Enlarged Breasts in Men
What Happens During Breast Reduction Surgery
During the gynecomastia procedure Dr. George Solomon will use liposuction to remove the fat under the breast. Sometimes he will remove the gland under the nipple depending on the patient.
Dr. Solomon first administers the anesthesia. He does this by injecting a tumescent solution. This solution contains epinephrine, lidocaine, and bicarbonate.
The lidocaine is acidic and that is why he adds the bicarbonate which takes away stinging which otherwise would occur. In fact the patient does not feel anything. Dr. Solomon is careful to stay above the muscle while inserting the anesthesia. He then injects under the nipple the glandular tissue. This is a fibrous tissue that is under the gland which gives the breast a pointed appearance which many males do not like. They prefer a nice flat breast. Once the injection of the tumescent is done, the breasts are numb. The patient is fully awake during the procedure but not experiencing any pain.
Dr. Solomon then uses Vaser liposuction on the breasts. He is also trying to break the tissue under the nipple. This is a very fibrous tissue. Many times he is able to break most all the tissue using the Vaser machine without having to go back and excise it. The Vaser also makes it much easier for the fat to come out because the tissue is broken up. Vaser is probably the best machine to do liposuction of the breast and the removal of the glandular tissue. At this point Dr. Solomon can feel that the Vaser is doing a good job of breaking up the tissue. The probe is moving around much easier. Once he has determined that the glandular tissue has sufficiently broken down he is ready to do the liposuction.
During the liposuction, fat is easily sucked out and runs through a tube into a tank. Again, the patients is fully awake but feeling no pain. Dr. Solomon removes all the fat in the breast area, leaving the patient with a flat breast. The patient still has some glandular tissue remaining under the nipple that could not be broken up with the Vaser machine. This has to be removed or the nipples will still point out when the patient is sitting up. Once it is removed he will have absolutely flat breast which is the goal of the patient.
Dr. Solomon makes a little incision from 3 o’clock to 9 o’clock right at the nipple line. He then dissects under the nipple to remove the glandular tissue. The amount removed is about the size of a half dollar. Dr. Solomon leaves a small amount behind so the patient doesn’t develop a dip in the breast. The results are a much flatter breast area. He finishes the procedure by stitching up the area where he made the incision. He uses absorbable stitches which will dissolve on their own without any need of removal. There are 2 small holes under the breast which allow any remaining tumescent fluid to drain out over the next 24 to 48 hours. There is no need for any drain tubes. The procedure is now complete.
*Each patient is unique; therefore, results of treatment may vary.