Gynecomastia is a medical that describes excessive breast development in men. The condition is estimated to occur in approximately 40% of males. Many boys experience gynecomastia during puberty. In most case this condition resolves spontaneously as the child grows. In certain cases, the breast tissue persists causing emotional discomfort. In other patients, the breast development can be secondary to medications or hormone use. The continuation of these medications should be considered prior to undergoing surgery. Excessive breast enlargement can be a source of embarrassment and discomfort. Surgery should be performed in individuals who are close to their ideal weight. Excessive obesity is usually a contraindication to surgery. Excessive laxity of the skin may preclude a good cosmetic result from this operation. A thorough evaluation of all these factors will be done during your consultation with Dr. Bromley. In addition, a complete medical history and physical exam will be done. As in any procedure, there are some risks and complications associated with the operation. Excessive bleeding and infection can occur. Some asymmetry of the breasts may result-- in some cases revisional surgery may be required. The temporary effects of breast reduction may include partial loss of breast sensation or numbness, which may last up to a year. The procedure is usually done as an outpatient procedure. General anesthesia may be used, or some patients have a local anesthetic with sedation. The procedure usually takes approximately one to two hours. At surgery, an incision may be made at the bottom crease of the breast or around the areola. Through this incision the excess breast tissue is removed. This removal can be performed by direct scalpel excision, liposuction or a combination of the two. The incision is then closed with absorbable suture and a compressive dressing is applied. The dressing is important to minimize any blood or fluid accumulation beneath the breast skin. Some bruising of the skin is common after surgery. This bruising usually resolves in two to four weeks. The discomfort after the surgery should be easily controlled with oral pain medication. Most patient resume light activities several days after surgery. By the end of the first week, usual daily activities can be resumed. Strenuous work and exercise can usually be resumed approximately three to six weeks after surgery. The surgical scars may appear prominent at first, but they gradually fade with time. There will be some firmness to the breast initially. As time progresses the breasts will soften and this swelling will resolve. The "final" appearance will not be achieved until approximately one year from the time of surgery.
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