Gynecomastia

Why choose Wake Plastic Surgery?

Although the treatment for gynecomastia is relatively straightforward, there is a fine art to getting excellent results. Taking too much tissue away can leave a patient with a deficit or indention on the chest which is much more difficult to correct than to avoid in the first place.  Leaving too much tissue behind can be frustrating for patients and leads to repeat operations that can be prevented. Our technique that includes both liposuction with power assisted liposuction and direct excision minimizes the need for revision procedures.

Who are good candidates for the procedure?

The best candidates are patients who are healthy and are at a stable weight.  Non-smokers have much lower risks than smokers. As mentioned above, the most common cause of gynecomastia is unknown. But patients that have a known cause should have those conditions treated before pursuing breast reduction surgery.

How bad is the scarring?

The scars from a typical reduction in which the only incision is along the lower arc of the areola are almost imperceptible. This is by far the most common procedure performed.

Donut mastopexy scars are not quite as elegant and have a tendency to widen over time, but are still well tolerated. A locking purse-string suture helps prevent scar widening.

The worst scars are obviously when an amputation technique is required, but the improvement in shape and form far outweigh the negatives of scarring for these patients.

 

That being said, we have a wide variety of treatments at the MedSpa at Wake Plastic Surgery that can help reduce the appearance of scars. We offer BBL laser, ProFractional laser, and Virtue RF as treatments that can aid in improving the appearance of stubborn scarring. All of Dr. Stoeckel’s surgical patients are eligible for a complimentary consultation at our MedSpa to discuss these aesthetic options and more.

How is the typical procedure performed?

Most patients will require a deep sedation anesthesia. Liposuction is completed using Power Assisted Liposuction (PAL) technology. This will remove much of the unwanted fatty tissue and some of the unwanted breast tissue. But it almost always leaves the dense breast plate tissue which requires surgical excision. A small incision is then made in the lower arc of the areola and the breast plate tissue removed. The skin incision is closed and steri strips applied. The entire procedure typically takes about 1-1.5 hours to complete.

When can I return to work or the gym?

Keeping the heart rate and blood pressure normal for the first week after surgery is important to reduce the risk of unnecessary bruising or bleeding. After the first week, you will be able to return to all core and lower body exercise activities. Upper body specific exercises such as pushups, pullups, bench press, etc. should be avoided for about 4-6 weeks. Most patients can return to a desk or office job in as little as 2-3 days. But if your job requires heavy lifting or aggressive upper body movements, you may be out for 4-6 weeks.

What causes gynecomastia?

There are rare medical conditions, medications, and herbal supplements that have been associated with gynecomastia. But the vast majority of patients have idiopathic breast enlargement, or no known cause. The underlying issue is thought to be either an imbalance in testosterone and estrogen hormone levels or in the sensitivity of receptors on the breast tissue. About 70% of males develop some level of gynecomastia during adolescence, but most of them see normalization of the tissues as the hormone levels equilibrate. For those that don’t, gynecomastia reduction surgery is the gold standard for treatment.