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Gynecomastia

Gynecomastia is a condition that presents in men with excess tissue growth in one or both breasts, and which is particularly pronounced under their nipple and areola. The condition can be the result of hormonal changes, extreme weight loss, heredity, aging, obesity, or the use of certain drugs. Men of all ages suffer from gynecomastia, which can lead to the avoidance of certain social and physical activities as well as intimacy. In males who have had significant weight loss, excess droopy breast skin rather excess breast tissue may be present, a condition that resembles gynecomastia but is referred to as pseudogynecomastia.

What Is Gynecomastia Correction?

When gynecomastia is present, male breast reduction — also known as gynecomastia surgery or male reduction mammoplasty — may be the solution. Dr. Motakis performs gynecomastia surgery to reduce breast size in men by flattening the area of fullness and restoring the normal contours of the chest. By removing excess fat, breast tissue and occasionally, excess or sagging skin, he gives his patients a flatter, firmer, more masculine chest shape. Patients who have the procedure feel more comfortable and confident about their body.

How Is The Gynecomastia Procedure Performed?

Gynecomastia correction surgery is usually performed under general anesthetic and usually takes 1-2 hours. Depending on the case Dr. Motakis may use one (or a combination) of three different techniques: the liposuction technique, the gland excision technique or in much fewer cases the skin and gland reduction technique.

If your case of gynecomastia is predominantly the result of excess fatty tissue, Dr. Motakis may recommend the liposuction technique. One to two tiny incisions are made, and vacuum suction is used to remove excess fat via a thin cannula. In cases where excess breast gland is present, liposuction is insufficient, and an incision is required around the areola in order to excise the hard, glandular tissue. The scar in this procedure is within the areola and virtually imperceptible. In cases where there is excess skin, such as in massive loss patients (pseudogynecomastia) liposuction and breast gland excision may be also inadequate. In such cases, the skin is tightened either with the use of a radiofrequency apparatus known as BodyTite© or in more severe cases excised directly usually around the areola or along the natural creases of the male chest. Dr. Motakis may also recommend this technique in cases where the size of the areola needs to be reduced or the nipple is droopy and in a very low position.

Am I An Ideal Candidate For Gynecomastia Correction?

The ideal candidates for male reduction mammoplasty are adult men who have excess breast tissue centralized around their nipple and areola. They also are physically healthy, fall within a relatively normal weight range, and their breast development has stabilized. Like all cosmetic procedures, the patient must have realistic expectations. If you are bothered by the excess fullness around your chest and under the nipple and feel uncomfortable clothed or unclothed, then a male chest reduction surgery may be right for you. Dr. Motakis will assess you to decide if you are a good candidate and discuss your surgical options during your consultation.

What Happens If I Don’t Treat My Gynecomastia?

Enlarged male breasts are not a health risk, so opting to leave them be is not dangerous to your long-term health. But unless your enlarged breasts are due solely to fatty tissue from weight gain (which can be decreased through diet and exercise) the condition won’t go away without surgery. Once the glandular area beneath the areola complex becomes enlarged, it won’t decrease without intervention.

The question would be “Why not address the problem?” It’s estimated that from 40 to 60 percent of men have enlarged breasts, but most don’t do anything about it. They simply avoid situations where they need to take their shirt off. That may be easy enough during a cold Toronto winter, but not during our awesome summers.

Gynecomastia correction surgery doesn’t make for difficult recovery, and the change in your chest can correlate to a change in your shirtless self-confidence. If you’re even considering doing something about your enlarged breasts, schedule a consultation with Dr. Motakis and he can explain everything about your condition and the procedure.

How Do I Need to Prepare for Gynecomastia Surgery?

Recovery from these procedures with Dr. Motakis is not difficult, so you don’t need to make extensive arrangements for a prolonged recovery. It is surgery, so you’ll prepare the same way you do for any surgery. You’ll need to stop taking any blood thinning medication, aspirin, anti-inflammatories, and most herbal supplements for one week prior to your surgery. These can cause excessive bleeding and subsequent bruising. If you smoke, you’ll need to stop for two weeks prior to and following your surgery, as cigarette smoking constricts blood vessels, and this impedes healing.

How Painful Is Recovery after This Surgery?

These are not painful recoveries. The incisions Dr. Motakis makes are small. Your swelling can last two weeks, but the discomfort resolves quickly after the first few days. Many patients don’t feel the need for prescription pain medication, opting only for over-the-counter pain relievers.

