Estetska kirurgija - Smanjenje muških grudi - Lege Artis 001

Male breast reduction

The term gynecomastia comes from the Greek “gynecos” which means “female”. Gynecomastia is a benign increase in male breast resulting from increased glandular breast parenchyma and accumulation of deposit of subcutaneous fat tissue. It occurs due to hormonal or metabolic reasons, or it is anatomical – it is constitutionally genetically conditioned. Statistically, one of three men who are younger than 40 years suffers from some degree of gynecomastia, and above the age of fifty, almost half of men have enlarged male breasts.

Description of the procedure

Gynecomastia represents the accumulation of fat or glandular tissue. Gynecomastia cannot be prevented, but it can be corrected by corrective procedures: mastectomy – by surgically removing breasts, or by liposuction. Prior to the procedure it is highly necessary to make an examination by an intern medicine specialist/endocrinologist in order to eliminate some another serious disorders, hormonal or metabolic, that could compromise the results of the surgery.

Candidates

Healthy patients with an objective expectation of results of the procedure, with an understanding of the advantages and disadvantages of the surgery are good candidates for submission to male breast reduction surgery.

Preparation

The first step is a preoperative examination of the patient on which we can discover  the type of gynecomastia. The approach to each patient is strictly individual. Medical history of the entire family is taken into consideration as well as personal medical history. It is important to provide full information.

It is necessary to stop smoking a month before the procedure due to a detrimental effect on microcirculation; a week before, it is necessary to stop taking preparations based on acetylsalicylic acid (Aspirin, Acisal, etc.) and other medications and preparations that can affect blood clotting in order to avoid unwanted bleeding.

Course of the procedure

The surgery takes 1-2 hours; it is performed under general anesthesia. After the surgery, a patient stays in a suite during the next few hours. The incision is done on the periphery of areola and glandular tissue is surgically removed. Less complex cases with the dominance of fat tissue can be completely and very effectively corrected with liposuction; it is nowadays actually a method of choice in treating gynecomastia.

After the procedure, breasts are wrapped in an elastic bandage; the next day, the bandage is replaced by an elastic corset, if necessary.

Recovery

Postoperatively, for the next couple of hours, a patient stays in a suite due to supervision and analgesia. In a general state of stability and safety, with analgesics taken and elastic band wrapped around breasts, the patient is discharged home. The next day, during the first control examination, bandage is replaced by a firm elastic corset, which is to be worn for the next 4-6 weeks. Swelling reduces in 3-4 weeks. Sutures are extracted after 8-10 days.
Return to daily activities is possible in 5-7 days; during the first postoperative week, it is necessary to avoid exercise, swimming and other intense physical activities; only light exercise should be done. In 3-4 weeks it is it is possible to deal with greater physical effort.

Precautions and limitations

Time necessary for the recovery depends on the procedure and the patient himself. Help is mostly needed during the first and second day, after that a patient can usually take care of himself. The second day after the procedure, a patient can function normally, although it can be individual.
It is of utmost importance to follow the instructions given by the doctor in order to recover as quickly as possible. Usually, we recommend several postoperative control examinations, in order for the surgeon to monitor the progress of recovery.

Side effects and complications

Every surgical procedure carries certain risks, such as risks of anesthesia, infection, bleeding and swelling. These complications occur rarely and can usually be avoided. Although pain after the procedure is generally very mild, when it is present, it is easily alleviated using adequate medications.
Due to safety, reliability and success of the procedure, during consultation a surgeon and an anesthesiologist will explain the risks that the surgery carries and provide instructions to be followed in postoperative period.

Package

Package includes: first consultation examination with the doctor, preoperative examination by an anesthesiologist, surgery under general anesthesia, postoperative supervision, necessary medications, reviews and bandaging during the first postoperative days, extraction of sutures and necessary control examinations one year after the surgery.
Package does not include: preoperative laboratory tests (blood tests), ECG, intern’s examination, consulting with other specialists (specialist for diabetes, asthma, high blood pressure, thyroid gland, transfusion), medications that you will take at home.
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