Treatment for Gynecomastia
Surgical Correction of Enlarged Male Breasts
Gynecomastia is a medical term derived from the Greek meaning "woman-like breasts." Although infrequently discussed, this is a very common finding in men. It may begin in puberty but usually subsides with maturity. It may affect one or both breasts in any given individual. Although persistence into adulthood may be related to certain medical problems, most cases are without known cause.
Men may seek correction of enlarged breasts for a variety of reasons, but most often this is related to being socially uncomfortable. If you are unhappy with the way your chest appears in clothing or are reluctant to remove your shirt in public because of enlargement of your breasts, you may be a good candidate for gynecomastia correction.
This page will give you a basic understanding of the procedure and the results you can expect. The cornerstone of Dr. Revis' approach is to individualize treatment to your specific circumstances and goals and to ensure that you have an adequate understanding of the issues involved so that you are able to make a fully informed decision. This will help you achieve the appearance you desire with the least invasive procedure available, thus creating a mutually rewarding experience. Dr. Revis invites you to visit his office for a complimentary consultation to discuss the procedure in greater detail. You are also invited to email Dr. Revis with your questions, or we can mail you more detailed information regarding the procedure.
As you consider plastic surgery, one of the most important decisions you will make is choosing your surgeon. Our pledge to you is to provide the latest, state of the art cosmetic plastic surgery in a safe and professional environment. Dr. Revis is a recognized specialist in the field of cosmetic plastic surgery and is board certified by the American Board of Plastic Surgery, the only plastic surgery board recognized by the American Board of Medical Specialties. He is also an active member of the American Society of Plastic Surgeons and has also been named among "America's Top Surgeons" by the Consumers' Research Council of America.
Our goal is to provide you with the ultimate patient experience. Our well-trained staff will help you understand your procedure, our financial policies, the scheduling of your surgery, and your post-operative care. We are available to assist you during our regular office hours, Monday through Friday. Dr. Revis is also available 24 hours a day to post-surgical patients; he will give you his cell phone number after surgery so that you will always be able to reach him with any questions or concerns you might have during your recovery.
During your initial consultation, Dr. Revis will inquire about your medical history, prior procedures, medications, allergies, and your motivations for seeking plastic surgery. It is very important that you be thorough when providing your medical history, as this information helps to prevent complications during your care. When asked about medications, be sure to include any vitamin or herbal preparations, as these can affect your blood pressure and clotting ability. Honesty regarding your use of tobacco and alcohol is also very important, as these may have a profound impact on your recovery period and your ability to heal following your procedure.
After reviewing your medical history, Dr. Revis will discuss your concerns, priorities and motivations for pursuing plastic surgery, as well as your fears. After examining you, Dr. Revis will be able to offer advice and options to help you achieve the appearance you desire. He will also explain the advantages and disadvantages of the different options you have before you.
At the completion of your consultation, our Patient Coordinator will give you a written estimate of the cost of your procedure. At this time, you will also have the option to schedule your procedure if you so choose. The decision to undergo surgery is a very important one, and the final decision should be given very careful consideration. Dr. Revis realizes the importance of this decision, and at no time will you be pressured to make a decision. You are also encouraged to bring your spouse, significant other, family member, or a friend to your consultation.
Where Your Procedure Will Be Performed
Dr. Revis has been granted staff privileges at our local hospitals and outpatient surgery centers. In the interest of the safety of his patients, he only performs surgery in fully accredited facilities with the proper services and staff. Dr. Revis usually performs gynecomastia surgery at Broward General Medical Center or Imperial Point Medical Center (both fully accredited hospitals) or the Imperial Point Surgery Center (a fully accredited ambulatory surgery center). The staff of these facilities are very experienced in the care of plastic surgery patients in general and specifically in the care of Dr. Revis' patients.
Types of Anesthesia
Anesthesia is an essential part of any surgical procedure and must be performed safely. General anesthesia is the deepest form of anesthesia. You are asleep, feel no pain, and will not remember the procedure. This form of anesthesia is usually not necessary for the treatment of gynecomastia.
Intravenous sedation, called twilight sleep, is a combination of local anesthetic administered at the surgical site by Dr. Revis and intravenous sedation administered by the anesthesiologist. You breathe for yourself, but you are in a deep sleep throughout the procedure. You should feel no pain, and you will not remember the procedure.
