1. Do men have breasts?
This is an interesting question. Usually people think that only women have breasts, but in fact, men also have them, but they include nipples, areolas and breast tissue that do not develop significantly. Men also have a very small amount of breast tissue, close to the deep side of the nipple and areola, which under normal circumstances is not visible on the outside.
2. How do I know if I have gynecomastia?
If a person only knows what his own breasts look like, then he certainly cannot tell if he has a problem with them. So a comparison with other normal people will allow one to initially determine if gynecomastia is present. The characteristic expression is a significantly larger chest. I’ll tell you an easy way to do it: cross your arms and push down, use your other hand to feel your chest when the pectoralis major muscle is contracted and tightened, if there is a more obvious protruding soft tissue that can move, then it is likely to be breast development.
3.Why am I so unlucky to have gynecomastia?
This question can be asked in depth by all the doctors and scientists in the world, including the top doctors and scientists who have won the Nobel Prize in medicine. However, many medical scientists have done a lot of research and found that gynecomastia may be related to abnormal sex hormone levels in the body, the effects of drugs, environmental factors, and so on. The results of these studies may be able to explain some of the causes of gynecomastia patients, but not all of them, for the simple reason that: the same drug, the same abnormal hormone levels, why some people’s breasts developed, while others do not develop? So, unless you aspire to be a medical scientist to overcome this scientific problem, you don’t have to worry so much about it. Anyway, the effects of this disease are very limited, and the treatment should be more effective and safe than appendectomy, which will be talked about later.
4. I found out that my own or my child’s breasts are bigger than other people’s. What should I do?
If you are a parent and you find that your child’s breasts are larger than normal, don’t worry about it because it happens to 30-50% of boys during puberty and 50-60% of them will subside naturally after 1-2 years, so the best way is to wait patiently and tell your child that it is normal to avoid excessive psychological burden. However, it is also important to carefully observe the development of other parts of the child, such as the laryngeal nodes and external genitalia, to see if there are any problems. If you are not sure, it is best to take your child to a pediatrician.
If you are the patient, I assume that you are an adult when you read this article, and the breast development does not subside within 1-2 years as I said earlier, then I suggest you first go to the endocrinology department to check the sex hormone level in your body. If it is normal, then you can breathe a sigh of relief, have a cup of tea and think about whether this “extra piece of meat” has an impact on your quality of life and use your imagination: social activities, swimming, fitness, sex life …… In fact, if you often think about the disease to dwell on this problem, then it means that it has an impact on your life, long pain is better than short pain, resolve to do surgery.
5.Can gynecomastia be treated through non-surgical treatment? Including drugs, fitness, etc.
For gynecomastia that has existed for years, there are no specific drugs that can make the breast tissue shrink or even disappear. Physical exercise can only reduce the fatty tissue in the breast, but it is not effective for breast tissue. For gynecomastia due to endocrine disease, medication is aimed at the cause of the endocrine disease, not the development of the breast. Therefore, for most patients, surgery is the only solution.
6, how is minimally invasive gynecomastia plastic surgery done? Where is the incision? How is it different from the traditional surgical approach?
In the clinic, I saw many patients who had surgery in other hospitals using traditional methods (not plastic surgeons), and the surgical incisions were very long and obvious, some on the outside of the chest, and some at the junction of the chest and abdomen, and the area where the breast tissue was removed was sunken into a crater shape.
Our minimally invasive approach only leaves a 3-100px curved incision in the lower semicircle of the areola and a 3-4mm needle eye in the lateral chest, which is the smallest incision that can be made. The advantages of this method are minimal incision scarring, minimal surgical bleeding, fast post-operative recovery, high morphological satisfaction, and the ability to effectively remove glands while also restoring breast flatness through liposuction. This surgical technique is not new, but it is the patent of plastic surgeons. It is currently used in the United States and Europe, and our center has been doing it for more than 10 years and is very mature. Please see my other article for a detailed description.
7, am I suitable for surgery?
