Awake Gynecomastia Surgery

Is awake gynecomastia surgery possible? The answer is yes, but first we need to learn more about the condition and its causes.

Gynecomastia or enlarged, female appearing breast, is a condition that keeps many males from feeling confident. Genetics, poor dietary and lifestyle changes, age, certain medications, and other unspecified reasons can cause gynecomastia. It can show itself at any age and it is thought to affect up to 50% of men in the US during their lifetime.

To address gynecomastia, a few options are available. First, losing weight can result in some improvement in breast appearance that resulting from the chest being flatter and less round. As the fatty tissues are lost a significant degree of improvement is observed. However, the glandular component often persists as this component of gynecomastia is unaffected by weight loss. As such, gynecomastia might be apparent even in lean patients. