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All you need to know about gynecomastia

What is a gynecomastia?

Gynecomastia can occur at any age.


It is a condition of overdeveloped or enlarged breasts in men as a result of hormonal changes, heredity, obesity, or the use of certain drugs, medications, and certain health conditions like hypogonadism.


The issue can cause emotional discomfort and lack of self-confidence, characterized by excess localized and glandular tissue development, and sometimes excess breast skin. Some men may even restrain from exercising or intimacy.


Gynecomastia surgery, also known as male breast reduction, is an outpatient plastic surgery procedure that corrects unwanted glandular breast tissue and excess fat using a combination of surgical techniques and liposuction.

What are the signs and symptoms of gynecomastia?

Gynecomastia is typically symmetrical in a location with regard to the nipple and may have a rubbery or firm feel.


Tenderness and sensitivity may be present, although there is typically no severe pain.


Who is an ideal candidate for gynecomastia surgery?


According to a study by the Mayo Clinic, gynecomastia is prevalent in 50% to 60% of adolescent males, but the swelling may go away as you get older.


The same study also says that up to 70% of men aged 50 to 69 have some level of gynecomastia.


Ideal candidates for gynecomastia surgery include:


Body mass index of 19 and up to 30.

Enlarged glandular breast tissue not responsive to medical treatment or weight loss

Men in good overall health, with no medical conditions that may impair proper healing


Men with realistic expectations about the surgery

Men who are self-conscious about their enlarged breast.


What are the benefits of gynecomastia surgery?


Besides the emotional improvement, gynecomastia surgery carries the following health benefits:


Long-term results if you maintain a stable weight and a healthy diet

Pectoral contouring improvements

Safe and effective procedure with a very low risk


You’ll see a difference in your pecs right away, but it will take a few days after your surgery for the initial swelling to go down.


Your new look won’t be fully apparent until your breast tissue heals, which could take four to six weeks, according to Dr. Doherty.


How is gynecomastia surgery like?


Gynescomastia surgery takes one to three hours and is performed under general anesthesia, local anesthesia, combined with an oral or IV sedative.


A few small incisions are made either under your arms or around your nipples.


If you only need liposuction, your plastic surgeon will use a cannula to remove the extra fat, contour the chest, remove excess tissue and a gland if found underneath the areola.


After the excess breast tissue is removed, your plastic surgeon will close the incisions with stitches and places a surgical drain tubes to prevent fluid build-up as you heal.


Depending on the extent of your surgery and gynecomastia, your doctor may also need to reposition your nipple.


What can you expect after gynecomastia surgery?


You should expect to have dressings or bandages applied to your incisions, and a support garment to assist to reduce swelling and help proper healing.


Gynecomastia surgery takes less than a week of downtime from work. Your doctor may prescribe pain medication for the first week.


A small, thin tube may be temporarily placed under the skin to drain any excess blood or fluid that may collect.

What should I expect during my gynecomastia surgery recovery?


You should expect to restrain from any strenuous activity for at least two weeks and wear a compression garment to help your tissue heal and reduce swelling.


Expect instructions about proper care of the surgical site and drains, medications to aid healing and reduce the potential for infection, specific concerns to look for at the surgical site or in your general health, and when to follow up with your plastic surgeon.


About five days after surgery, the stitches will dissolve or removed by your doctor, along with the surgical drains.


Complications from surgery are rare. Make sure to follow your plastic surgeon’s instructions for a successful surgery.


Are gynecomastia surgery results permanent?


Gynecomastia surgery results are permanent if you maintain a stable weight and exercise the pectoral muscles.


You will notice a substantial difference of your pecs size right after surgery, which are more noticeable as the swelling goes down.


It may take between three to six months for the final results to show up. Incision lines usually fade over time depending on your skin type.


According to a study published in the World Journal of Plastic Surgery, on a scale of 1 to 10, the majority of patients rated their satisfaction with a score of nine, while the mean satisfaction score among physicians who performed the surgery was 8.36.

Who is an ideal candidate for breast reduction?

