Posts Tagged ‘gynecomastia reduction’
Friday, June 17th, 2011
Q: Hello, I am a 27 year-old athletic male who is bothered both my puffy nipples. Some days they don’t seem that bad. But other days they really stick out. I don’t know why they are so different on different days. I am not sure whether I need my nipple cut down or the tissue under the nipple removed. Whatever it takes to do it I don’t care as I just want it gone. What do you recommend and what is the surgery like and how quick will I recover?
A: Puffy nipples are different than pointy nipples as patients often describe these two male chest problems. A pointy nipple is when the centrally located nipple within the areola sticks out like a small sharp point. It is small protrusion and is managed by a simple nipple reduction which is an office procedure done under local anesthesia. There is no real recovery as small dissolveable sutures at placed and one goes about their activities as normal immediately afterward. A puffy nipple refers to the development of a small mass of breast tissue underneath the nipple-areolar complex that makes it stick out or be puffy. This is known as areolar gynecomastia and is a limited gynecomastic reduction. It is treated by an outpatient procedure in which the enlarged breast tissue is removed from under the nipple by a small lower areolar incision. Patients wear a chest wrap for a week or so and show refrain from exercise or strenuous exercise for a few weeks to avoid a fluid collection or excessive scar tissue formation which will wipe out the benefits of having the puffy breast tissue removed.
Dr. Barry Eppley
Indianapolis, Indiana
Tags: dr barry eppley, gynecomastia reduction, indianapolis, nipple reduction
Posted in Your Questions | No Comments »
Saturday, January 8th, 2011
Q: I am a 59 year old male that has developed breasts from my cancer medication. I have prostrate cancer and am on Casodex. I am told by my doctor that I can not go off this medication for the rest of my life. I want to do something with my breast enlargement not only because of the way it looks but also because they hurt all the time. I have been told by one doctor that I can’t have the surgery unless I stop the medication as it will just come back. What do you think?
A: Gynecomastia is a known complication of the prostate cancer medication, Casodex. Bicalutamide (Casodex) is usually used with a luteinizing hormone-releasing hormone to treat metastatic prostate cancer (cancer that started in the prostate and has spread to other parts of the body). This medication is in a class of drugs known as nonsteroidal antiandrogens. It works by blocking the effect of androgen (a male hormone) to stop the growth and spread of cancer cells. Because of its antimale hormone effects, it is no surprise that male breast enlargement can occur with its use.
The question with doing gynecomastia reduction on a patient taking this medication is will it come back? That would depend on several factors including the type of gynecomastia reduction (extent) and the dose of the medication. But all those issues aside, the bottom line is there is definitely some risk that recurrent gynecomastia could develop after surgery. However, as long as you are aware of this possibility, the benefits of reduced pain and a more comfortable chest contour would seem to outweigh that potential risk. If it returns the surgery can always be repeated. But there is also the possibility that it may not come back as no one can predict with absolute certainty what may happen after your gynecomastia surgery.
Dr. Barry Eppley
Indianapolis Indiana
Tags: casodex for prostate cancer, dr barry eppley, gynecomastia reduction, indianapolis, plastic surgery
Posted in Your Questions | No Comments »
Wednesday, October 27th, 2010
Q: Hi, I need your help. Three months ago I had a gynecomastia operation done and now I have a problem. The problem is that my nipples are folded in now and going inside. My skin is also very dry around nipples and my nipples have become cracked. This looks like a serious problem. How can I fix my nipples?
A: Gynecomastia reduction procedures can be done two fundamental ways; liposuction or open excision (removal) of excess breast tissue. Sometimes the two techniques are done together to get the best result. With the open excision technique, breast tissue is removed through an incision on the underside of the nipple. (technically the areola) Removal of this breast tissue is largely an art form. How much to remove and how to shape what is left behind is more of matter of experience than an exact science.
One of the known complications of open gynecomastia removal is over-resection, removing too much breast tissue. This make look alright in the very beginning (or not) but as the swelling subsides and scarring sets in, the nipple gets pulled into the over-resected space where breast tissue once was. This is called nipple inversion or a retracted nipple. It most commonly appears underneath the nipple since this is closest to the incision but it can appear outside the diameter of the areola if the over-resection goes beyond just that area.
Correction of the inverted nipple after gynecomastia reduction requires replacement of the missing tissue to support the projection of the nipple. This is best done by a fat graft or a dermal-fat graft using the patient’s own tissues. This requires a donor site and a scar elsewhere on the body to do it.