This question needs to be answered on three levels.
(1) whether your condition has reached the point of needing surgical treatment: go see a genuine plastic surgeon, let him / her help you to do a detailed examination and assessment, also just 5 minutes, this problem is naturally solved. Don’t think this is easy, know that this 5 minutes is required to read N years, get a bachelor’s, master’s, doctoral, or even post-doctoral certificate, and also to conduct N years of surgery, plastic surgery rotation study, after which you can do it, believe it or not you can also try it.
(2) Do you feel that the breast problem must be solved?
Excluding other physical diseases, simple breast development is not particularly harmful to health (I will mention the problem of male breast cancer later), but in most cases it is mainly a morphological and psychological problem. You will often see men with very obvious breast development in gyms and at the beach, especially when they walk with their breasts bobbing up and down, making many women envious, but they also look very confident, swimming, sunbathing, running and everything else, so such men do not need to consider treatment. There are also some men who actually do not have large breasts, but they are afraid to be seen by others, and even walk on the road always feel that others are looking at him, afraid to swim, go to the gym, very low self-esteem, walking hunchback bending. If you are in this situation, you should have the surgery sooner.
(3) Do you have a reasonable expectation of the surgical result? Do you understand the risks of surgery and post-operative precautions and are you able to follow medical advice?
Although the current plastic surgery technology is very mature and advanced, doctors are not gods and surgery is not a magic trick, so the result after surgery is never what you want it to be. A responsible and qualified doctor will never say “guaranteed”, “sure”, “perfect”, “100%” and so on. “It is not because of legal responsibility, but because he/she has a respect for life and health, and is aware of the complexity of the human body and diseases, as well as the limitations of modern medicine. I believe that the majority of doctors treat every patient seriously and responsibly, hoping for a speedy recovery without the slightest complication. However, there is no doctor in the world who can perform 100% of the procedures without problems and 100% of the patients are satisfied. Why? For example, scarring of the incision after surgery is a concern for all plastic surgery patients. But who can accurately predict what your incision scar will look like? I use the same sutures and the same stitches, why do some people’s scars recover almost imperceptibly while others are very visible? Most likely, it has to do with the “constitution” of each patient, but what is the “constitution”? Which gene, which protein, which signaling pathway …… What is the problem? I’m sorry, but no one in the world can answer this question. So, be patient and listen to your doctor as he or she tells you all the risks and issues to be aware of, all of which have certainly occurred in the history of tens of thousands, hundreds of thousands, and millions of cases where this procedure has been performed, but with varying degrees of probability. Chance of occurrence is a statistical term, and there are only two possibilities for an individual: occurrence and non-occurrence. Therefore, carefully consider whether you fully understand and are mentally and physically capable of coping with the possible risks and make a mature decision.
8. How long will the surgery take? What kind of anesthesia? Does it hurt? Do I need a urinary catheter? Will I know I am having surgery? How long will I be awake after the surgery?
The procedure takes about 2 hours from the time of sterilization and preparation to the end of the procedure. The procedure is usually performed under IV sedation combined with local anesthesia. The nurse MM will put anesthetic in your IV and you will soon fall asleep and there is no pain. The doctor will then inject a large amount of local anesthetic into the area of the chest surgery. It is strange that many patients will ask about the urinary catheter, which is not needed for this surgery. You will be awake after the surgery, but usually you will sleep for another 2-3 hours.
9.What is the recovery cycle and precautions after the surgery?
Brushing your teeth, washing your face, taking a walk, surfing the internet, playing on your cell phone, reading a book, watching TV are all activities that you can do. For other special requirements, please see the following.
(1) Hospitalization for surgery.
Very mild gynecomastia can be performed under local anesthesia in an outpatient setting without hospitalization. You can come to the hospital 1-2 days after surgery to change the medication and have the drainage tube removed; in most cases, you need to be under inpatient intravenous sedation anesthesia and usually stay in the hospital for 2-3 days and be discharged when the drainage tube is removed.
