Metropolitan Plastic Surgery

Gynecomastia Repair (Male Breast Surgery)

Gynecomastia Virginia, Male Breast Reduction Virginia

A benign enlargement of the male breast, a condition known as gynecomastia, may be due to excessive fatty tissue, excessive glandular tissue, or both. Gynecomastia excision, or male breast reduction, is a procedure designed to remove unwanted fat and glandular tissue, with minimal incisions, from the male breast.

With liposuction and glandular excision, you can take away fat and breast tissue permanently. When you remove the fat cells from the breasts, the fat never comes back. You will still have some cells remaining in that area but if the procedure is done correctly, it will have long-lasting effects. Similarly, the removal of glandular tissue is permanent. In most cases, the skin of the breasts contracts and it is not necessary to remove excess skin. However, on occasion, the redundant skin may need to be excised. This is sometimes done at the same time of the initial surgery, while at other times it is done in a delayed fashion. Waiting several months may limit the length of the scar that the patient has in the breasts.

In the Virginia male breast reduction procedure, the breasts are first liposuctioned. This is done through a small puncture hole that is usually hidden in a natural fold of the body or around the nipple. The breasts are infiltrated with a solution containing medicines that reduce bleeding and postoperative pain, allowing large amounts of fat to be removed with little blood loss and no need for hospitalization. The glandular tissue is removed through one of the liposuction incisions under the nipple. Usually these incisions heal very well and are hardly visible after a while.

After male breast reduction surgery, you will have a moderate amount of drainage from the liposuction incisions. You will need to rest for the first 2 or 3 days, but most people are up and about shortly after Virginia male breast reduction surgery. We generally recommend our patients take off 5-7 days from work. Heavy lifting and exercising should be avoided in the first two weeks. Your body will tell you when you are ready to get back into your regular exercise routine.

What is Gynecomastia Repair (Male Breast Reduction)?

A benign enlargement of the male breast, a condition known as gynecomastia, may be due to excessive fatty tissue, excessive glandular tissue, or both. Gynecomastia excision, or male breast reduction, is a procedure designed to remove unwanted fat and glandular tissue, with minimal incisions, from the male breast.

Who is a candidate for Gynecomastia Repair (Male Breast Reduction)?

Gynecomastia repair is for men who have larger than normal breasts. This condition is very common and affects men starting at adolescence. The degree of breast enlargement varies and the decision to have this corrected by surgery depends on the individual. Most men who have enlarged breasts can not reduce the size by dieting and exercising. In some men, the loss of skin elasticity may result in sagging  of the breast. The nipple falls below its natural position on the chest which may require repositioning of the nipple, removal of the excessive skin, in addition to fat and gland removal.

Who is not a good candidate for Gynecomastia Repair (Male Breast Reduction)?

This procedure is not designed to treat widespread obesity. For patients who have excessive skin in the breast or who have lost the elasticity of their skin, a traditional skin resection may be necessary. If their body contouring irregularities are due to structures other than fat, such as bone or weaknesses in the muscles, these problems cannot be corrected by this operation. On occasion, it may be necessary to address these problems at a later date with other surgical procedures.

What does Gynecomastia Repair (Male Breast Reduction) accomplish?

With liposuction and glandular excision, fat and breast tissue can be taken away permanently. When the fat cells are removed from the breasts, the fat never comes back. There will still be some fat cells remaining in that area but, essentially, if the procedure is done correctly it will have long-lasting effects. Similarly, the removal of glandular tissue is permanent. In most cases, the skin of the breasts contracts and it is not necessary to remove excess skin. However, on occasion, the redundant skin may need to be excised. This is sometimes done at the same time of the initial surgery, while at other times it is done in a delayed fashion. Waiting several months may limit the length of the scar that the patient has in the breasts.

What happens during the first Gynecomastia Repair (Male Breast Reduction) consultation in Virginia?

In the first consultation, you will have a chance to discuss your concerns with our patient care coordinators and Dr. Marefat. We will explain what you need to know about Virginia male breast reduction surgery and help to determine what is best for you. You will receive information booklets and pricing on the procedure.

How is Gynecomastia Repair (Male Breast Reduction) performed?

The breasts are first infiltrated with a solution containing medications that cut back on bleeding and postoperative pain. This tumescent solution makes it possible to remove large amounts of fat with little blood loss and need for hospitalization. The breasts are then liposuctioned. This is done through small puncture holes that are usually hidden in natural folds of the body or around the nipple. The glandular tissue is removed through a small incision in the nipple area. The incisions heal very well and are hardly visible after a while. If there is need for skin excision it can be done with incisions around the nipple and under the breast. Dr. Marefat usually does not remove the extra skin immediately. He prefers to wait and remove it in a secondary procedure several months later. This will give your skin a chance to contract down which can significantly reduce the length of your scar.

