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Gynecomastia Washington DC

Gynecomastia (Male Breast Reduction) Washington DC

Gynecomastia is caused by an increase in glandular tissue and/or fat in the male breast. This often occurs at times of hormonal changes, such as adolescence and increasing age, and with fluctuations in weight. It can be present in up to 2/3 of adolescent boys, and resolves spontaneously in the majority of these cases. It may be asymmetric or even occur on just one side. Most of the time, there is no underlying cause for the gynecomastia. However, one should be aware that it can also be caused by drugs such as steroids or marijuana, testicular or pituitary tumors, or other systemic diseases.

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Male Breast Reduction Surgery

The procedure is performed on an outpatient basis typically with general anesthesia. There are a number of approaches to the treatment of gynecomastia, depending upon the relative amounts of glandular tissue and fat. If there is a small amount of glandular tissue alone under the nipple/areolar complex, this can be excised through a small incision on the periphery of the areola. If there is both excess fatty tissue and breast tissue, this may be treated by initially using liposuction to remove the fatty component. The patient is then reassessed, and if there is a significant amount of remaining glandular tissue, this is then directly excised at the same procedure. If an excision is performed, a temporary drain may be placed to prevent fluid accumulation.

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A newer technique is VASER ultrasonic liposuction, which allows for better removal of both the glandular and fatty components through small incisions on the chest as well as better skin tightening. In more severe cases, direct excision may still be needed. At the end of the case, the patient is placed in a dressing consisting of gauze padding and ace bandages wrapped circumferentially like a tube top.

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Recovery from Male Breast Reduction Surgery

For the initial 24 hours after surgery, it is normal for there to be drainage staining the dressing on the outside. The patient is seen a few days following surgery for dressing removal (and drain removal, if applicable) and placed in a compression garment. This should be worn for 24 hours a day except for showering for the first 2 weeks, then only during the day for an additional 2 weeks. The patient is asked to limit the use of his arms, keeping his elbows by his side for a period of 2 weeks from the day of surgery. At that time, he will gradually start resuming his normal level of activity with the expectation that he will be back to normal at approximately 3-4 weeks.  The patient may resume weightlifting and contact sports at 1 month.

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Male Breast Reduction Risks and Complications

Risks and complications are uncommon, but may occur. They include, but are not limited to: infection, bleeding, scars, sensory changes of the nipple and surrounding skin (increased, decreased or lost), actual loss of the skin or nipple (very rare), persistent asymmetry, and need for revision in the future. On occasion, fluid may accumulate beneath the skin, which is called a seroma. If this occurs, the fluid can be withdrawn by needle aspiration in the office.

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