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Male Breasts | Gynaecomastia

About Male Gynaecomastia

gynecomastia picThis is a procedure to reduce enlarged breasts in men by direct surgical excision of excess glandular tissue.

In most cases gynaecomastia is unrelated to any underlying medical problems but this should be investigated prior to surgery.

Where there is a large amount of breast tissue to be excised simultaneous reductions in the skin and areolar size are required.

Generally the incision is located at the interface of the chest skin and the encircling pigmented areolar.

Length:

Approximately one and a half to three hours (generally related to the size of the reduction required)

Anesthesia:

Either deep intravenous sedation with local anesthetic or general anesthesia.

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BEFORE YOUR SURGERY

Arrange to have a responsible adult over 18 years of age stay with you the first evening after surgery. The procedure will be cancelled if you do not have support.

SMOKING

Smoking increases the risks of complications significantly and should be ceased 4 weeks prior to surgery.

ALCOHOL

No alcohol 48 hours before surgery.

DIETARY REQUIREMENTS

Be well nourished, hydrated and rested before your surgery.

MEDICATIONS

A script will be issued for antibiotics and pain tablets. You will need to purchase them from a chemist and bring them with you on the day of your procedure. Do not take these prior to surgery. The nursing staff will advise you and your carer after your procedure on how to administer them.

Certain over the counter products and prescription medicines can cause complications before and after surgery. They can reduce the ability of your blood to clot and could increase your tendency to bleed during and after surgery.

These include medications containing aspirin & anti-inflammatories (Voltaren, Brufen etc) they should not be taken 2 weeks prior to your procedure.

Avoid Vitamin C & E supplements and red wine 3 days before your operation. Stop all herbal medications 1 week before surgery. These include Echinacea, Ephedra, Garlic, Ginseng, Ginkgo, Kava, St. John's Wort, and Valerian.

*(Please ask us for a more comprehensive list if required.)

Please consult Dr Geldenhuys before ceasing any chronic medications. Arrange to have someone fetch you on discharge & stay with you for 2 nights.

ADDITIONAL PRECAUTION & ADVICE

Report any signs of a cold or infections; skin (boils, bites scratches etc) dental etc within two weeks of your surgery. These may increase the risk of surgical infections and may require delaying your surgery for a few days/weeks.

Obtain any desired "comfort items" for after surgery e.g. music, comfortable clothing, pillows, healthy prepped meals, anything that will facilitate a pleasant environment for your recovery. Avoid sun/UV exposure for two weeks prior to surgery. Any evidence of sunburn will result in your surgery being cancelled.

Do not save questions for the morning of your surgery. This is a busy time for us and it should be a relaxing time for you. Please contact the office PRIOR to your surgery if you have any questions.

DAY OF SURGERY

On arrival at the clinic you will be offered a pre-med, this is to ensure you are relaxed & calm for the procedure. Prior to surgery, Dr. Geldenhuys & your anesthetist will see you in the ward. You should have nothing to eat or drink for 6 hours before your operation. If you are required to take chronic medication during this time please do so with a sip of water..

WHAT TO BRING WITH YOU

  • Any current medicines and those which have been prescribed.
  • Medical Aid membership card
  • ID Document
  • Credit Card or other agreed means of payment
  • Toiletries if required.

WASHING

Medicated soap will be provided to be used on the morning of your operation.

PRODUCTS

Do not apply make-up, perfume/deodorant, nail polish or hair products after washing.

JEWELRY

Remove all jewelry.

CLOTHING

Wear loose, comfortable clothing and footwear. Front opening garments with buttons or zips are ideal.

POST-OPERATIVE INSTRUCTIONS

MOBILITY

  • During the first week, you will sleep on your back. Get out of bed every 2-3hrs and walk a little bit, then back to resting. Avoid any strenuous movements and heavy lifting. Keep your arms closely to your sides for the first 2-3 weeks.
  • First 3 weeks: You may take a gentle walk within a few days, “short Sunday stroll”. You may drive when you are comfortable and have discontinued all medications, typically 10 days post operatively.
  • Weeks 4-6: Legs & light cardiovascular exercise only (lower body movement, no arms).
  • Week 7-12: Gradual increase in cardio exercise & light upper body training ( abdomen, biceps - no peck exercises for first 3 months )

DRESSINGS

Leave the dressings intact for the first 48hrs. We will see you and change dressings at your post operative appointments.

SHOWERING

You will need to have "bird baths" until the drains and bandages are removed. Thereafter, you can shower as usual.

ACTIVITIES

You should limit any strenuous activity during the first 2 – 3 weeks. Thereafter, you can steadily increase your activity level within the limits of discomfort. Heavy exercise or straining can cause bleeding or swelling during the first few weeks. You may drive when you are free from pain medication, usually 7 –10 days.

COMPRESSION VEST

This will be fitted in theatre or at your post operative appointment when your drains are removed at 24-48hrs. The vest should be warn as much as possible for 8 weeks. You may remove this for showering.

SUN

Scars take at least one year to fade completely. During this time, you must protect them from the sun. Even through a bathing suit, a good deal of UV radiation can reach the skin and cause damage. Wear a sunscreen with a skin-protection factor (SPF) of at least 30 at all times when in the outdoors.

SCAR MANAGEMENT

The incisions will be covered with micropore & Bactroban ointment for about 2-3 days after surgery, then topical Vit A or Silicone for 8-12 weeks.( this will be explained to you after surgery )

MEDICATION - Take medications as directed.

Contact Dr Geldenhuys if you develop nausea, heartburn, diarrhea, constipation or bloating. If pain persists despite pain medications please contact Dr Geldenhuys.

DIET

Have 3 meals a day with plenty of fiber, protein & carbohydrates. Hydrate yourself with plenty of noncarbonateddrinks: water & freshly squeezed juices.

HEALING

Requires time. How much swelling you develop depends on the extent of the surgery, surgical technique and your physical condition. Healing continues over a long period of time, up to 18 months. Most of the swelling develops in the first 48 hours. As healing progresses, swelling and bruising decreases. About sixty to eighty percent of your swelling will disappear in the first two months and the remainder gradually thereafter until a year later.

CALL ROOMS (021) 424 5218 IF YOU HAVE:

  1. A temperature greater than 37’C.
  2. Bleeding from the incision or drain sites.
  3. A sudden increase in pain, or swelling of the breast or around the incision site.
  4. Any questions regarding your care.