What are the goals of Gynecomastia Repair (Male Breast Reduction)?

Our objective is to improve the shape and proportions of the breasts. However, we cannot change the nature of the skin. We want to establish normal proportions and give the chest a better balance. We also want to improve the patient's appearance both in and out of clothing.

What kind of anesthesia will I have during Gynecomastia Repair (Male Breast Reduction)?

This procedure is usually done either with general anesthesia or intravenous sedation. In either case, local injection of the tumescent solution is used to decrease blood loss and postoperative pain. With the tumescent technique, the requirements for giving IV sedation or general anesthetic are also decreased, and thus there is less risk of side effects as a result of these anesthetics.  

What can I expect after Gynecomastia Repair (Male Breast Reduction)?

After Virginia male breast reduction surgery, you will have a moderate amount of drainage from the liposuction incisions. You will need to rest for the first 2 or 3 days, but most people are up and about shortly after surgery. We generally recommend our patients take off 5-7 days from work. Heavy lifting and exercising should be avoided in the first 2 weeks. Your body will tell you when you are ready to get back into your regular exercise routine. You will need to wear support garments for approximately 4 to 6 weeks after Virginia male breast reduction surgery. This helps in the attachment of the skin back to the underlying tissues after liposuction and reduces the chance of fluid collection under the skin. During this interval, you can remove the garment to shower and rest your skin for short periods of time. There will be some numbness associated with the surgery. This numbness usually persists for about 4 to 6 weeks. Minor lumps and irregularities are common after liposuction. These irregularities are related to accumulations of fluid in certain areas of the subcutaneous fatty layer of the skin, as a result of either infiltration of the fluid or as a result of the trauma associated with liposuction. Irregularities even out after the first 2 or 3 weeks after the surgery. Minor asymmetry between the two sides of the body can be seen after the liposuction. This, too, is related to accumulations of fluid or trauma related to the operation. These asymmetries usually resolve within 2 to 3 weeks after the surgery.

Will there be waviness and irregularities from Gynecomastia Repair (Male Breast Reduction)?

Not usually. However, this is still the most common aesthetic complication of gynecomastia repair. The removal of the glandular tissue from under the nipple can sometimes result in depression or irregularity in this area. One way to avoid this is for the doctor to use very small gauge cannulas and to take his or her time removing the fat and glandular tissue. However, even when everything is done right, there is still a chance that you may develop some irregularity.  If this does occur, we usually fix this problem in a touch-up procedure. This touch-up procedure is done approximately 3 months after the initial surgery.

What are some of the complications of Gynecomastia Repair (Male Breast Reduction)?

Before you focus on the complications of gynecomastia excision, first consider how best to digest these bits and pieces of information. Reading about complications can be quite scary. Many people cannot comfortably sit through a consultation session without having some real doubts about surgery. But it is different when you have these complications explained to you by Dr. Marefat. He can put them in perspective for you and tell you the likelihood of such complications occurring. Most complications are very rare. Some are less rare and need to be explained to you in more detail so that you know how we would tackle these problems if they occurred. The purpose of explaining risks and complications is for you to know what steps we would take to treat you and put you back on the road to recovery. Remember that every surgeon has his or her own way of treating problems. You must go over these potential risks with your surgeon to gain better insight and understanding.

