Model Image Gynecomastia Patient Information

Gynecomastia patient information


Introduction
Gynecomastia is a medical term meaning enlarged breast tissue. Although certain drugs and medical problems have been linked to gynecomastia, in the vast majority of cases there is no known cause. Surgery to correct the condition may be performed on healthy men of any age. The best candidates for surgery have firm, elastic skin that will reshape to the body’s new contours.

Excess Glandular Tissue
If excess glandular tissue is the primary cause of the breast enlargement, Dr. Zevon will excise it with a scalpel. He will make an incision in an inconspicuous location, either on the edge of the areola or in the armpit, depending on your anatomy. He will cut away the excess glandular tissue, fat and skin from around the areola and from the sides and bottom of the breast. The excision may be performed alone or in conjunction with liposuction.

Liposuction
If your gynecomastia consists primarily of excess fatty tissue, Dr. Zevon will use liposuction to remove the excess fat. Through a tiny incision, a fine hollow tube called a cannula is inserted to vacuum the fat layer that lies beneath the skin. The cannula is pushed and pulled through the fat layer, breaking up the fat cells and suctioning them out. The suction action is provided by a vacuum pump. Ultra-sound assisted liposuction has been shown to be especially effective in fibrous areas such as the enlarged male breast. UAL requires the use of a special cannula that produces ultrasonic energy, exploding the walls of the fat cells and liquefying the fat.

Anesthesia Options
Dr. Zevon will discuss anesthesia options with you during your consultation. Your options depend on the extent of your gynecomastia surgery, and your personal preferences. Most patients have surgery for gynecomastia under sedation or general anesthesia, although occasionally patients choose to have the male breast reduction surgery under local anesthesia. Dr. Zevon will recommend an anesthesia option for you and explain why it is the best choice.

Preparing for surgery
STARTING NOW:
Please read and familiarize yourself with these instructions. By following them carefully you will assist in obtaining the best possible result from your male breast reduction surgery. If questions arise, do not hesitate to communicate with Dr. Zevon and discuss your questions at any time. Bring these instructions with you on the day of your gynecomastia surgery.

Re-read the General Instructions for Cosmetic Surgery Dr. Zevon gave you.

Locate your Personal Information Sheet and complete it so that Dr. Zevon’s office will know who will escort you home after your surgery and where you plan to spend the night of your male breast reduction surgery. Bring it to your pre-operative appointment, or telephone, e-mail or fax the information to us. If you cannot locate it, let us know so that we can provide you with another.

The Day Before Your Surgery
Unless you are having local anesthesia, NOTHING TO EAT OR DRINK AFTER MIDNIGHT.

If you are having local anesthesia, or your male breast reduction surgery is in the afternoon, check with us as to what or when you may eat or drink before gynecomastia surgery.

The Morning of Your Surgery
Hygiene: Shower or bathe with anti-bacterial soap. Wash your chest and armpits. Do not apply any moisturizers, deodorant, talcum powder or other products afterwards. Do not use hairspray, cologne or aftershave.

Clothing
Wear simple, comfortable, loose-fitting, dark-colored clothing that does not go on over your head. Wear tops with front closures such as buttons or zippers, bottoms that are easy to pull on and comfortable shoes. Do not wear new clothes. Sweat pants are ideal. Do not bring jewelry or valuables with you.

Post-Operative Care
Rest
When you arrive home, be prepared to rest in bed for the first 48 hours after gynecomastia surgery. Eat lightly and drink to replenish your body fluids. You may go to the bathroom with assistance as needed. If you feel nauseated, lie on your back with your head down and remain still. Any sensation of nausea should pass by the morning after your gynecomastia surgery. If you feel fine, light activity will not harm you.

Sitting Up
The easiest way to sit up from lying on your back is to move to the edge of the bed and swing your legs over the edge, bending your knees and placing your feet on the ground. Use your abdominal muscles to sit up instead of pushing yourself up with your arms and pectoral muscles. If you have assistance, another person can carefully support your back to help you sit up.

Pain
If breast tissue has been removed, placing ice bags padded with a towel over your chest may relieve discomfort significantly. The period of greatest discomfort usually does not last more than 12 to 14 hours. Most male breast reduction patients take the prescribed pain medication.

Medication
Take the antibiotics and pain medication prescribed by Dr. Zevon according to the pharmacy instructions. Don’t take the pain medication on an empty stomach, as this will produce nausea and vomiting. Have another adult give you the pain medication at the correct time and/or keep written records of how much you take and when you take it. You do not have to take the pain medicine if you are not in pain, but you must take all of your antibiotics. Do not drive while taking pain medication.

Contact Dr. Zevon If…

  • You have severe pain that does not respond to pain medication;
  • You have more swelling and/or pain on one side than the other; or
  • Your chest wrap seems too tight.

DON’T TAKE CHANCES! Call if you are concerned about anything you consider significant. During office hours, call 212.496.6600. After hours, call 917.612.3800.

