In some men, the volume of the male breasts is affected by an excess of mammary tissue and accumulated fat. This condition can cause extreme embarrassment, social inhibition and self-consciousness for boys and men who suffer from it.
If you think that you have this condition, you should consult with your physician to rule out a more serious condition such as liver or endocrine disease. If you are otherwise healthy, breast reduction surgery may significantly help your appearance and self-image.
This procedure is used to remove fat and/or glandular tissue from the breasts. In extreme cases, skin is removed as well. The result is a flatter, firmer and more masculine-looking chest.
Depending on the case the patient presents, the volume of the breasts can be reduced with Liposuction procedure, or with Areola incision. In both instances, a small elliptical incision is made on the lower half of the nipple area (areola). These procedures are done at the Santa Rita Hospital with local anesthesia and sedation.
For those men with tissue that is more glandular in nature, all breast tissue directly under the nipple is removed. This procedure can improve the appearance of the chest in cases where diet and exercise have failed.
On the other hand, if the patient shows more fat excess, then the Liposuction procedure is done. During this procedure, a 3mm cannule is used to extract the fat. Liposuction is a cosmetic procedure where unwanted fat deposits are removed from certain areas of the body. These fat deposits are typically those resistant to diet and exercise. This procedure results in a slimmer and better body contour for the patient.
BEFORE THE SURGERY EVERY PATIENT MUST:
Send photographs fro a pre-evaluation.
Surgery Costa Rica will schedule an appointment with your doctor for you. During this visit you can ask him any questions you might have about the surgery.
Have a complete medical check up, an electrocardiogram and laboratory blood and urine tests; including a complete whole blood count, partial tromboplastin time, prothrombin time, platelets, and HIV.
Take antibiotics such as Augmentin 500mg, (one capsule three times a day with each meal) Cipro or Ceclor 500mg (one capsule twice a day with a full breakfast and dinner); two days before surgery, the day of the surgery, and seven more days after the surgery.
Inform doctor of your daily vitamin and medication intake.
Notify doctor if you have developed a cold or the flu a week prior your surgery date.
Please avoid: aspirin, more than 500mg of Vitamin E, ginkobiloba, ginseng, or any blood thinners two weeks prior your surgery. Also avoid alcohol intake, and passive or active smoking for one month before and one month after the surgery. Remember that nicotine and alcohol delays and might even complicate your healing processes.
THE DAY OF SURGERY:
Please brush your teeth, but do not eat or drink coffee or tea. Only fruit juice with your antibiotic.
Please remove your contact lenses or dentures before the surgery. Do not wear any make up, nor apply moisturizer in your eyes or face.
The evening, and the morning prior your surgery, clean the operative area with soap and water.
Please do not bring any jewelry or valuables to the Hospital.
Please wear a robe, housecoat or warm up suit that buttons or zips in the front and flat shoes after the surgery. No tight-fitting clothes.
Someone must drive you home, to your Hotel, or to the Recovery Home you choose to stay at.
*Postoperative instructions regarding activity, medications and office visits will be given following your surgery.
AFTER THE SURGERY:
Place ice cubes or crushed ice into a plastic bag, covered within a towel (to avoid the burning on the skin) in the breasts area. This relieves the pain and helps diminish the post-operatory swelling.
Remember to take the oral antibiotics Azitromicina (Zithromax) 500mg (once a day) Ceclor 500mg or Ciproxina 500mg, (twice a day) Augmentin 500mg (three times a days) should be taken with sweet juice at breakfast and dinner time or with each meal a day (three meals). Start taking them two days before surgery, the day of the surgery, and for 8 more days after surgery. TOTAL of 10 days.
In case of pain, take Tylenol or Winasorb every 4-6 hours. In some cases, Feldene Flash is prescribed, every six hours for the stinging and pinching feeling.
Following the surgery, some patients develop a one degree C fever during the afternoons for three to five days. They can take a shower once a day after surgery and they should follow a healthy low fat diet with plenty of fruits, vegetables, fish and skinless chicken.
Internal bleeding is a rare complication which produces pressure and local pain. If the condition is severe it is called hematoma or seroma. A draining procedure is used to extract the blood trapped in the skin. The draining system is used from 24 hours to 48 hours.
The internal bleeding causes your breasts or one of your breasts to increase dramatically in size, looking dramatically different from the other breast. To avoid internal bleeding you have to avoid physical effort, smoking (primary and secondary), alcoholic beverages, aspirin or any medication containing aspirin, and sun exposure, during at least two-four weeks preferably before and after surgery
Please consider that each side of our bodies in different from the other. As a result, the size of the breasts after surgery is always different. One will always be larger than the other, or higher than the other. It is very important to realize that after surgery, the affected areas will swell dramatically, one side more than the other; this is uncontrollable and unpredictable. If liposuction is done in an area of the breast around the collar bone, swelling will be exaggerated there.
Remember that swelling reduces with time. Normal sensations for the areola and nipples will be recovered between six to twelve months after surgery.
Bruising usually last for 3 to 4 weeks if Liposuction procedure was done.
In case that one breast is noticeably larger than the other, this will be corrected with a simple liposuction under local anesthesia as an out-patient basis. Normally if this procedure is required, it is recommended to do it one year after surgery.
The results of these procedures are significant and permanent. Most men who have had surgery for gynecomastia have been very satisfied with the results. Patients do not complain of any significant post operative pain. However, they report feeling a stinging and a pinching sensation when exposed to cold weather conditions. Post surgical garments with slight pressure on the breast are recommended to ease such uncomfortable feelings. It is also recommended to use heavier clothing than normal to avoid catching a cold.
Stress and anxiety after surgery
Do not bend over, not make impulsive movements with your arms
Avoid alcohol, smoking or being around smokers, exercising, aspirin or any product containing aspirin, and Vitamin E for one month after the surgery.
Avoid visiting the sauna, sun exposure, and showering or bathing with hot water for one month after the surgery.
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