  • Bleeding. This is very uncommon with gynecomastia repair because we are generally not cutting tissues but using a blunt-tipped cannula to remove the fat. The glandular tissue under the nipple is removed with minor cutting and there is not much bleeding in this part of the surgery. However, there have been some reports in the literature of bleeding as a complication. There are those who are at higher risk of bleeding. The use of some medications, such as aspirin or coumadin (a blood thinner), could put you at higher risk of bleeding. If you are contemplating male breast reduction surgery, you should refrain from using aspirin- containing products from 2 weeks before surgery until 2 weeks after surgery. Some people with a history of uncontrolled hypertension could be at higher risk of bleeding after the surgery. There are some individuals who are unaware of problems with their coagulation system and, consequently, have had bleeding after surgery. If you have bleeding after surgery, it may entail returning to the operating room to stop it.
  • Infection. It is very uncommon to get an infection with this procedure. We usually give all our patients antibiotics both before and after surgery. If infection occurs, however, we will treat it very aggressively with stronger antibiotics.
  • Skin discoloration. This can occur in any surgery. It is due to blood metabolites and is usually temporary and self-limiting. Sometimes these blood pigments stay in the subcutaneous tissues permanently. This is very rare and generally occurs in patients with darker skin complexions. If this occurs, we may need to treat your skin with certain bleaching agents, which could help ameliorate the problem.
  • Discomfort and pain. This is easily controlled with oral pain medications.  With the use of the tumescent technique and the use of the local anesthetics in the tissues, both the pain and the discomfort should be minimized.
  • Temporary numbness associated with the surgery. This numbness usually persists for several weeks and depends on the extent of surgery performed.  Most of this numbness returns to normal after 7 to 10 days. However, it is not unusual to see persistent numbness even after 4 to 6 weeks have passed.
  • Minor lumps and irregularities. These irregularities are related to accumulations of fluid in certain areas of the subcutaneous fatty layer of the skin, as a result of either infiltration of the fluid or trauma associated with surgery. Irregularities even out after the first 2 or 3 weeks after the surgery.
  • Minor asymmetry. Minor asymmetry between the two sides of the body can be seen after the liposuction. This is related to accumulations of fluid or trauma related to the operation. These asymmetries usually resolve within 2 to 3 weeks.
  • Permanent scars. Scars are present whenever there is any incision. Almost all operations will involve some scarring. The extent of the scar will depend on the nature of the problem and the extent of surgery. Liposuction puncture wounds are minute, and in 2 to 3 months they heal so well that they are barely visible. Other operations may have more extensive incisions, and thus more scarring. The nature and extent of the scar also depends on the location of the incision, as well as the genetic ability of the patient to heal scars. It is rare to see cases in which the scar has become a major problem. However, if scars do become prominent and visible, they can be improved with scar revision procedures. It is more prudent to wait approximately 1 year before attempting scar revision.
  • Excessive skin. In certain individuals the skin has lost its ability to contract after having been stretched. The patient may be left with an excessive roll of skin in the area of surgery that does not go away. In such cases, it is necessary to remove this excessive roll of skin directly. This will result in having a permanent scar in the area of excision.
  • Waviness and surface irregularities.   This is a problem that is perhaps one of the most undesirable side effects of liposuction. It is unpredictable, and we will not know which patient will have surface irregularities, but it seems to occur more in people with poor skin turgor and patients who have cellulite. Dr. Marefat has avoided waviness and irregularities by using very small gauge cannulas and taking time removing the fat. Nevertheless, there is still a chance that you may develop some irregularity, and if this occurs we can usually fix this problem in a touch-up procedure. This touch-up procedure is done in a second stage, approximately 3 months after the initial liposuction.
  • Persistent edema. This problem is very rare, but if it occurs it can be bothersome and may last for many weeks after surgery. Generally, this is not a permanent problem. The literature has noted only a few cases in  which people have had problems with a persistent edema. To prevent persistent edema, we encourage the use of compression garments after surgery. Should there be a continued edema, we encourage the use of compression garments until the problem is resolved.
  • Altered areas of sensation.  On rare occasions, it is possible to have an area remain permanently numb or experience paresthesia. Usually, these problems are seen in cases where a skin resection is being performed at the same time as the liposuction. The liposuction can injure nerves in the area, and these injured nerves can later develop permanent scarring and problems related to nerve conduction. Usually, the surrounding nerves are able to cover the area of impaired sensation, and after 4 or 5 weeks the area is re-enervated. However, if this does not happen, the patient is left with an area that has permanent numbness or altered sensation. This may or may not be a correctable problem. Often, the impaired sensory area is not much larger than a half dollar or a quarter and most patients are not bothered by it.
  • Surgical shock and pulmonary complications. There are certain uncommon risks and complications that can also occur. These include shock, which might require a transfusion. This is a very uncommon problem, and one that Dr. Marefat has not seen in any of his patients, but it is occasionally reported in the literature.  Because of the tumescent technique, the need for autologous blood transfusion in these cases has been virtually eliminated.
  • Seromas and hematomas. These are collections of fluid or blood under the skin. If such a problem occurs, it will need to be drained. This is usually done with the use of a syringe. The patient  will have to make more frequent office visits after surgery until the problem is resolved. Usually, these problems do not cause any permanent damage.
  • Skin loss. This has been seen in cases associated with major skin undermining. Usually, this occurs in people who are smokers or who have some underlying problem with circulation. If you smoke, you are strongly encouraged to quit smoking 2 weeks prior to surgery and to refrain from smoking until 2 weeks after surgery.
  • Fat embolism. The literature has noted a few cases of liposuction resulting in  pulmonary fat embolism. This problem is very uncommon, and there is no clear explanation for why it occurs. It may be related to the entrance of fat into the blood vessels during the operation. These could travel to the lung and obstruct the pulmonary vessels. If this occurs as a result of the operation, and the problem is severe, there is no question that the patient will need to be admitted to the hospital.
  • Life threatening conditions. It is very uncommon to see severe complications with cosmetic surgery. However, should such a condition arise for any reason, you will be immediately admitted to the hospital.

