasonic liposuction. He will use this technique if you need more extensive sculpting or contouring through the chest area.
In the vast majority of his male breast reduction patients with pseudogyneomastia, Dr. Lo can provide excellent contouring of the chest by using one of the three techniques explained above: tumescent liposuction, ultrasonic liposuction or PAL.
Subcutaneous mastectomy to treat true gynecomastia. If you have true gynecomastia, liposuction is not an effective treatment — at least not by itself. In contrast to removing excess fatty tissue with liposuction, Dr. Lo cannot suction out enlarged glandular, or breast tissue. Instead, he will perform subcutaneous mastectomy which is the surgical procedure that removes the glandular tissue. Dr Lo calls this “cutting out the glands”. If you have puffy nipples, this will also be corrected. In some cases, he may also have to remove excess skin in the breast area to achieve better chest contouring. With subcutaneous mastectomy, Dr. Lo makes an incision in the lower part of the areola, the area around the nipple, through which he removes the excess breast tissue. The incision will be hidden in the more pigmented areola, so patients, including athletes and body builders, will not be embarrassed by scars.
If your gynecomastia is severe, Dr. Lo may recommend a combination of surgical techniques. If you have larger male breasts (e.g., a C- or D-cup breast size), Dr. Lo will use a different incision type or placement. A male breast reduction technique may be recommended which involves removal of the excess breast tissue AND skin at the same time. Dr. Lo will discuss all these options with you and recommend an appropriate course of surgical treatment during your consultation.
“This was by far the best decision I have ever made. Growing up I was overweight – thus developing breasts and when I lost all of my weight at the age of 21, I still couldn’t get rid of the excess tissue that developed on my chest. After regularly working out and going to the gym for over 9 years with no improvement to that area, I did some research and went to Dr. Lo’s office for a consultation after reading some positive reviews online. Dr. Lo was very thorough during my consultation and walked me through the entire process while providing realistic expectations, timelines, and risks. It didn’t feel as though he was reading from a book and talking at me, he actually cared about my personal goals and expectations while determining the best path forward. After the initial visit I was extremely nervous, but after 9 months of continued research/web boards/pictures/videos/horror stories/etc I called the office and decided to go through with it! Prior to surgery, Dr. Lo will have you for a re-evaluation and his staff makes sure you are fully prepared (schedules/supplies/etc). The day of surgery Dr. Lo goes over everything one more time and makes sure you are comfortable and ready for the procedure, he even called me at home that night to make sure I was feeling okay and if I had any questions. The open and consistent communication is definitely what put me at ease for this operation and opened up my trust to both the Dr. and staff.
I am now 72 hours Post-Op and I feel great! I had the surgery Monday morning – it is now Thursday and I am back at my office (60 min commute via train). After having other surgeries in the past I was nervous this was going to be as bad as them, but it was nothing in comparison. After surgery, I didn’t feel much pain (didn’t use the meds) but it definitely was uncomfortable given what I had just been through – with that being said, the more I started moving around – the more comfortable I became. I was walking around my house unassisted within 6 hours and in 48 hours I was back at the office getting my drains removed. After the drains were removed I definitely felt more comfortable and was able to be more active around my place/ neighborhood. It is now day three and I am still swollen as that will go away with time, but other than that I don’t feel much of anything especially wearing my compression garment but am taking it easy as not to overexert myself/ and pull the incisions,. I am worlds better than I thought I would be after reading all of the blogs – the only thing I wish I had done differently would be doing this sooner and I can’t wait to see the long term results!” — M.S./Surgery June, 2016
Day of Surgery
On the day of surgery, it is normal for you to feel both excited and anxious. Although you may feel nervous prior to surgery, there is nothing to worry about. You will arrive at the accredited surgical facility or hospital where Dr. Lo’s expert surgical team will greet you and take care of you. Male breast reduction surgery is typically performed on an outpatient basis, and you will return home the same day. Before starting the procedure, Dr. Lo uses a marker to draw on the treatment area. These marks will serve as a visual guideline for him during surgery. Once you are prepared for surgery and are in the operating room, anesthesia is administered. You will not feel any discomfort or pain during gynecomastia correction surgery. Surgery takes about one hour, depending on the complexity of your situation. With gynecomastia treated with liposuction alone there will be no drainage tubes. With subcutaneous mastectomy or cutting out the glands, Dr. Lo will place a thin drainage tube under the skin to alleviate any fluid accumulation. Any drains will be removed two to three days following the procedure. He will also bandage the treated area and apply a compression chest garment/vest, which you should wear for about 3-4 weeks. The drains and the compression garment hide very easily underneath your clothing and will not be seen. Once Dr. Lo has completed the surgical procedure, you will be brought to the recovery room, where you will rest for one to three hours. An attending nurse will monitor your progress. Once you are awake and the anesthesia has worn off, a nurse will release you to the care of your friend or family member. Dr. Lo’s staff can arrange transportation if necessary. You should have a responsible adult stay with you the first night following surgery. If you live out of town or do not have anyone to stay the night with you, please visit the Out-of-Town Patient Information page for more details regarding post-operative care. Dr. Lo will call you that night to check on you. He will also give you an emergency phone number, so you can contact him any time during your immediate recovery period if necessary. Dr. Lo’s patient coordinators will also follow up with you to help monitor your recovery.
