Gynecomastia SurgeryGynecomastia Surgery for Those with Hormonal CausesWhen the gynecomastia condition is made up of excessive glandular tissue due to the hormonal causes outlined here, Dr. Heil removes the offending tissue by glandular excision. The unwanted tissue is carefully removed with surgical tools designed for precise extraction. Next, fibrofatty tissue can be sculpted to create the desired masculine chest appearance. In many cases, the operating table is elevated 80 degrees, in order that the doctor may gain a more accurate perspective. After aggressively but carefully sculpting the remaining tissue using a special surgical tool, our Pittsburgh gynecomastia surgeon may or may not remove subcutaneous tissue from the skin. This will depend on how stretched the skin is, in conjunction with the patient's degree of skin elasticity. Gynecomastia Surgery for Those with Excessive Weight CausesFor patients whose gynecomastia originated with excessive weight gain, Dr. Heil prefers to employ liposuction. No matter the method of liposuction (laser, ultrasonic, or traditional), the procedure begins with an injection of tumescent fluid. The components of this solution are as follows:
After a brief period during which the solution takes effect, liposuction is then performed through a microincision that is normally made in the armpit. It is performed primarily around the nipple-areolar area. Should the patient have an accumulation of fat in the axillae (the lateral aspect of the chest surrounding the armpit), more aggressive liposuction is performed; this will create a more even contour with the neighboring chest area. As with the glandular excision technique described above, underlying gland and fibrofatty tissue is also removed during gynecomastia liposuction. After making a microincision on the bottom half of the areola, Dr. Heil will elevate the operating table to 80 degrees to mimic the illusion that the patient is standing. This increases accuracy, and does not wake the patient at all. Also a potential component of any gynecomastia surgery, skin excision may take place following tissue removal. As stated above, whether subcutaneous tissue is removed from the skin will depend on how stretched the skin is, as well as the patient's degree of skin elasticity. At the close of the procedure, a drain is placed through the liposuction incision to create negative pressure in the open space and remove the naturally accumulating fluid. This is a key factor in the prevention of a seroma, which is a buildup of bodily fluid underneath the skin - a dangerous complication for many surgeries. At the end of each procedure, special dressings and a compression garment are placed around the chest, and the patient is taken into recovery. Gynecomastia Surgery: Skin ExcisionAs stated, some patients may require skin excision to tighten the skin on the chest if it has become stretched beyond contraction. Data shows that this is only required in approximately 20 percent of gynecomastia patients; but should you fall into that category, it is important to understand the details. This portion of the procedure is similar to a mastopexy, during which the excess skin is removed and the nipples are repositioned to "lift" the chest. Depending on the amount of skin, patients either receive a minor lift, which excises a crescent or half-doughnut-shaped piece of skin above the areola, or a peri-areolar lift, which is a more aggressive technique that removes a doughnut-sized portion of skin around the areola. Gynecomastia Surgery: The RecoveryUpon completion of surgery, you will be wheeled into the recovery room for approximately 90 minutes of observation by a Registered Nurse. Before you are released, he/she will confirm that you have:
Once you are released, you and the party you have elected to drive you home will review post-operative instructions with the staff. It should also be noted that patients who live more than one hour away are strongly advised to stay at a local hotel for the first night following surgery, in order that we may evaluate you at a moment's notice if you experience emergency problems. This is the optimal scenario for your protection. The first of a short series of follow-up appointments will take place two to three days after surgery. The first order of business is to remove surgical drains, followed by obtaining feedback from you regarding your experience. This is the ideal time for you to ask questions regarding recovery. Normally, patients return to work within this first week (with the exception of physically laborious occupations). During the second week, your sutures will be removed. Again, you may ask questions of Dr. Heil during that time. Your final visit to us will take place six weeks post-operative, when the compression garment will be removed. It's important that you do not engage in exercise or other strenuous efforts during this time. When the garment is removed, you will be advised as to whether or not these activities can resume. |
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