When and where are Gynecomastia Repair (Male Breast Reduction) touch-up procedures performed?

Touch-ups are done after 3 months. These procedures are much simpler than the first procedure and are not as painful. They are done in our Virginia office with a small amount of local anesthetic solution.

When are the Gynecomastia Repair (Male Breast Reduction) sutures removed?

There are very few sutures in gynecomastia excision procedures in general. These usually come out in 1-2 weeks. You may have absorbable sutures that do not need to come out.

How many visits do I have after Gynecomastia Repair (Male Breast Reduction) in Virginia?

We like to see our patients frequently after surgery. You are seen by Dr. Marefat or a nurse within 2-3 days of male breast reduction surgery. Then the normal postoperative routine is 1 week, 1 month, 3 months, 6 months, and 12 months. Of course, if there is a need, you may be seen more often. After the first year, we encourage our patients to come in for routine follow-up visits every 3-5 years.

Am I a good candidate for Gynecomastia Repair (Male Breast Reduction)?

You are a good candidate for gynecomastia excision if you have localized areas of fat collection, good skin tone, good general health, and realistic expectations. This does not mean that you cannot have  Virginia male breast reduction surgery if you do not meet these criteria. However, the best results are seen in individuals who have 1 or 2 areas of localized fat in their body that don’t go away with dieting and exercising. Generally, the younger you are, the better a candidate you are for surgery. A person’s physiological age is more important than his chronological age. That is to say, you may be 60 years old, but your skin and general health may be better than that of most 50 year olds.

How do I pay for Gynecomastia Repair (Male Breast Reduction) in Virginia?

You can pay for Virginia male breast reduction surgery by certified check, credit card, or cash. Payment for cosmetic surgery is expected prior to any procedure. If you are scheduled for surgery several weeks in advance, you may pay by personal check.

Are there Gynecomastia Repair (Male Breast Reduction) scars?

Yes. However, these scars are very small (about 1/8th of an inch) and are usually hidden in areas of the body where you would not normally see them. Each area of liposuction will generally have 1 or 2 small scars. After several months, these scars fade and are hardly visible.

If glandular tissue is being removed, it will be through a half-inch incision in the areola (the darker skin surrounding the nipple). If you have excess skin after liposuction, this may need to be trimmed. In this case, you will have a permanent scar in the area of skin excision.

Does Gynecomastia Repair (Male Breast Reduction) hurt?

The pain involved in Virginia male breast reduction is very tolerable. We have heard our patients describe it as “muscle aches and pains” or just “soreness.” Many patients do not finish the pain medications prescribed to them for pain relief. Having said that, remember that pain is very subjective, and it is not easy to predict what degree of pain you will have.

Will I be awake during Gynecomastia Repair (Male Breast Reduction)?

No. Virginia male breast reduction is almost always done with the patient under general anesthesia. In certain cases, if general anesthesia is contraindicated, we can do this procedure with heavy sedation. If you are having a minor area touched up or liposuctioned, this can be done in the office while you are awake with local anesthesia.

Where will the Gynecomastia Repair (Male Breast Reduction) be performed in Virginia?

Virginia male breast reduction surgery is usually done in the outpatient facility. We rarely see the need to perform this operation in the hospital setting. Only in rare situations, in which the patient may have risk factors, does Dr. Marefat suggest surgery in a hospital environment.

Are medical photographs taken of Gynecomastia Repair (Male Breast Reduction)?

Yes. In all cosmetic and reconstructive cases medical photos are taken. Photographs are mandatory. This is the only way for us to compare your status before the procedure to your results. Photographs in plastic surgery serve much the same role that x-rays serve for orthopedic surgery.

How do I get started with Gynecomastia Repair (Male Breast Reduction) in Virginia?

Dr. Marefat and the staff at Metropolitan Plastic Surgery would be happy to help you set up a private consultation to discuss gynecomastia repair (male breast reduction) in Virginia. Schedule an appointment online or call one of our locations, our Arlington, Virginia office at 703-516-7600 or our Woodbridge, Virginia office at 703-560-9583.

Are there financing options for Gynecomastia Repair (Male Breast Reduction) in Virginia?

Dr. Marefat offers a number of financial assistance programs and payment programs to cover the cost of gynecomastia repair (male breast reduction) in Virginia. Please visit the Patient Financing section of our website for more details or ask the staff at Metropolitan Plastic Surgery about these options so you can get started with gynecomastia repair (male breast reduction) in Virginia today.