An intermediate form of anesthesia, the laryngeal mask airway (LMA), is a relatively new technique. This technique is similar to twilight sleep in that you are breathing on your own, but the method of sedation differs. With an LMA, you actually breathe anesthetic gases administered by the anesthesiologist, rather than receive intravenous sedation via your intravenous line. These anesthetic gases cause you to sleep during the procedure. At the completion of the procedure, the gases are turned off and you wake up from your sleep. You will feel no pain, and you will not remember the procedure.
The prevention of post-operative nausea and vomiting is also a focus of Dr. Revis' approach to gynecomastia treatment. To improve your overall experience and ensure you feel better faster following your surgery, he has developed a technique that has resulted in a very low incidence of post-operative nausea and vomiting. You will be given an intravenous dose of Zofran at the beginning of your operation. Zofran is a new drug which is currently the best medication available to prevent nausea and vomiting. Dr. Revis feels it is a very important component of his overall approach to make sure that your experience is as pleasant as possible.
Dr. Revis will discuss all of these options with you more thoroughly at the time of your consultation, and please ask him about anything you do not understand.
Details of the Procedure
Male breast reconstruction takes one to two hours to perform, depending on what type of reduction you are having performed. The most simple type involves the use of liposuction. This is for younger males with good skin elasticity. Dr. Revis makes several tiny incisions and passes a thin, hollow metal cannula back and forth through the enlarged breast tissue. This cannula is attached to a suction device that removes the excess tissue. At the completion of the procedure, Dr. Revis closes the incisions very carefully so that after healing the scars are virtually imperceptible.
If you have less elastic skin or more extensive gynecomastia, Dr. Revis may have to make an incision around the nipples to remove the excess tissue directly and to remove excess skin. At the completion of the procedure your scar will lie in the natural border of the areola (the pigmented skin surrounding the nipple) and the surrounding skin.
If a large amount of tissue is removed, Dr. Revis may place a slender rubber drainage tube underneath each incision to drain any fluid that may accumulate. You will also wear an elastic garment called a compression garment that decreases bruising and encourages the wounds to heal more rapidly.
Products to Help You Heal
SinEcch Arnica Montana is a natural product from Sweden which has been shown in clinical studies to reduce post-operative bruising and swelling. Begun the evening prior to surgery, this product is continued for four days post-operatively.
Scarguard MD A combination of hydrocortisone, silicone and Vitamin E, this product is painted on your scars topically like nail polish beginning three weeks after surgery, and it helps your scars fade so that they fade as much as possible.
These products are available for purchase in our office. Please ask us about these products and others if you have any further questions about whether or not these would be beneficial for you during your healing period.
After Your Procedure
Male breast reduction procedures are usually performed as outpatient surgery. However, if you live alone or are from out of town, you may choose to stay in the hospital overnight. Drains placed at the time of surgery will be removed by Dr. Revis within a few days of the surgery. Sutures are absorbable and do not need to be removed. This technique has improved patient satisfaction and post-operative comfort.
The antibiotics that were prescribed during your preoperative visit (usually Augmentin) should be taken twice daily beginning on the evening prior to surgery. Continue this medication for five days post-operatively or until it is gone. The pain medication prescribed by Dr. Revis during your preoperative visit (usually Lortab or Vicodin) should be taken fairly regularly, every four hours or so, during the first 24 hours (when you are not asleep, of course). Most patients find that they are able to transition to Tylenol after three or four days. It is not safe to drive a car within 24 hours of taking pain medication, as your reflexes and alertness may be altered.
You should plan to take it easy following breast reduction. No strenuous activities, heavy lifting (over 20 pounds), aerobic exercises, swimming, contact sports, tennis, or golf should be planned for the first several weeks. As Dr. Revis monitors your recovery, he will advise you when it is safe to resume specific activities.
The Results You Can Expect
You will notice the change in your breast size immediately, but some swelling will be present. This will gradually subside over the first few weeks. Dr. Revis will encourage you to wear the compression garment for approximately three weeks following surgery. You can return to your normal daily routine on the day following surgery, and you can expect to be able to return to all sports activities within three weeks.
Please call (954) 630-2009 or email Dr. Revis for further information.
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