GSC surgery
GSC during surgery

Gynecomastia Surgery

If after the consultation with his surgeon the patient decides that surgery will meet his goals, a date is selected for the procedure and a deposit is paid. The anaesthetist and surgical nurses are reserved for that day, and a compression garment is ordered based on the measurements taken during the consultation. Also ordered are all the single-use medical supplies and medications needed for the procedure, as well as for post-operative care.

Then, the surgeon orders some blood tests for the patient to check for anaemia, infection, or any blood clotting problems, to ensure that surgery can be performed safely. A skin swab is also taken to check for the presence of any drug resistant microbes.

Gynecomastia is a minor surgical procedure, typically performed under local anaesthesia, and on the day of the operation, the patient can have a light breakfast early in the morning before coming to the clinic. The surgery itself requires a few of hours, and after, before returning home, the patient will spend another few hours in the clinic to recover while being monitored by the surgical team.

Alternatively, if the patient wishes, or the surgeon deems advisable, the surgery is performed using IV sedation. Under these conditions, the procedure is performed in hospital. Patients must abstain from eating or drinking after midnight on the day prior to surgery.

Our Surgery Process

Liposuction

The procedure begins with a liposuction for the removal of fat. A small incision is made in the skin, and anaesthetic solution is used to infiltrate the fat layer between the skin and muscle in the treatment area. Once numb, a fine metal tube is passed into the layer, and fat is aspirated under suction. The tip of the tube vibrates at ultrasonic frequencies, and this adds in dislodging and removing the fat. The time required will depend on the volume of fat to be removed, as will have been estimated during the consultation.

Excision of Glandular Tissue

Once the fat has been aspirated, the mound of glandular tissue is better defined under the skin. The surgeon will remove most of this tissue, however, will leave a small amount to support the nipple and preventing it from becoming inverted. The excision is made through a small incision made along the lower border of the areola. Once removed, the glandular tissue core for each side is preserved, and subsequently sent for histological testing, to ensure no presence of cellular malignancy.

Removal of Excess Skin

Men with significant amounts of glandular tissue and chest fat cannot expect that their skin elasticity will be sufficient to fully and smoothly retract over the now smaller volume of the chest. In these cases, some skin excision will be needed to prevent sagging and folds. This is done by removing a crescent shaped flap of skin above each areola. The sides are then drawn together with a special type of suture. If needed, excess skin on the sides of chest are managed by excising another crescent of skin at the sides of the chest under the armpits. The removal of excess skin does give rise to more noticeable post-operative scarring.

Nipple Repositioning and Areola Size Reduction

Severe cases of gynecomastia will typically require an upward repositioning of the nipples and areola. This is done after excess skin excision. In some cases, where the areola have been stretched, their size is reduced. If the surgical plan requires removal of excess skin or nipple repositioning it would have been discussed in depth, and agreed with the patient during the consultation.

Patient Monitoring and Discharge Home

After surgery, the nurses apply dressings to the wounds, and put the compression garment on the patient. The patient is monitored for a about an hour, but can be longer for cases performed under IV sedation. Once the patient has sufficiently recovered, he may return home, but must be accompanied by a relative or friend. The patient should not use public transport, but can order a taxi if a personal vehicle is not available. Before leaving, the patient is provided with pain-killers, antibiotics, spare dressings, and a written recap of post-operative care instructions.

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