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Male Breast Reduction: Post-Operative Care Instructions

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By Jerome Edelstein, MD

The healing time for a given procedure varies between different patients. The following represents the general recovery you might expect following your male breast reduction and the treatment of male gynecomastia. Individual patients may experience variations from this course.Gynecomastia Surgery RecoveryWhen you awake from your surgery you will be in the recovery room. You will have your support garment on. If you are not staying overnight, you will be able to go home when you have fully recovered from the sedation.

Pain and Discomfort

You may feel some pain and discomfort, but this is generally well controlled by pain medications. Most patients experience a mild degree of discomfort for 5-7 days.

Nausea and Vomiting

A few patients react to the anesthetic after surgery with nausea and vomiting. This usually lasts less than 24 hours and should be treated with lots of fluids, Gravol and rest.

Swelling

Maximum swelling occurs at about 3-5 days. Most of the swelling will be gone in 2-3 weeks, but some firmness can last 6-8 weeks. The final result can usually be assessed at 3-4 months.

Bruising

Most bruising resolves in 10-14 days. Some light skin discolouration can last several weeks.

Numbness or Burning Sensation

Many patients experience numbness over the treatment areas. A minority report superficial burning pain. Over time the feeling will gradually return to normal. As the feeling comes back you may notice some electric tingling sensations which is quite normal and will subside. Most sensory changes go away by 6-8 weeks, if not sooner.

Activity Level

We encourage you not to spend all your time in bed. Getting out of bed and doing normal things around the house, or even a little stroll outdoors, is a good thing. This activity will greatly minimize the risk of deep clots in your leg veins and will help to decrease swelling.

For the first 3 days you may go on leisurely walks. After 4-5 days, most people are able to return to work and gradually increase their activities, but this is variable depending upon the number of sites treated and discomfort tolerance.

For example, if you’ve had many areas treated, you may require 7-10 days before going back to work. Athletic activities usually have to wait until 3 weeks.

Washing

You can start taking showers on the second day after surgery (eg if your surgery was on Thursday, you can take a shower on Saturday). When taking a shower, remove the support garment and underlying dressing. It is a good idea to have a family member or friend present the first time you take off the garment in case you feel lightheaded. The small white tapes (called steri-strips) over your incisions should be left on. If they have come off on their own, don’t be alarmed. You can cover the incision with a Band-Aid once you have dried off. Wet and soap yourself everywhere, including the tapes and your incisions. Use mild soap such as Dove, Ivory, or Zest. Pat yourself dry using a towel (do not rub) and put the support garment back on. If there is a lot of drainage from the incisions, put a gauze over the incision before putting your garment back on. This daily routine will help keep the incisions clean, and will promote wound healing.

Do not submerge yourself in a bath, swimming pool, or whirlpool for 2 weeks

Support Garment

When you wake up from your procedure, you will have your body garment already on. The garment helps prevent accumulation of fluid in the areas where fat has been removed. It will also help to decrease swelling, and to conform the skin to its new position, maximizing the cosmetic outcome. It will allow you to see the final result following surgery much sooner. Failure to comply with garment instructions will increase the risk of seroma formation and suboptimal results.

The garment should be worn day and night for 3 weeks. You should only remove the garment if you wash it or you take a shower. From 3 to 6 weeks, the garment should be worn during the day, but you can take it off at night.

Once there is no further drainage from the incisions, you can wear an undergarment beneath the support garment. This will help prevent indentations in the skin and will be more comfortable. The undergarment must be tightly fitted, relatively thin, cover the entire treated area and then some, and have minimal seams. Examples include extra-support, high-waisted, full length pantyhose, leotards, tight t-shirts, and spanx.

Massage

As the discomfort gradually subsides, you should begin gently massaging the treated areas. This is usually possible by day 7-10. Massage will help to decrease the swelling faster and to smooth out any irregularities.

Massage each area in all directions using your hands, or, a soft paint roller. Massage should be done once or twice a day for up to 20 minutes.

Some patients hire a massage therapist two to three times per week.

Incisions

You will be seen back in the clinic to have your contoured areas inspected.

Non-absorbable sutures are removed at 7-10 days. At the time the sutures are removed, a steri-strip will be placed over the incision. Once the steri-strip starts to curl up at it’s edge, you can remove it the rest of the way and throw it out. After the steri-strips are removed, no dressing will be required over the incision. You can then begin applying a scar cream such as Dermatix.

Avoid direct sunlight to the incision line as this may result in pigmentation changes. This is particularly true during the first year after the surgery. Never expose the incision to sunlight without sunblock – use SPF 30 or greater.

Scars will initially be red and a little raised, but over 3-6 months they usually get lighter in colour and flatten out.

Lifestyle

In order to maintain the contour changes that have occurred following the procedure, we strongly recommend lifestyle changes. Many patients become quite motivated after their surgery. You should become involved in a regular exercise program (wait 3 weeks after surgery!) and eat a healthy, well balanced diet. Walking on a treadmill for 30 minutes at least 3 times per week is a good way to start. See a nutritionist if you need guidance in proper caloric monitoring.

NOTE

The quality of your cosmetic enhancement may be compromised if you fail to return for any scheduled post-op visits, or follow the pre- and post-operative instructions.

Don’t hesitate to report any unusual or concerning changes during your gynecomastia recovery.

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