Dr. Barry Eppley
Indianapolis Indiana
Tags: dermal-fat graft for nipple inversion, dr barry eppley, gynecomastia nipple deformity, gynecomastia reduction, indianapolis, plastic surgery
Posted in Your Questions | No Comments »
Sunday, October 10th, 2010
Q: I am the parent of a son who is suffering terribly. He is developing breasts like a woman. This started when he was fifteen years old and he will now turn twenty next month. The doctor said that it is Gynecomastia and that he will require surgery to correct it. Although he is not in any danger medically, this is a source of embarrassment for him as it shows no sign of going away and he is not happy with it. We would like to know what it will cost for the surgery.
A: Gynecomastia is extremely emotionally disturbing for many young teenagers and men that are afflicted with it. This has become particularly so in our current youth culture in which the very flat chest is exemplified in many ads aimed right at teenagers. (e.g., Abercrombie Fitch) Given the obesity and overweight issues that now exist in the young American population, gynecomastia problems and young males seeking treatment exist now like never before.
The cost of gynecomastia reduction surgery is in direct correlation to its size and the type of surgery needed to correct it. Smaller gynecomastias may be removed with liposuction only or simple areolar excisions. Larger gynecomastias require both excision of skin and breast tissue as well as liposuction. Without seeing pictures of the gynecomastia problem, it is impossible to give an accurate fee for the surgery. Generally, the will be somewhere between $5,000 to $8,000, which includes the associated costs of operating room and anesthesia expenses.
Dr. Barry Eppley
Indianapolis Indiana
Tags: cost of gynecomastia surgery, dr barry eppley, gynecomastia reduction, indianapolis, plastic surgery
Posted in Your Questions | No Comments »
Thursday, September 16th, 2010
Q: I am 54 years of age and have dealt with large breasts since I was in high school. I exercise daily, diet and nothing makes them go away. Even though my wife says it doesn’t bother her, it bothers me a lot. I have still not psychologically gotten over being told in high school gym class that I had bigger boobs than the girls! Is 54 too late to have something done? I hate taking off my shirt at the gym or anywhere else, including the doctor’s office. I actually had them liposuctioned and they were flat for a few days but now that are big as ever. Please advise.
A: Age has nothing to do with whether gynecomastia can be surgically treated. It is only about how much the problem bothers you, there is no age limit for gynecomastia surgery. Gynecomastia, however, comes in many different sizes and the surgical techniques used to treat it are different. By your description and the fact that you had an unsuccessful liposuction experience indicates that your chest problem is just as much about too much skin as it is about too much breast tissue. In other words, when the chest starts to or has the appearance of an actual breast mound, the reduction technique must be more like a female breast reduction to be successful. This means that skin has to be removed which will result in visible scars on the chest wall. To be able to get you a lot flatter, you will have to accept the trade-off of scarring. That, rather than age, is the real rate-limiting consideration at your or any male age.
Dr. Barry Eppley
Indianapolis, Indiana
Tags: dr barry eppley, gynecomastia reduction, indianapolis, older male gynecomastia reduction, plastic surgery
Posted in Your Questions | No Comments »
Tuesday, July 20th, 2010
Cosmetic plastic surgery has long been unintentionally gender-biased. Since the field began, the vast majority of patients who seek cosmetic enhancements, albeit it surgery or office-based treatments, have been women. Men have always made up less than 10% of most plastic surgery practices. Hollywood would lead you to believe otherwise but it just isn’t so. The only rare exception to that has been the more recent popular treatment of laser hair reduction. When it comes to hair removal, men make up about half of the patients seen with the hairy back and shoulders being the prime targets.
But more men are finding their way into the plastic surgeon’s office in the past few years. Besides a steady increase in male numbers, what is noteworthy is the change in what what men are requesting. While there remains some traditional procedures that have always been of interest, technology, societal trends, and younger men have opened up new areas of the face and body for change and improvement. Here are four of the most popular younger male (teenage to early 40s) procedures today.
Liposuction still remains the most requested male procedure. The culprits are always the same, the stomach and love handle areas. But most men that want liposuction are not fat and many are not even overweight. To the contrary, they are lean but have fat collections at the side of the waist and flanks. Even in men that work out regularly, those love handles can be impossible to work off. Today’s liposuction techniques can even give that ‘six-pack’ look for those leaner men that are not opposed to a little surgical cheating.
Chest recontouring is the one male plastic surgery procedure that is really on the rise. Male breast enlargement, known as gynecomastia, has always been an issue. But with increasing teenage weights and the present young male aesthetic for a completely flat and smooth chest, improvement in the male chest is sought out like never before. Even small nipple protrusions can be bothersome for the teenage male. Obvious man boobs are not desireable at any age.