Recovery From Male Breast Reduction Surgery
Prior to surgery, you will receive post-operative care instructions, a list of needed items that you should stock in your house before the procedure so they are easily accessible after surgery, and any needed prescriptions for pain medication (which is rarely needed or used) and possibly antibiotics. Again, a responsible adult should stay with you the first night after surgery, and you should wear the required compression garment/vest for several weeks or as advised by Dr. Lo. The compression garment will support the chest area and help reduce swelling, bruising and pain in the treated area. After 1-2 weeks, many patients will transition into wearing a second stage breathable compression athletic shirt as recommended by Dr. Lo. In the first day after the procedure, you should rest and avoid any strenuous activity. Minimal pain is no more than 1-2 days, if at all, men usually just experience a “tender” feeling. Men often just use acetaminophen or Tylenol for any tenderness. Dr. Lo encourages you to get up right away and walk around and do normal activities as tolerated. You can shower in 1-2 days. You can drive in 2-3 days if you feel comfortable. Most men go back to work or school in 2-3 days but avoid heavy lifting and repetitive activities with their arms and chest. Walking and treadmill and lower body exercises are recommended as tolerated. You should avoid strenuous activity and chest exercises for about three to four weeks, and should ease back into your exercise routine as recommended by Dr. Lo. Most men are back to light chest exercises by 3 weeks, 4 at most.
“I was amazed at my recovery. It was just like what Dr. Lo said. I had little or no pain after surgery. My chest felt like I had worked hard at the gym, just a little sore. I didn’t even take the strong pain medication that Dr Lo prescribed. I was walking around right after surgery and had my normal dinner because I was so hungry after surgery. The next day I felt normal, took the dressing off and was so pumped up because my chest was flat for the first time in my life. I took a shower. I had the surgery on Thursday and went back to work on Monday. Dr. Lo and his staff were great. I can’t wait to get back to working out.” — JT, age 28
Your first visit with Dr. Lo will be 2-3 days after surgery, to remove the drains. At this time, Dr Lo will check your chest to make sure everything is healing properly and then remove the drains. If you do not have drains then your first visit with Dr. Lo is 1 week after the surgery. All stitches/sutures dissolve themselves and do not need to be removed. You will be happy because you should see results of the surgery immediately, and have a flat chest. After the first visit the next follow up visit is 2 weeks post-surgery, 1 month and 3 months, 6 months after surgery and as needed. If you live a distance away or are an out of town patient, then you will be asked to communicate your healing process with Dr. Lo via SKYPE. You will be happy to see your new look right away, but your chest contour will continue to improve as swelling goes away and incisions heal. You can further enhance surgical results by performing chest strength-building exercises once Dr. Lo has cleared you to start exercising again. Be sure to keep all follow-up appointments with Dr. Lo, so he can properly monitor your healing and overall progress. To learn more about gynecomastia treatment, including information about male breast reduction costs, or to schedule a one-on-one consultation with Dr. Lo, please contact his office by calling (215) 829-6900.