The cause of the condition is usually unknown but gynecomastia can be associated with the ingestion of certain medications such as antidepressants, blood pressure medications, ulcer medications, and steroids. Sometimes, gynecomastia can be related to an imbalance of hormones, the smoking of marijuana, or the overconsumption of alcohol.
Every case of gynecomastia is unique to the patient experiencing it. There are various surgical options to treat gynecomastia, depending on the presentation and severity of gynecomastia. In some cases, it is possible to perform removal of excess fat using liposuction alone and wait/hope for the skin to retract on its own. Sometimes skin retraction can take a minimum of one year to see any significant progress. If the skin does not retract on its own, then an additional surgery to remove the skin may be warranted at that time. In very severe cases, the surgical incision may have to extend beyond the nipple incision. If your nipple/areola has changed in shape due to the excess fat/tissue, it is possible for your surgeon to perform a nipple revision during the surgery.
The decision to have plastic surgery is extremely personal, and you’ll have to decide if the benefits of the surgery outweigh the risks and potential complications of surgery.
You will be asked to sign consent forms, similar to the ones found here, to ensure that you fully understand the procedure and any risks. It is important that you address all your questions directly with your surgeon.
Gynecomastia surgery is often done under a general anesthetic. In very mild cases of gynecomastia, it is possible to perform the procedure under local anesthetic. The surgery requires an incision to be made around the lower portion of your nipple and requires a combination of direct surgical removal of the breast tissue with some possible liposuction to smooth the surrounding area.
During the surgery, your surgeon will weigh the risks and benefits of the placement of surgical drains and decide whether you will need them at that time. If so, two Jackson-Pratt drains will be placed along the opposing sides of your surgical incision or through two small stab incisions at the lower corner of your chest closest to the armpit. Dissolvable stitches will be used along the surgical incision, with exception to the two black stitches used to tether your drains. Surgical dressings will be applied and a compression vest will be used on top. Depending on your surgeon you may be fitted for the garment a week after surgery rather than going home with a garment the same day.
A good candidate for surgery is a patient who is relatively healthy and has realistic expectations for post-operative outcomes. It is also strongly advised that you be a non-smoker at the time of surgery. If you are a smoker we recommend you quit smoking at least 3 months prior to surgery as nicotine can interfere with blood supply and potentially cause complications with healing after surgery.
