Dr. Jacobs has over 30 years of experience with gynecomastia surgery. He performs new cases each week using unique minimally-invasive techniques he developed.
Dr. Jacob’s male breast reduction operation is performed on an out-patient, ambulatory basis in our fully accredited, hospital-type operating suite at Sanctuary Plastic Surgery, which is certified by The Joint Commission. The surgery takes from 60 to 90 minutes.
Safe, “twilight sleep” anesthesia is administered by a board-certified MD anesthesiologist. You will be sleeping gently and comfortably – eyes closed, without any pain, and totally unaware of the passage of time. You will awake quickly after surgery – refreshed, alert, and with no grogginess, nausea, hangover, or sore throat.
Tumescent fluid is injected into the areas of concern through a tiny 1/8 inch nick in the skin on the side of the chest just under the armpit. This fluid contains additional medication to numb the tissues, different medicine to reduce bleeding, and saline (saltwater) which makes the tissues soft, mushy, and easier to remove.
Using liposuction, performed through the same nick in the skin and utilizing Dr. Jacobs’ custom-designed instruments, he initially contours the breast. In some cases, this is all that is necessary since the instrument is capable of removing both fat and breast tissue. The chest wall muscle (the “pec”) is unaffected by the surgery. By removing the overlying excess tissues, the skin will tighten, contour, and re-drape to reveal the underlying muscular contours. In essence, the tissues “masking” the muscles will be removed.
In some cases, there may be residual, very solid breast tissue directly beneath the areola which the instrument cannot remove. In these cases, an additional incision around the edge of the areola will facilitate direct removal of the excess breast tissue. Care is specifically taken at this point to remove sufficient breast tissue but ensure there is no “cratering.” If necessary, fat flaps are used to reinforce the support of the areola. The wound is then closed with dissolving sutures underneath the skin, so there are no external sutures to be removed.
If there is additional fat extending onto the sides of the chest or into the armpit, Dr. Jacobs will remove them through the same nick in the skin. If excessive armpit sweating has been a problem, this too can be addressed with a tiny incision in the armpit crease. During surgery, the skin of the chest will spontaneously tighten, depending upon the patient’s innate skin elasticity. In addition, the diameter of the areola will spontaneously decrease in size. Drains are rarely used.
At the end of the procedure, the chest will have a better, more trim, and contoured shape which will reveal the contours of the underlying muscles, the skin will have tightened and the areolar diameter will have diminished – all with minimally visible scars!
Routinely there will be some swelling, bruising and temporary diminished feeling in the chest and the nipples. These are all normal! All of these symptoms subside within several weeks. Discomfort, which begins several hours after completion of the surgery, has been described as “an intense chest muscle burn” and mostly disappears within 2-3 days. Pain killers are prescribed as well as an antibiotic to prevent infection.
Most men are able to return to office work within three to seven days after the surgery. A snug compression garment will be placed on the chest and can be discreetly worn under one’s clothing for approximately four weeks. Strenuous exercise and sports may begin four weeks after surgery. Complete healing may take from three to six months.
Book a consultation to get rid of gynecomastia once and for all – call our office (212) 570-6080 or email us today.