Male Breast Surgery & Male Breast Reduction in Orange County & Newport Beach

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Procedure: Depending on the amount of excess fat, glandular tissue, and/or skin tissue over the breast, the patient can expect a surgery requiring liposuction, direct excision of glandular tissue, and/or direct excision of fat, glandular tissue, and redundant skin. For patients with minimal sagging skin, minimal glandular tissue, but excess fat, liposuction only may be sufficient. However, most patients present with excess glandular tissue underlying the nipple areola, which requires direct excision of the glandular tissue using an infra-areola incision. In severe cases of skin redundancy and breast sagging, direct excision of redundant skin and excess fat is required in order to avoid a deflated and overly sagging breast that would result with liposuction alone. In these patients, nipple areola complex will require removal, trimming, and skin grafting.

Length: 1 to 4 hours

Anesthesia: Local anesthesia combined with intravenous sedation or general anesthesia depending on the complexity of the surgery required

Place of Treatment: Outpatient surgical facility, office-based surgical facility, or at a hospital

Recovery: Most patients can return to work and resume most normal activities 7 to 10 days after surgery.  Strenuous activities such as heavy lifting can usually be performed 4 weeks after surgery.

Duration of Results: Breast reduction in men yields permanent results unless patients experience significant weight gain or continue consumption of causative agents. Identified causative agents are numerous and have included consumption of excess alcohol, marijuana, and chronically prescribed steroids.

Side Effects: Side effects are events that may be experienced by patients as a result of your surgery and should not be considered adverse events. Our patients are counseled regarding these effects and if experienced they are tolerable and often temporary in duration.

1. Numbness: Swelling after surgery usually results in loss of feeling in the breast and nipple area during the first several weeks.  This impairment is typically temporary and resolves within a few months.
2. Scarring: Incisions may be lumpy and red for a few months, but incisions become less apparent over time and can even fade to thin white lines. In general, due to improvements in suture quality, patients can expect superior results today when compared to just a decade ago. It is important to acknowledge that smoking impedes the healing process and will result in more prominent surgical scars in patients who smoke.
3. Breast asymmetry: Breasts may not be identical in size and shape if there is significant asymmetry preoperatively. Furthermore, when liposuction is used, you may experience subtle contouring irregularity but this will improve as any skin redundancy tightens over time.

Risks: Risks are unwanted events that may occur during or following surgery. These events are recognized as “complications” but their occurrence is minimized by appropriate patient selection, proper surgical decision making, effective surgical technique, and thorough preoperative and postoperative patient management.

1. Hematoma: Hematoma refers to the accumulation of blood in the early postoperative period which pools into a surgical pocket. Hematomas provide a perfect medium for harboring growth of bacteria. In fact, if the patient has an infection anywhere in the body, the bacteria will travel through the blood stream and resettle in the hematoma; this can lead to an infection and subsequent wound development. Patients are evaluated preoperatively to make sure that they do not have a blood clotting deficiency. Finally, patients are asked to wear a breast compression garment at all times for the 1st two weeks to prevent hematoma formation.
2. Seroma: Seroma formation refers to the accumulation of plasma fluid in pockets created by surgical elevation of the soft tissue and disruption of lymphatic vessels. This fluid may accumulate if the patient’s blood count is low and/or the patient’s nutrition poor. When nutrition is poor, protein levels in the blood are diminished which promotes leakage of this plasma fluid out of vessels. This fluid can be a nuisance to patients often requiring several aspirations in the office prior to its resolution. More importantly, these plasma fluid pockets may harbor bacterial growth and result in a clinical infection. Patients are asked to wear a breast compression garment over the 1st two weeks to prevent seroma formation.
3. Infection: An infection can occur after male breast surgery and result in disruption of surgical incision lines and may leave the patient with an open breast wound.  Prolonged antibiotics may be required to fight an infection and to prevent further extension of the infection. Risk of infections are minimized by using sterile technique, using intra-operative antibiotics, and sealing all incisions sites so that bacteria can’t get in through external contact. In addition, infections are less likely in patients who don’t smoke cigarettes or in smokers who quit smoking for at least 1 month prior to surgery.
4. Skin edge compromise/death: The skin incision can be disrupted if the skin edge is vascularly compromised and/or dies or if there is local infection. This complication is best avoided by counseling patients on the terrible consequences of nicotine in cigarettes. Nicotine will literally clog all the small vessels found in the skin that are critical for the delivery of nutrients and healing of the skin edge. Male breast surgery patients are usually mandated to quit smoking for at least 1 month prior to surgery. In addition, uncontrolled diabetes can lead to the undesired sloughing of the skin. Diabetic patients are urged to be vigilant about controlling their blood sugar levels prior to surgery. If patients develop an open wound, they will require prolonged local wound care with frequent dressing changes. Unfortunately, any delays in healing of the skin edges will compromise your aesthetic outcome.
5. Pulmonary embolism: Blood clots may form in leg veins during any surgery when the patient is under general anesthesia. Patients with a leg vein clot will complain postoperatively of pain in their calves. Patient’s with this complaint should be taken seriously and treated if a vein clot is diagnosed. Early treatment of patients with a deep leg vein will avoid migration of leg vein clot to the heart and lungs causing pulmonary embolism. Even though pulmonary emboli are rare, pulmonary emboli are the leading cause of death after surgery. Pulmonary emboli must be detected early by performing a CT Scan and should be treated urgently.