Name of the Procedure:

Mastectomy for Gynecomastia

Summary

A mastectomy for gynecomastia is a surgical procedure aimed at removing excess breast tissue in males who have developed enlarged breasts. This is typically achieved through a combination of liposuction and direct excision of glandular tissue.

Purpose

The procedure addresses gynecomastia, a condition characterized by the abnormal enlargement of breast tissue in males. The goal is to restore a more typical male chest contour, reduce discomfort, and improve psychological well-being.

Indications

• Persistent breast enlargement despite weight loss or medication adjustments
• Pain or tenderness in the breast area
• Psychological distress or self-consciousness due to breast size
• Gynecomastia persisting for over a year and not reversed by other treatments

Preparation

• Pre-operative consultation including medical history and physical examination
• Blood tests and possibly a mammogram or ultrasound to rule out other breast conditions
• Fasting for 8 hours prior to surgery
• Adjustments to medications as advised by the doctor (e.g., stopping blood thinners)

Procedure Description

1. Anesthesia is administered (general or local with sedation).
2. Incisions are made around the areolar or in the natural creases of the chest.
3. Excess glandular tissue, fat, and skin are removed using a combination of scalpel and liposuction.
4. The incisions are closed with sutures, and dressings or a compression garment is applied.
5. The patient is monitored as the anesthesia wears off.

Duration

The procedure typically takes 1 to 2 hours, depending on the extent of tissue removal required.

Setting

The procedure is performed in a hospital or outpatient surgical center.

Personnel

• Surgeon (typically a plastic or general surgeon)
• Anesthesiologist or nurse anesthetist
• Surgical nurses and possibly a surgical technician

Risks and Complications

• Infection
• Bleeding or hematoma
• Scarring
• Asymmetry of the chest or nipple placement
• Changes in nipple sensation, temporary or permanent
• Anesthesia-related complications

Benefits

• Improved chest appearance
• Reduced physical discomfort
• Enhanced self-esteem and confidence
• Relief from psychological distress

Recovery

• Wear a compression garment for several weeks to minimize swelling and support healing tissues
• Avoid heavy lifting and strenuous activities for about 4-6 weeks
• Attend follow-up appointments to monitor healing
• Most patients return to work within 1-2 weeks, depending on their job

Alternatives

• Observation and delayed intervention, especially if the condition is recent and mild
• Medical therapy (e.g., hormone treatments) in selected cases
• Lifestyle modifications such as weight loss and exercise

Pros and Cons Comparison:

• Mastectomy: Definitive treatment with more immediate results, but surgical risks are involved.
• Medical Therapy: Non-invasive but may not be effective and could take longer to see results.
• Observation: No risks or costs but uncertainty about spontaneous resolution.

Patient Experience

During the procedure, the patient will be under anesthesia and should not feel pain. Post-operatively, mild to moderate pain is expected, which can be managed with prescribed medications. Some swelling and bruising are common, subsiding over a few weeks. Emotional well-being often improves as final results become apparent over the healing period.