Sleep
You may sleep on your back or on your side, but do not sleep on your stomach for 4 weeks.

Dressings & Wrap
At the time of gynecomastia surgery, gauze dressings and a compression vest will be applied. These will be removed 1–2 days after breast reduction surgery and will be replaced with clean dressings, which will remain in place until any drains are removed 4–5 days after surgery. You must wear the compression vest 24 hours a day for two weeks, and thereafter at night only for another 2–4 weeks. The vest helps reduce swelling, compressing the skin as it re-adjusts after breast reduction surgery. It is very important for the skin to be supported and sculpted for the proper re-shaping to occur. You can remove the compression vest to shower. Dr. Zevon will tell you when you no longer have to wear the vest based on your progress as evaluated during post-operative appointments.

Drains May Be Used
If breast tissue has been removed, one drain may be placed on each side at the time of gynecomastia surgery. Drains evacuate the fluid that accumulates after surgery and promote faster healing. When the drain is first inserted, the bulb at the end of each tube is compressed to create gentle suction. As the fluid collects in the bulb, the bulb slowly expands.

Drain Care
Safety pin the bulb of the drain to your dressings. Empty the bulb by opening the plug at the top and pouring out the contents twice a day or when it is half full. Do not remove the bulb from the tubing. Squeeze the bulb to recompress it, and put the plug back into the hole at the top. If the bulb fills rapidly after emptying, or you need to empty it more than 3 times a day, please call us. Dr. Zevon will remove the drains 4–5 days after male breast reduction surgery, when the fluid begins to turn a clear straw color and/or the amount of drainage has diminished. Showering or bathing with the drains in place is not harmful, but do not soak the drain sites under water.

Hygiene
You may shower 30 hours after your male breast reduction surgery. If you have drains in place, do not sit in a bathtub with water above your waist or with the drains underwater.

Activity Restrictions
Do not smoke for 48 hours after your male breast reduction surgery to prevent coughing and bleeding. Do not drink alcohol for 5 days after gynecomastia surgery or while you are taking the pain medication. Alcohol dilates the blood vessels and could cause bleeding, and mixing pain medication and alcohol is dangerous. You may drive a car with power steering after one week, if you are no longer taking pain medication. Do not raise your arms above your shoulders for 2 weeks, and DO NOT CARRY ANY HEAVY WEIGHTS, BAGS OR PACKAGES for 4 weeks. For these purposes, anything weighing more than 10 pounds is considered a heavy weight.

Massage
Some male breast reduction patients experience post-operative scarring within the breast tissue or “hard spots.” Some patients may feel an edge around the areola. Massage may aid in the resolution of these conditions. If you have areas in your chest that are more swollen and harder than others approximately 10 days after gynecomastia surgery, you may begin to massage them if it feels comfortable to you. You can massage gently with your hands and/or with a rolling pin, you can use a massage oil, moisturizing lotion or cream, or you may visit a massage therapist. We can provide you with the name of a massage therapist experienced with post-surgery patients.

Herbal Remedies
Some gynecomastia patients report that arnica contributes to a reduction in bruising or swelling, resulting in reduced discomfort and edema as well as improved healing. Ask us if you wish for assistance in locating a source of arnica. Take arnica orally according to manufacturer’s instructions on the packaging.

Post-Operative Appointments
It is important to see Dr. Zevon as scheduled after male breast reduction surgery. If you have drains, they will be removed during the first few days after your surgery. If you have sutures around the areola, they will be removed approximately 7 days after gynecomastia surgery. Remaining sutures below the skin will stay in for 2-3 weeks. Check your post-operative instructions for your first appointment. If you don’t have an appointment, call (212) 496-6600, tell the receptionist the date you had male breast reduction surgery and she will schedule your post-operative appointment. At each post-operative appointment, Dr. Zevon will advise you how soon the next one should be scheduled.

Recovery Time
INITIAL: 7 days
SUBSTANTIAL: 3 to 4 weeks

Resuming Normal Activities
WORK: Follow the plan you and Dr. Zevon have agreed upon. For scheduling purposes, you can assume that you will be able to return to work within 5 to 7 days, although some male breast reduction patients are able to return to work sooner. If your job involves heavy lifting, you may not be able to return to work for several weeks.

Activity & Exercise
Avoid sexual activity for a week or two, depending on how you feel. Don’t do anything that hurts your chest. For at least four weeks, avoid vigorous activity, including strenuous sexual activity and contact sports. Stay away from any sport or job that puts you at risk of a blow to the chest area. Do not lift heavy weight (more than 10 pounds). During this time, walking is fine. Dr. Zevon will give you permission to increase your activities according to the progress of your recovery and your overall fitness level.

Exposure To Sunlight
Scars take at least one year to fade to their greatest extent. During this time, it is advisable to protect them from the sun. Be especially careful if areas of skin on your chest have reduced sensitivity. Use a high SPF sunscreen. We carry sunscreens suitable for post-surgery male breast reduction patients.

Call (212) 496-6600