(2) From the day of surgery to 1 month after surgery: avoid excessive activities of the upper limbs, including sports, holding heavy objects, sudden straining; wear elastic tights.
(3) From the day of surgery to 3 months after surgery: Avoid spicy food, alcohol and smoking, which can make the incision scar grow more obvious and unsightly. Of course, surgery is only a part of your life, and it is your personal decision to balance the conflict between scarring and lifestyle.
(4) The issue of compression garments.
The hospital provides temporary compression garments in the early post-operative period, but they are not very comfortable. My patients have bought many kinds of elastic tights in the past, some of them are not elastic enough, some are poor in comfort, I found one of them is very good, it can achieve the effect of elastic compression and good in comfort. There are multiple sellers online who can provide this kind of stretchy tights, and I am very serious: I have no interest in these sellers, and at no time will I provide the address and name of the seller (in fact, I have not bothered to check, nor do I want to), but I can provide example photos of the de-identified stretchy tights, which means that from the photos you can know what this kind of stretchy tights is like, but it is not written on it where it is sold. The rest of the work is for you to find it online. Of course, as long as you can achieve the effect of elasticity and compression, any kind of stretchy clothes can be. If you feel uncomfortable wearing stretchy clothes, you can wear a cotton tank top or short-sleeved, and then put on the stretchy clothes outside.
(5) Bathing.
You can take a shower 5-6 days after the surgery, please consult your surgeon for the specific practice. You can take a shower, do not sit in the bath, the water temperature should not be too hot, wash within 10 minutes, you can use soap, shampoo application, avoid rubbing the surgical area, dry with a hair dryer after washing, rest for 10-20 minutes and then put the elastic garment on.
(6) The problem of wound gauze.
The gauze can be removed 5-6 days after surgery, the incision is exposed to the air, if there is a small amount of oozing you can put gauze on again for 2-3 days.
(7) Post-operative nipple sensation.
The nipples will feel numb after surgery and some will have occasional pain, which are normal. The recovery of the nerves is the slowest and may take 6-12 months.
(8) Problems with fitness exercises.
Exercise can be resumed gradually and progressively after 1 month after surgery. It does not mean that you can play basketball immediately from the 30th day, but you can increase the strength and intensity little by little according to your own recovery situation. How long it takes to get back to normal is different for everyone, and only you know yourself best.
I highly recommend to post-op friends (this is you are no longer a sufferer because your problem is solved, congratulations!) Pay attention to fitness exercises, especially for the pectoralis major, which is very important to improve your body shape. As the developing breast tissue as well as the fat is removed, although the chest becomes flat, it does not look good and you need to increase the thickness of the pectoralis major muscle through exercise to achieve a fuller male chest appearance (look at Schwarzenegger and Stallone).
(9) Will surgery for gynecomastia affect sexual function?
Many patients ask me this question, and I wonder, does this surgery have anything to do with sexual function? For men, breasts are not a major organ involved in sexual function, so there is no obvious relationship with the surgery. The only thing that might be related is nipple sensation. It does take time to recover nipple sensation, but there is no evidence that there is a sensory abnormality in the nipple that affects the quality of sexual life in the long term after surgery.
(10) What kind of problems should I contact my surgeon about after surgery?
If you experience sudden, persistent/progressive pain that does not resolve, sudden enlargement of the breast, fever (38 degrees or higher), purple or darkening of the breast skin, or any problem that you feel so worried that you cannot sleep without asking, please contact your surgeon promptly so that your professional surgeon can make a judgment and provide appropriate and timely answers and treatment.
(11) What is the relationship between gynecomastia and breast cancer?
Breast cancer in men only accounts for 1% of all breast cancer patients, so in absolute terms it is very low. There is no evidence of a correlation between gynecomastia alone and breast cancer, but there is evidence that low androgen levels, high estrogen levels, mutations in the BRCA gene, family history, and prior radiation therapy increase the risk of breast cancer. If you are in doubt, please consult your breast oncologist for more details.