Nose reshaping (rhinoplasty) has always been a popular male operation and that has not changed. It is the one procedure of the face that young men are not afraid to change. Noses that are big with prominent humps and wide nasal tips are bothersome and distracting to an otherwise balanced face. Sports and recreational activities make the young male nose a good target for injury causing twisted and deviated noses that often pose problems for breathing as well.
One set of procedures that is really new and undoubtably influenced by movies and models is structural facial reshaping. Creating that chiseled and angular face is what some young men aspire to achieve. A good jawline in particular is associated with enhanced masculinity. While one perceived just as making a strong chin with an implant, modern plastic surgery implants can be extended all the way to the back of the jaw. With the development of jaw angle implants, the jaw line can become more defined than just with a chin implant alone.
A new generation is redefining male plastic surgery. Have a lean body, flat chest, and a nose and jaw line that creates a well defined face has probably never been out of style. But modern surgical developments make them more attainable than ever before.
Dr. Barry Eppley
Indianapolis, Indiana
Tags: chin and jaw angle implants, dr barry eppley, gynecomastia reduction, indianapolis, liposuction, male plastic surgery, plastic surgery, rhinoplasty
Posted in Newspaper Articles | No Comments »
Saturday, May 15th, 2010
Q: I am interested in some form of gynecomastia surgery. At one time I was much heavier and have lost a lot of weight through the help of bariatric surgery several years ago. Since the weight loss, much of my chest has not only gone flat but it sags with nipples that are very stretched out. My chest needs to be reshaped. Help!
A: Chest changes after weight loss are common in men. Men suffer a deflation of the chest soft tissues after bariatric surgery which is magnified by the usual presence of weight-related gynecomastia. This results in a skin sag with enlarged nipples that is particularly unflattering in a man.
Correction of this type of male chest wall change is not really gynecomastia surgery per se. There is usually not much fat or breast tissue to contend with. Rather it is more like a breast lift in a female. Skin needs to be removed and tightened and the nipple needs to be lifted and usually made smaller. If the skin sag is very minor, a circumareolar skin lift with nipple reduction can be made. This has the advantage of keeping the scar relegated to around the nipple area. More significant chest skin sag, however, needs a skin excision pattern that goes beyond the nipple. This is always problematic in men where scars are not well hidden in the more flat topography of the male chest.
Chest wall reshaping is usually the second most requested change (abdominoplasty is number one) in men who have had gastric bypass.
Dr. Barry Eppley
Tags: chest wall reshaping aftwe weight loss, dr barry eppley, gynecomastia reduction, indianapolis, plastic surgery
Posted in Your Questions | No Comments »
Friday, May 14th, 2010
Q: I am inquiring about breast surgery for my son who is 14. He has developed small breasts and is quite conscious of it. He will not go swimming or even take his shirt off during gym class. (so I am told by his brother) My family doctor said it is gynecomastia and that it goes away in most teenage boys. He said we should wait until he is 18 years old before considering surgery. Given that it bothers him so much, and has made him very shy and reclusive, I was wondering what your thoughts were. Can surgery be done sooner rather than waiting? I am just desperate to help him and make him feel better.
A: While gynecomastia, male breast enlargement, does go away in some teenage boys, many times it does not. The historic teaching is to wait until the teenage male is near full development. In analyzing that approach further, its intent is to not subject a teenager to unnecessary surgery. In the spirit of such waiting, however, the teenage boy may (likely) develop self-image issues and psychosocial issues.
Given the exposure to potential social pressures and ridicule, I not think that such waiting is worth the trade-off. Gynecomastia surgery can be repeated (although I have never seen that necessary) but the emotional damage can be very difficult to get past. Therefore, in my Indianapolis plastic surgery practice I am an advocate of surgically treating gynecomastia early (age 14 is an acceptable age) provided that it is significant enough and one is certain that there is not a hormonal reason for it. While a hormonal cause (endocrine tumor) is a very rare cause of gynecomastia, they do occur. If the gynecomastia involves both sides of the chest and is not subtle, I would recommend getting him seen by an endocrinologist first.
Many cases of teenage gynecomastia that I seen today are less significant than they used to be. This is undoubtably a reflection of the changing cultural standards from decades ago.
Dr. Barry Eppley
Tags: dr barry eppley, gynecomastia, gynecomastia reduction, indianapolis, plastic surgery, teenage gynecomastia surgery
Posted in Your Questions | No Comments »
|
|
|
|