Excessively large male breasts, known as gynecomastia, can produce a feeling of self-consciousness about body image that can inhibit lifestyle choices and daily activities. In most cases, the glandular and fatty tissue enlargement of the male breasts begins during puberty. It is usually a benign condition, but can be associated with hormonal abnormalities that may need additional evaluation.
Gynecomastia procedures improve the problem of excess breast size by:
Most patients experience a dramatic improvement in their appearance soon after gynecomastia surgery. They can often participate in many activities that they were either unable or unwilling to do before the procedure and feel more comfortable in clothing.
Is This For Me?
Consultation
Preparation
The Procedure
What to Expect After Your Procedure
The Stages of Recovery
Potential Risks and Complications
During your consultation, Dr. Forley will ask about your medical history and any hormonal conditions that may be affecting you. After an examination of your chest, the options for reducing the size of your breasts will be discussed. The indications for liposuction alone versus an open procedure, via an incision at the lower edge of your areola to remove glandular tissue, will be reviewed. He will show you before and after photos so that you can get a realistic idea of what can be achieved with gynecomastia surgery.
An appointment for your pre-operative visit will be scheduled 2 weeks prior to your surgery date. Instructions for you to follow before and after surgery will be discussed. The procedure will be reviewed in detail and you will have an opportunity to ask any questions. Routine blood tests will be obtained in preparation for your surgery and if indicated, an evaluation by an endocrinologist will be requested. A program of vitamins and supplements to optimize your healing and recovery will be provided to you. Photographs will be taken and kept strictly confidential.
In some cases, liposuction alone may be sufficient to improve the prominence of the breasts. In patients where there is a significant glandular component to the breasts, an open procedure may be indicated. Prior to your surgery, Dr. Forley will make several measurements and mark specific areas of your chest. During the procedure, specially designed liposuction instrumentation is used to enable the removal of the fibrous-fatty tissue that is a major component of the enlarged male breast. The amount and location of removal depends on its distribution on the chest. Dr. Forley will spend time achieving the best symmetry and contour possible when removing this tissue. In some cases, excess glandular breast tissue is removed using an incision at the lower edge of the areola border. These incisions produce scars but, in most cases, the scars are minimally apparent over time. Nerve sensation of the skin and nipple may be temporarily decreased during your recovery but some permanent loss of sensation is possible following the surgery.
The skin will usually retract following the surgery. In rare cases, additional skin resection may be necessary or a radiofrequency energy device may be used to stimulate tightening of skin laxity.
A drain may be placed to remove any oozing of blood immediately after surgery. This will be removed within a few days following which you will be able to shower. You will need to wear a compression vest for about 3-4 weeks after surgery.
All of your incisions will be carefully closed with stitches placed beneath the skin so that they do not have to be removed—they simply dissolve.
Following gynecomastia procedures, most patients have very little pain, but rather experience nuisances such as tightness or fullness. You may have a moderate feeling of soreness for which we’ll prescribe medication. Most patients require medication for only 2-3 days. You may develop some bruising on the chest that will resolve in about a week.
We encourage a return to full normal activity very rapidly. Just don’t do any type of strenuous exercise that would push your pulse over 100 for about two to three weeks. Any aerobic activity that increases your pulse over 100 could also increase your blood pressure and make you bleed.
Limitations and risks associated with gynecomastia are few. Other risks common to all surgical procedures such as bleeding, infection, thickened scar tissue formation, and blood clots occur in a very small percentage of cases. We will give you more detailed information about these and other rare risks in our written information and encourage you to discuss any which concern you during your consultation.
Meet Dr. Forley’s patients and hear about their experiences.
In most cases, incisions are placed at the lower edge of the areola. Since this is a point of color transition to the surrounding skin, the scar usually blends well and will be minimally apparent over time.
Skin rarely needs to be excised with gynecomastia surgery. It will usually contract on its own following the procedure. In some cases, the BodyTite subdermal radiofrequency device can be used to stimulate additional skin contraction should it be necessary.
Liposuction alone can be used to reduce the male breast when the primary contributor to the contour prominence is fat. If fibrous glandular tissue predominates, an open procedure is needed to achieve the best result.
Although most cases of gynecomastia are isolated to the male breast, there are hormone conditions that may be associated with enlargement of the breast. If Dr. Forley suspects a systemic problem, he will refer you to an endocrinologist for further evaluation prior to performing any surgical treatment.
The surgery is performed under a twilight sedation type of anesthesia in the Joint Commission accredited operating facility in the office. Any discomfort immediately after the procedure improves rapidly and the recovery period is well tolerated by most patients. A compression vest is used for 3-4 weeks to reduce swelling and support the healing process.
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UK-based Tatler discussed Dr. Forley in its 2008 Beauty and Cosmetic Surgery Guide as one of the "A-list of cosmetic surgeons"..."who are at the top of their game"...and whose "innovations are shaping the art of cosmetic surgery around the world." It was noted that Dr. Forley’s "discreet Upper East Side clinic is perfect for women and men in search of minimally invasive natural-looking surgery.
Julia Reed writes that Dr. Forley, "disarms me by asking what I might like to have done. Nothing, I say, sure that I mean it. And then he shows me before and after books of tiny little neck lifts, subtle browlifts involving tiny little incisions well hidden within the hairline. In ten years, he assures me, I’ll be thinking about it. I actually like him. And I fear he may be right."
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