Overly large breasts cause health and emotional issues, back pain, and discomfort.


An ideal candidate for a breast reduction surgery meets the majority of the following criteria:


  • Overall good healthy

  • Self-conscious about the size of your breast

  • Your breast limits your outdoor activities

  • Have realistic expectations

  • You experience back, neck and shoulder pain that requires pain medications

  • You have skin irritation under the breast crease and shoulder indentations from the bra straps

  • Difficulty fitting into bras and clothing


Breast reduction surgery generally isn't recommended if you:


  • Are a smoker

  • Have certain conditions such as diabetes or heart problems

  • Are morbidly obese or plan to lose a substantial amount of weight

What are the risks of breast reduction surgery?

The following risks are associated, but not limited, with breast reduction:


  • Bleeding

  • Bruising, usually temporary

  • Infection

  • Adverse reaction to the anesthesia.

  • Scarring

  • Removal of or loss of sensation in the nipples and the aureola, which may be temporary or permanent

  • Breast-feeding issues

  • Blood clots

  • Slow healing

  • Breast contour and shape asymmetry

  • Allergies to tape, suture materials, and glues, blood products, topical preparations or injectable agents

  • Possibility of revisional surgery


While a breast reduction procedure can be performed at any age, it is best done when your breasts are fully developed.

How is the breast reduction surgery process 

Before breast reduction surgery, patients are encouraged to stop taking over-the-counter anti-inflammatory medications, such as aspirin and ibuprofen, as these can increase bleeding.


Also, smoking should be stopped several weeks before the procedure as it increases the risk of the nipple or areolar damage, tissue necrosis, and other complications.


Breast reduction surgery is usually done under general anesthesia, either in a hospital or outpatient surgical facility.




Your plastic surgeon will make an incision around the areola and down each breast.




Then, he will remove excess breast tissue, fat and skin to reduce the size of each breast.




Following fat and tissue removal, your plastic surgeon will reshape the breast and repositions the nipple and areola, which usually remain attached to the breast though there is a possibility of removal and reattachment at a higher position.




The surgeon will close the remaining skin with sutures and surgical tape. Also, the breast is wrapped in gauze bandages. The insertion of small tubes into the breasts is a must to drain excess fluid and reduce swelling after the operation.

What should I expect right after breast reduction surgery?

Patients are prescribed pain medication and antibiotics, to decrease swelling and the risk of infection, respectively.


Expect your breast to feel tender, sensitive, and bruised.


A follow-up visit is needed to remove stitches and check recovery.

What should I expect in a breast reduction recovery?

Expect to feel tired and to have breast pain. Some patients experience an emotional reaction, such as feeling depressed.

Your recovery needs a minimum of two weeks off from work. While you recover, you'll need to stop physical activity for at least one month after surgery.

The recovery time depends on your natural healing rate, the extent of the surgery, and your self-care.

Expect a limited range of motion of your arms. Asking for help to get dressed or shower is encouraged.

You may resume exercising after a minimum of four weeks. Walking is beneficial for proper healing.

Make sure you follow your cosmetic surgeon’s guidelines regarding work, physical activity, breast care, and medications.

What results should I expect after a breast reduction?

Breast reduction surgery is one of the most rewarding cosmetic surgery procedures. A successful procedure can relieve pain and increase your overall health.


You can expect smaller, lighter breasts for a lifetime as long as you maintain a stable weight and do not have any more children.


It may take anywhere from six months to a year for the final results to show up.

Is breast reduction covered by insurance?

If your breast size carries other health-related issues like severe back pain, some insurance companies may cover part or all of the cost of a breast reduction surgery.


Your surgeon can help you gather the necessary information and measurements to send to the insurance company before surgery.

How much breast reduction cost?

In the Dominican Republic, breast reduction surgery costs range between 4,400 and 4,700 dollars for an all-inclusive package that includes hospital and surgeon's fees, local transportation, recovery house, basic medication, and lab test. 

Air fare, insurance,and compression garment is not included in this cost. 

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