Plastic surgery abroad - Estonia

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Male Breast reduction

Why breast reduction for men?

Men's breast enlargement is not a common subject to talk about, although it is quite a common medical condition called gynecomastia. 40 – 60 per cent of men in different ages have enlarged breasts, and the symptoms will not disappear in about 10 per cent of the cases.

Men with increased womanish breasts often avoid wearing tight shirts or tend to be afraid of being seen without their shirts on. Normal everyday activities like swimming, sporting, sunbathing and sex are disrupted, because men feel embarrassed about their emasculate forms.

Gynecomastia that has emerged during adulthood is usually irreversible and can be treated only with breast reduction surgery. Men's breasts can increase due to many different reasons and often without any reason at all.

However, before having the surgery, one should find out from his surgeon or doctor the possible reasons for their enlarged breasts. Breasts can, for example, also grow bigger as a result of gaining weight, but men who are overweight usually don't have the best potential for the breast reduction surgery. In this case the surgeon can recommend working out in the gym and/or diet, and consider breast reduction surgery only if this hasn't had any effect on the breast size. Either one or both breasts may need to be operated.

Male breast reduction surgery

The breast reduction surgery is usually performed under general anesthesia. The surgeon will make markings where the incisions will be. Different methods, depending on whether there is more fatty or mammary gland tissue, are used to reduce the breast size. To find out about the specific situation, a mammography or an x-ray is taken.

• If the breast consists mostly of fatty tissue, liposuction is usually used. A minor incision will be made under the areola or sometimes also under the armpit, and the fatty tissue will be sucked out through a slim tube called cannula, which is connected to a device that will suck the excessive fatty tissue out of the breast.
• Otherwise, a minor incision is made under the areola or armpit and the excess mammary gland tissue will be removed surgically. The surgeon will use a scalpel as the mammary gland tissue is harder than the fatty tissue, and it is impossible to suck this out through the cannula.

Often both of the methods, liposuction and the surgical intervention, are used to achieve the best result since liposuction alone may not always give the desired result. The more tissue needs to be removed, the bigger the cut is made. If necessary, the excess skin is removed to avoid sagging.

If the nipples have expanded or protruded remarkably, their size is corrected, although some of the tissue is still left under the nipples, as otherwise they might sink. Also, the breasts need to be given a new shape, which is usually done by liposuction, but sometimes by changing the location of the breast tissue in the deeper layers. Otherwise, the breast may look unnatural later. Finally the incision will be stitched with absorbable or nonabsorbable sutures.

Pre-surgery and post-surgery advice abroad

A detailed consultation with the surgeon is necessary before any surgery.

• The surgeon will examine the problematic area and will find the best individual method to solve the problem with the patient.
• It is likely that a mammogram is made or an x-ray taken in order to get a better understanding of the breast construction and whether there is more fatty or mammary gland tissue in the breast.
• The patient needs to provide a thorough medical history of his previous illnesses and current medical condition and medications he takes.
• The surgeon then gives guidelines about the necessary diet; consequently limits or forbids drinking alcohol and smoking, because it reduces the amount of oxygen in your blood which hinders the recovery process and can leave more noticeable scars.
• It is also prohibited to use aspirin or medicinal herbs before the surgery. Before taking any medications you need to consult your surgeon.

It is important to buy some painkillers as well. It is also wise to think through the possible alternatives for transportation from the clinic and finding an helping hand for the first couple of days back home. You should keep the scar area dry until the sutures are removed.

You need to wear special underwear for a week or two, after which (usually after 8 days) the sutures will be removed unless they are absorbable. It is recommended to keep the scar from direct sunshine for about 6 months as sunlight can change the scar pigmentation and make it darker. We recommend using silicone plasters afters the sutures have been removed.

Physical exercise should be moderate during the first 2 weeks, but then should be increased step by step as it supports the healing process. The surgeon may ask you to avoid sexual intercourse for a week or two after the surgery. Also, you should avoid lifting any weights. You can see the final results after 3 – 5 months.

Taking care of your body

Gynecomastia is a condition in which men develop abnormally big mammary gland tissues, which results in unmanly enlarged breasts. Nevertheless, it can be only one breast that suffers from the condition. It is common to see the kind of physiological gynecomastia among teenage boys, but it usually withdraws during years, except when the boy is overweight.

Elderly men's hormones have the inclination to turn into female hormones and this might cause gynecomastia.

In general terms, gynecomastia is caused by the imbalance of male and female hormones. However, there are many other reasons:

• taking certain medications,
• drugs,
• anabolic steroids,
• excessive use of alcohol,
• testis cancer or suprarenal cancer,
• cirrhosis of the liver,
• over-productivity of the thyroid gland,
• and others.

Therefore, if you have enlarged breasts, you should first see your doctor to find out the primary cause.

The difference between the breast enlargement caused by ill health and breast enlargement caused by other reasons is that it must be approached differently. It is not possible to cure gynecomastia which is not caused by ill health. If breast enlargement is caused by medications, then one should stop using those medications or replace them.

When the primary cause has been identified, you should see a surgeon to stop the enlarging. If the breast still keeps getting bigger, the surgery would be of no help. It may be necessary to have an x-ray, which in worst case scenario can help discover breast cancer. In any case, it reveals the condition of the breast which is essential for choosing the technique.

In case the breast enlargement is a result of over-eating, you should start dieting and/or exercising as weight loss also reduces the size of breasts in most cases. However, in case the breast has enlarged as a result of increased mammary gland tissue, the outcome of exercise can be totally opposite. Surgery will guarantee flatter, firmer breasts with a more attractive shape.