Gynecomastia is the medical term for large breasts in men which take on a female appearance. There are many different sizes and variations to gynecomastia. It may be worth looking at our before and after photography section in this website as some breasts are pendulous while others are very large and round. Some can be small and pointy. Sometimes the gynecomastia is just from fat which lends itself to liposculpture treatment. Other times, the gynecomastia is due to actual breast tissue which is fibrous, white, and hard. The size of the fibrous tissue can vary from a small marble to almost a handful. When this tissue is present, an excision of the tissue is also required. In some cases the gynecomastia also involves a large amount of fat on the sides of the breast. This is worth treating at the same time.
There is a strong genetic tendency with gynecomastia. Often we see it running in families. The procedure starts with the assessment. Firstly, I will take photographs so that we can have good records. I will then mark the areas of fat, paying particular attention to where the most prominent amount of tissue needs to be removed. Different concentric circles are drawn which will aid in the understanding of what needs to be removed during the procedure. The procedure can be done under local anesthetic or general anesthetic. When the gynecomastia surgery is done under local anesthetic patients will feel a small sting as the local anesthetic is infiltrated into the breast tissue. This takes about 5 or 10 minutes. After the initial sting, the breast becomes numb. Often we will wait 30 – 90 minutes to help the anesthetic work. The anesthetic also contains adrenaline. The adrenaline causes closure of blood vessels. It is for this reason that after 15,000 liposculptures Dr. Lanzer has not had to give a blood transfusion on any occasion. This breakthrough method was described by dermatologist, Dr. Jeffry Klein, in America.
Once the breast is tight, firm, and numb then Dr. Lanzer will commence the suction process. There are usually 2 small keyhole incisions around the breast. Dr. Lanzer attaches a very powerful suction device to a cannula. Dr. Lanzer uses a specialised device called MicroAire. MicroAire is a vibrating cannula which allows him to pass easily between the fibrous tissues of a male breast. In some cases he will also use the Vaser ultrasound to help soften the fat and tissue as well. It is important that Dr. Lanzer removes the fat on multiple layers and levels so that all the fat is removed. This will enhance the skin contraction. Once the tunnels have been created, the skin will contract so that the skin collapses down and tightens down to the muscle.
A significant amount of tissue between the skin and the muscle is removed. If there is breast tissue present, then Dr. Lanzer will do a small incision under the nipple and remove the breast tissue. Sometimes, the breast tissue will be really small and just be a pebble under the nipple and other times it can be as large as almost a tennis ball. It has a white thickened appearance. This breast tissue sometimes occurs for no reason other than genetics. Other times, it can be caused by hormones and drugs. Once the tissue has been removed, Dr. Lanzer will put some stitches along the edge of the nipple to close the area where he removed the tissue from. No stitches are placed on the actual liposculpture incision. Padding is applied onto the breast and a compression garment is worn. This will reduce the amount of bruising and swelling. Ice is sometimes beneficial in the recovery period. Dr. Lanzer always gives pre-operative antibiotics. He usually starts a cephalosporin derivative the night before orally and gives an intramuscular injection just before surgery. Infection is extremely rare, but it is still worthwhile taking prophylaxis prevention antibiotics. Dr. Lanzer also recommends anti-septic washes to be applied the night before surgery. Pain is not a major issue with gynecomastia surgery. Basic panadeine tablets are prescribed following the surgery.
Dr. Lanzer’s experience is that this procedure brings a lot of happiness to men. The small change can really change people’s lives and it is quite a satisfactory procedure both for the patient and the doctor.
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Surgical Warning: Every form of surgery has a possibility of a complication and these are given to you in detail by Dr Lanzer. It is a good idea to understand your surgical procedure well, and to obtain further advice from another Specialist Cosmetic surgeon such as a Dermatologist like Dr Lanzer.
All photographs represent one person’s experience, and results may vary for each patient. All photographs are of actual patients of Dr Lanzer. The visible change in these photographs has occurred as a result of the procedure/s undertaken.