How Much Fat Can Be Removed During Gynecomastia Surgery?

The amount of fat Dr. Motakis removes isn’t important; it’s the way he removes fat and sculpts the area. Removing too much fat can create areas of loose, uneven skin, so the goal is never a specific amount of fat to be removed. Dr. Motakis removes what’s needed to make your chest look great.

Is Male Breast Reduction a Permanent Solution for Gynecomastia?

Patients wonder if this surgery will need repeating in the future. True gynecomastia, versus enlarged breasts due to weight gain or other lifestyle factors, is caused mainly by excess glandular tissue. This causes the protrusion of the nipple-areola complex. In male breast reduction surgery, Dr. Motakis removes most of the mammary gland, leaving enough to support the nipple-areola. With this tissue gone, the chances of recurrence are very low.

However, if the gynecomastia was due to the use of steroids, marijuana, or other medications, it is possible for a patient’s breasts to become enlarged again if usage is continued. Also, a sizeable increase in weight can allow fat to accumulate in the breasts, although this isn’t true gynecomastia.

If you want to maintain your new chest contours, keeping to a healthy weight, and moderating your alcohol or marijuana use will be necessary. Steroid use would fully need to cease, as enlarged breasts are a direct side effect.

Do I Have Treatment Options Other than Surgery?

If your breast enlargement is due to an expansion of your glandular tissue, adjusting your hormone levels, especially estrogen, could correct the condition. But if this doesn’t alleviate the enlargement, surgery is the only remedy. However, if your breast enlargement is tied to medication use or weight gain, you have various non-surgical options to treat the condition.

How Long before I Can Begin Exercising Again?

Normal activities can be resumed in about one week, and this includes exercise. As you would probably assume, any exercise that specifically targets or involves the chest will need to wait for a month or so. Dr. Motakis will discuss these timeframes with you.

Are There Certain Qualifications to Have Gynecomastia Surgery?

Whether or not your condition is right for surgical intervention involves ruling a few things out first. If your enlarged breasts are due to weight gain, the first step is to lose the weight and see if the condition persists. Heavy drinkers and marijuana users also aren’t candidates for surgery, as their breast enlargement comes from their lifestyle choices.

Dr. Motakis can diagnose when gynecomastia is to blame. The key is to feel for a firm rubbery mass underneath the nipple area. The size of this mass is usually less than two inches in diameter. It will often be sensitive to applied pressure. Before opting for surgery, Dr. Motakis will likely begin treatment by prescribing medication that reduces the amount of estrogen the patient’s body is producing.

What Is The Recovery Period After Gynecomastia?

Recovery after surgery takes 1-2 weeks during which a supportive compression vest is worn. Specific dressings will be applied after your surgery and they will stay intact until your follow up visit one week after surgery. You will be able to shower the next day after the procedure as Dr. Motakis does not usually use drains with this procedure. Your chest will be slightly swollen and may feel slightly sore, but when needed, you will feel comfortable with the use of mild analgesics. After one week, you should be able to return to work, but you will need to limit intense physical activity such as going to the gym for 3-4 weeks. At your one week follow up appointment your bandages will be changed, the small incisions inspected, and a special tape applied to expedite healing and reduce scarring. The compressive garment is worn for 6-8 weeks after surgery in order to decrease swelling, improve contour and expedite healing. There are no sutures that need to be removed with gynecomastia surgery, as Dr. Motakis uses only internal dissolving sutures in order to minimize scarring and decrease patient discomfort.

What Are The Risk Factors For Gynecomastia?

Complications of gynecomastia surgery include unfavorable healing or scarring, change in skin or nipple sensation, the presence of residual excess skin, infection or asymmetry, among others. However, these seldom occur. Dr. Motakis will discuss all risks in detail during your consultation and pre-operative appointments. Correcting these complications may also require additional surgery.

Are There Any Alternatives To Gynecomastia?

Currently, there are not alternatives to treat gynecomastia.

Can Gynecomastia Be Combined With Other Procedures?

Gynecomastia correction can be combined with other surgical procedures and is often performed concurrently with liposuction of the body or the area under the chin.

Schedule a Gynecomastia Consult Today!

Be sure to contact Dr. Motakis if you have any questions about our Gynecomastia surgery! You can reach us by calling (416) 925-5775 or by clicking here to send our talented team an Email Contact Form. Our practice serves Toronto and the surrounding areas of Ontario, and we look forward to meeting you!

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