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Blog. Anesthesia for Gynecomastia Surgery: The Options

When it comes to committing to surgery for male breast reduction, patients occasionally face an obstacle or two. Some need to do a bit of planning to fit gynecomastia surgery into their budget. Some think plastic surgery is for celebrities and just don’t view it as an option for an ordinary guy.

For a few, the factor that stands in the way of gynecomastia surgery is anesthesia. Some South Florida patients have one of these two things to say:

• I want local anesthesia!

Once in a while we meet guys who say they prefer local anesthesia. Often the motivation is to save money—they have heard that local anesthesia can be given by the plastic surgeon; therefore the patient does not need to cover the cost of an anesthesiologist.

The challenge with performing gynecomastia surgery with local anesthesia is that the pain sensing fibers are not adequately numbed for the extensive liposuction needed to treat most patients. The to and fro motion of the cannula causes significant discomfort, and even the most “macho” guy tends to move around on the operating table. The surgeon can’t help but be distracted trying to manage the patient and post-op results are often less than optimal.

• General anesthesia is not for me!

We are not surprised when a guy considering male breast reduction tells us they absolutely do not want general anesthesia. Some are simply afraid of “going under,” and even though this method of sedation is quite safe, we do understand.

Others have experience with general anesthesia and have first hand knowledge of the side effects: nausea, vomiting, sore throat and prolonged wooziness. And, if the patient has another medical condition to manage, such as high blood pressure or diabetes, he can be even more hesitant to have general anesthesia.

Fortunately, we have the answer! Almost all our gynecomastia patients undergo IV sedation. This combination of medication administered through an intravenous tube is also called “twilight sedation” and even “conscious sedation.” Patients sleep lightly but completely through surgery and wake up quickly afterward. No breathing tube is needed, and guys do not have to worry about the hangover that comes with general anesthesia.

We can reassure guys who are concerned about “going under” that their sleep will be light. Our surgical team has worked hand-in-hand for many years, and they are experts in ensuring patients are not aware of the procedure while being ready to wake up very quickly. Surgery lasts just 90 minutes on average and does not invade the chest cavity. Although it takes a great deal of skill and experience to sculpt smooth, masculine contours, from a medical point of view male breast reduction is a straightforward operation.

For guys interested in local sedation, we offer this input: IV sedation delivers an easy, comfortable experience. Gynecomastia surgery should be a once in a lifetime event—why not sail through it with as little discomfort as possible, giving your plastic surgeon every opportunity to create the chest you’re hoping for?
Read more about our surgical team and you’ll see how prepared we are to offer our male breast reduction patients the utmost in care and results. Then email us to set up a phone or in-person consultation.


Dr. Elliot William Jacobs is a board-certified aesthetic plastic surgeon who specializes in FTM top surgery, gynecomastia surgery, revision gynecomastia surgery and male breast reduction. He is a native of New York and has over 40 years of experience in his field. Dr. Jacobs is a highly respected and sought-after surgeon who is known for his skill, experience, and compassion. Whether you are interested in gynecomastia for the first time, or are looking to correct a gynecomastia you aren’t happy with, Dr. Jacobs can deliver amazing results.


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