1206 Somerville Rd
Decatur, AL 35603
Gynecomastia is enlargement of the male breast. Most commonly it is caused by breast growth at puberty due to a stimulation by circulating estrogen. Most often it will subside on it's own. However, it can persist on one side or both sides.
It can also be caused by hormonal imbalances, drugs, genetic conditions and taking external hormones.
It is also becoming increasing common among guys who are taking anabolic steroids for athletic reasons. The extra testosterone suppresses the normal pathways for producing testosterone and this permits increased production of estrogen.
Rare reasons include tumors of the testicles or adrenal glands. It also can be caused by some prescription drugs and marijuana.
The name of this procedure is called, mastectomy for gynecomastia. The goals is to make the front of the chest have a normal contour. The skin and fat over the pectoralis major muscle should be a normal thickness. A technique must be chosen to limit the scaring on the chest. Different techniques are available depending on the size of the gynecomastia. Some techniques require dealing with excess lax skin.
During your initial consultation we will discuss all of the aspects of the operation and how it relates to you. We will have a second visit that is the pre-operative visit where I will answer all of your final questions, write the prescriptions for the medicines you will need after the surgery and you will do your pre-operative visit at the hospital.
Most, but not all insurance companies cover mastectomy for gynecomastia. It can also vary by specific insurance contract. The insurance companies require a significant deformity that is apparent of pictures of the chest in multiple views. We always send a pre-approval to your insurance company to see if your procedure will be covered. The insurance companies will also require some blood work to rule out current female hormone excesses. Concerning the pictures, your face will not be on the pictures and we process and print all of the photos digitally in the office. It takes 4 to 6 weeks to hear back from the insurance company about you approval. The insurance company will usually send a letter regarding the approval to both our office and you home. Deductibles and co-pays are not covered and are subject to the terms of the patient's insurance contract.
The operation is done as an outpatient procedure or day-surgery at Decatur Morgan Hospital using general anesthesia. It is done in the main operating rooms at Decatur Morgan Hospital and takes just over 2 hours to perform. We do the operation in the morning and you will get discharged to home late in the afternoon or the early evening. You will go home with a drainage tube in each chest area to remove postoperative blood and fluid so it does not accumulate in the surgery site. The drains will be in place for 3 to 6 days. You will have an elastic binder on your chest to compress the skin and the surgical site. I discharge you from the hospital with a prescription for narcotic pain medication, an antibiotic and a nausea medication.
All patients are unique and the response to post-operative discomfort is variable. Most patients state that the discomfort feels like tightness and burning in the bottom portion of their breasts. Some patients take the narcotic medicine only for a day or two and then switch to Tylenol for pain. Some patients take a narcotic medicine for 3 or 4 weeks after the surgery. As I said, patients are all unique and their pain tolerance is very different. Almost all patients feel normal by 4 weeks.
For a desk job that does not require any heavy lifting you should expect to be away from work for 1 1/2 to 2 weeks. For school you should expect to be off for 1 1/2 to 2 weeks and when returning you should not carry heavy book bags and will not be able to do physical education for at least 4 weeks.
You will need to come to the office about 3 to 3 days after your surgery and you should arrange for someone to drive you to this appointment because you will be sore and on narcotic medications. At this first postoperative check, I will change your dressings and possibly remove your drain tubes, depending on how much drainage there is. Removing the tubes pinches a little but is not terribly painful. You will go home with a light gauze dressing. You can take a full shower 24 hours after you drains are removed. You will take off your dressings, shower, soapy water will not hurt your incisions, pat yourself dry and replace your light dressings. You will continue to wear the elastic binder under your clothes for about 3 to 4 weeks.
Your next appointment will be in a couple of days depending on your drain care. The next appointment will be in 1 to 2 weeks.
Your next appointment will be in approximately 1 month. After that I will see you again in approximately 6 months. Therefore, I will see you between 8 months and 12 months after your surgery and do a final assessment of your size and shape, assess the quality of your scars and get your final opinion on the surgery.
You can resume normal activities after the initial post-operative swelling is resolved and there are no wound problems. This is usually 4 weeks after the surgery. Generally you can resume all physical exertion and exercise after 4 weeks. This could be delayed slightly if there are any healing problems.