Gynecomastia is the condition of enlarged breasts in men. It can happen to men at any age and can cause a decrease in self confidence and avoidance of physical activities to hide their condition. The good news is that this problem is easy to fix. Gynecomastia can result from hormonal changes, certain diseases, or drugs. It can also occur in healthy normal men because of heredity. First, it is important to make sure that any drugs or diseases that may cause gynecomastia are treated. If no causes are found then surgery may be the answer to correct the gynecomastia permanently.
An initial consultation is set-up where we will discuss the gynecomastia correction procedure and whether you are a good candidate for the surgery. Your medical history is reviewed, and you will be asked to see your medical doctor for a physical check-up and a few labs to make sure you can undergo the surgery safely. Your doctor will review your medications and determine whether gynecomastia is caused by drugs or a medical condition. You are asked to stop medications that cause bleeding, such as aspirin, or aspirin-like products (Motrin or Ibuprofen), a week before this procedure. You are asked to stop smoking two weeks before and two weeks after surgery, for the surgery to be performed safely, and for you to have optimal results. You are given the opportunity to talk to patients who have had the same surgery you are considering. We will see you shortly after the surgery (in a day or two usually). You are seen regularly after your surgery. You are always welcome to come back for follow-up, even years after your surgery, free of charge.
The breasts of a man are similar to that of a woman in that they have both hard breast tissue and fat. In gynecomastia there may be an excess of both breast tissue and fat. The operation will depend on the severity of the gynecomastia:
At the Bitar Cosmetic Surgery Institute, we take pride in making sure we provide for our patients the best surgical experience possible, anticipating problems or set-backs, and addressing them before they happen. This is a process that includes the pre-operative preparation, the actual surgery, and the after care.
General complications can occur with any surgery. Cosmetic surgery is usually a safe surgery performed on healthy patients and, as all surgeries go, is with low risk. What we do to even lower the risk of complications is to operate at a first class surgery center with board certified anesthesiologists and nurses. To avoid post-operative complications, we advocate early mobilization –patients seen in our office one or two days after surgery- and active participation in their own post-operative care. When we create a partnership, the results invariably improve.
Bleeding after a gynecomastia correction is rare. Before surgery, our patients are tested to make sure they don’t have any common bleeding disorders by their own physicians, and by lab tests. In our practice, the rate of significant bleeding is less than 1%. Very rarely, we will put drainage tubes in the breasts if we feel there will be some bleeding after the surgery. The blood will be drained into a plastic bulb that the patient can empty. Those drains are removed in the days after surgery.
The most important step in avoiding infections, in our opinion, is to perform the surgery at a first-rate surgical facility with board certified anesthesiologists and nurses. Patients are given the appropriate intravenous antibiotics coverage throughout the surgery. During the surgery, the skin surface of the patient is cleaned properly. After the procedure, our patients are prescribed antibiotics to minimize infection. As a result of these extra precautions, our rate of infection after a gynecomastia correction is extremely rare.
In a gynecomastia correction, the incision is usually at the bottom pole of the areola and heals very nicely. We have not had any open wounds in our gynecomastia patients.
Loss of Nipple Sensation or nipple / Areolar skin
Loss of nipple sensation is a potential complication that may be due to the removal of breast tissue and fat from behind the nipple. Temporary loss of sensation from a “stunned” nerve or a bruised nerve may occur in the time period after surgery, but sensation in the vast majority of cases returns within a few weeks. Loss of nipple or areolar skin has not been a problem.
All of the skin, fat, and breast tissue that is removed during gynecomastia correction is measured. If the breasts appear similar before surgery, then equal amounts of fat and breast tissue are removed from each breast. If the breasts are not symmetrical, then more breast and fat tissue is removed from the bigger breast to achieve symmetry.
Smoking is an absolute contraindication in gynecomastia correction. The carbon monoxide and nicotine in cigarette smoke causes severe reduction in blood supply to the skin during healing. This results in delayed wound healing, wound separation, death of the skin or nipple, and a higher risk of infection. Cotinine testing is performed in patients with a smoking history to ensure that they are safe when having this procedure.
Our office will provide a comprehensive post-operative plan to ensure the best possible outcome. The plan will include what to expect postoperatively, such as estimated recovery time, pain management, garments or dressings, and anticipated activity level. For your safety, we require that an adult stay with you at least the first 24 hours after surgery and drives you to your next day follow-up visit. With most procedures, you will be instructed to limit activity for the first week or two, which could include restrictions on driving, prolonged travel and flying. In addition, we ask you refrain from exercise until cleared by the physician, usually around four weeks post-op. You are asked to refrain from smoking for a minimum of two weeks. To optimize healing, we recommend that you eat a high protein diet. You should anticipate a variable degree of bruising and swelling, as with any surgical procedure; light make-up may be used to cover bruises starting a week after surgery. We also offer scar creams at an additional cost to optimize results.
To promote healing and minimize complications, you will be seen in a series of post-op appointments, including the day after surgery. These appointments will continue throughout the first year after the procedure to make sure you are healing as planned. For your added convenience, you also have direct access to Dr. Bitar’s cell phone number if you need to reach him after hours. The final post-op visit, one year after surgery, is one of our favorites since the results are fully apparent and we love seeing our patients happy. You are always welcome to come back and see us, even years after your surgery.
At the Bitar Cosmetic Surgery Institute, we take pride in providing our patients with the best surgical experience possible, emphasizing patient safety while trying to optimize surgical results. This is a process that includes comprehensive pre-operative preparation and patient education, the development of a personalized operative plan, and a thoughtful post operative care regimen emphasizing patient comfort and promoting recovery.
There are a number of strategies which the Institute has adapted to further ensure patient safety. We are selective and only offer surgery to patients whose general health and lifestyle choices permit healing and facilitate recovery. To minimize risk, we require a preoperative assessment that includes a thoughtful history and physical exam, as well as targeted laboratory tests.
We operate at accredited hospitals and surgicenters that have demonstrated a commitment to the highest standards of care, employing board certified anesthesiologists and nurses. We adhere to well established surgical principles designed to ensure patient safety and have developed policies and protocols to minimize the risk of infection. Dr. Bitar is committed to continuing education, honing his skills and introducing new techniques always with the aim of improving safety and surgical results.
We emphasize patient safety in our peri-operative care plan, advocating early mobilization, optimizing nutrition, and providing detailed care instructions. After surgery, patients are seen in our office frequently and early, starting the day after their procedure, and a staff member is available around the clock for any questions or concerns. Our entire team is committed to our patients’ well being and every measure is designed to minimize potential complications, promote comfortable and rapid recovery, and optimize surgical results.
Our commitment to excellence and exceptional patient care is in every step of your doctor-patient experience. Dr. George Bitar is a distinguished board certified plastic surgeon who stays on the cutting edge of advancements in cosmetic surgery and technology to offer the best possible results. With a blend of artistry and meticulous surgical technique, he is able to achieve beautiful and natural results for our patients. We provide a high level of patient safety and our experienced and caring staff will be with you every step of the way. Our institute offers a wide variety of surgical and non-surgical options, from skin care, injectables and lasers to in-office or hospital options, to provide a versatile approach to fit individual patient needs. Your aesthetic goals are our priority and each procedure is customized to ensure you receive the best possible outcome.
For more information, call our office at 703-206-0506.
Content on this website is for information only and should not be used to diagnose or treat your plastic surgery or cosmetic surgery problems. Please contact your plastic surgeon with all questions and concerns.
If you would like further information regarding this procedure, please feel free to contact our office to schedule an appointment by calling (703) 206-0506 or filling out an online request form.