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Once you have chosen a surgeon and scheduled your procedure, your surgeon will give you a list of pre-operative instructions. This will include some lab testing such as routine blood work and a cardiac work-up if you have any history of heart disease. Your surgeon will likely ask you to stop taking certain medications, including aspirin, non-steroidal anti-inflammatory drugs (NSAIDs) and blood thinners, all of which can increase bleeding risk. The pre-op instructions will also include a list of dos and don'ts about eating and drinking before your procedure. Most surgeons recommend that prospective patients kick the smoking habit for the month before and the month after surgery. Smoking can cause a delay in wound healing and skin necrosis (death). The good news is that many tools are available today to help smokers become ex-smokers. Nicotine replacement products such as nicotine patches, nicotine gum and nicotine lozenges are available over-the-counter. A nicotine nasal spray and inhaler are available by prescription. These products can help relieve nicotine withdrawal symptoms. Nicotine patches and other nicotine replacement systems can't be used as smoking cessation aids immediately before or during surgery. They cause some of the same problems with wound healing as cigarette smoking. Tell your surgeon if you are using any nicotine replacement products. Drugs such as buproprion SR (Zyban) and varenicline tartrate (Chantix) are non-nicotine pills that may help you quit smoking before surgery. Talk to your doctor about a prescription. Hypnotherapy or acupuncture may help some people quit smoking, too. Acupuncture involves placing extremely thin needles into the skin along specific acupuncture points to help curb the desire to smoke. Causes of Gynecomastia Medications may cause enlarged breasts, including: •Anti-androgens used to treat prostate enlargement or cancer and some other conditions •AIDS medications •Anti-anxiety medications •Tricyclic antidepressants •Antibiotics •Ulcer medications •Cancer treatments •Heart medications •Anabolic steroids and androgens •Alcohol •Speed •Marijuana •Heroin Diseases may cause enlarged breasts as well: •Any conditions that interfere with normal testosterone production •Some tumors, such as those involving the testes, adrenal glands or pituitary gland •Hyperthyroidism (the thyroid gland produces too much thyroid hormone) •Kidney failure •Liver failure and cirrhosis •Malnutrition The Gynecomastia Surgery Procedure If your enlarged breasts consist primarily of excessive fatty tissue, your surgeon may use liposuction. If excess glandular tissue is the primary cause, the tissue may be cut out with a scalpel. This excision may be performed alone or in conjunction with liposuction. During an excision procedure, the incision is made either on the edge of the nipple (areola) or in the underarm area. The surgeon cuts away the excess glandular tissue, fat and skin from around the pigmented area surrounding the areola and from the sides and bottom of the breast by working through the incision. Major reductions that involve the removal of a significant amount of tissue and skin may require larger incisions and more visible scars. If liposuction is also used to remove excess fat, a slim, hollow tube (cannula), is inserted directly through the existing incisions. The cannula is attached to a vacuum pump to suction out the fat. For liposuction-only breast reduction, your surgeon will likely make a small incision of less than a half-inch in length around the edge of the areola. Or he or she may make the incision in the underarm area. You may feel a vibration or some friction during the procedure, but generally no pain. Sometimes a small drain is inserted through a separate incision to remove excess fluids. Once closed, the incisions are covered with a dressing. The chest may be wrapped to keep the skin firmly in place. Breast reduction surgery for gynecomastia is most often performed on an outpatient basis, in an office-based or ambulatory surgical facility or in the hospital. Sometimes an overnight hospital stay is recommended. Time in surgery is typically an hour and a half, but a more extensive male breast reduction may take longer. The procedure may be performed under general anesthesia or local anesthesia with sedation. Your surgeon will discuss your anesthesia options with you once you have decided on surgery. Risks of Gynecomastia Surgery Surgical risks include: •Scarring •Swelling •Bruising •Bleeding •Blood clots •Infection •Poor wound healing •Temporary or permanent changes in nipple or breast sensation •Anesthesia risks •Breast contour and shape irregularities •Skin discoloration •Permanent pigmentation changes •Damage to the nerves, blood vessels, muscles and lungs •Allergies to surgical materials •Breast asymmetry •Fatty tissue found deep in the skin might die (this is called fat necrosis) •Fluid accumulation •Deep vein thrombosis •Cardiac and pulmonary complications •Pain •Possibility of revision surgery for additional tightening or repositioning of the breasts •Death Risks of liposuction for gynecomastia include: •Uneven contours •Rippling or loose skin •Irregular pigmentation •Excessive fluid loss •Fluid accumulation •Infection •Blood clots in the lung (pulmonary emboli) •Hematoma (a collection of blood in the areas suctioned) •Temporary numbness or discoloration in the treated area •Asymmetry, dimpling, wrinkling, unevenness and surface irregularities over the treated area •Perforation wounds in surrounding tissue or organs •Anesthesia reactions •Swelling •Burns (from ultrasound-assisted and laser-assisted liposuction) •Death Recovering From the Surgery Have someone drive you after surgery and help you at home for a day or two if needed. Whether you've had liposuction, excision with a scalpel or both for your gynecomastia, you will feel discomfort for a few days. The pain can be managed with a prescription from your doctor. To help reduce swelling, you'll probably need to wear an elastic pressure garment continuously for a week or two, and for a few weeks longer at night. Although the worst of the swelling will subside in the first few weeks, it may be three months or more before the final results of your surgery are apparent. You'll be encouraged to begin walking around on the day of surgery, and to return to work when you feel well enough, which could be in a couple of days. Stitches are removed one to two weeks after the procedure. Your surgeon may advise you to avoid sexual activity for a week or two and heavy exercise for about three weeks. You will be told to stay away from any sport or job that risks a blow to the chest area for at least four weeks. Your activities should be back to normal after about a month. It's important to avoid exposing surgical scars to the sun for at least six months. Sunlight can affect the skin's pigmentation permanently, causing the scar to turn dark. If sun exposure is unavoidable, use a strong sunblock. If you experience shortness of breath, chest pains, or unusual heart beats after the procedure, contact your surgeon immediately. These complications may require hospitalization and additional treatment. Cost of Gynecomastia Surgery The cost of male breast reduction typically includes the surgeon's fee, hospital or surgical facility costs, anesthesia fees and prescriptions for medication and post-surgery garments. According to statistics from both the American Society for Aesthetic Plastic Surgery and the American Society of Plastic Surgeons, the national average for plastic surgeon fees for gynecomastia surgery is roughly $4,400. In most cases, the cost of male breast reduction surgery is not covered by insurance. But each insurance policy varies greatly, so review your policy carefully to determine coverage. The ASPS has published a position paper for physicians and insurers defining the recommended criteria for coverage of reconstructive cases. This document grades the condition based on its severity, the length of time it has been present and the symptoms that it is causing in both adults and teens. The ASPS states that male breast reduction surgery should be covered by insurers when it is performed to relieve symptoms or signs of deformity related to excessive breast size. Ask your physician for a copy or of this document to submit to your insurer or view the online version. Many plastic surgeons offer patient financing plans, so be sure to ask. Choosing the Right Surgeon It's important to choose a board-certified plastic surgeon with extensive experience in male breast reduction procedures. Board certification may not always guarantee the best results; however, board certification does require specific and rigorous surgical education and training that improve the odds for a successful male breast reduction Thanks for reading my article hope it may help and explain things, hope you understand please look and read at other articles that i have written take care and thanks,Douglas Fanning. Please have a look at the link as this may help you in your choice Please have look at link as this may help you in your choice..
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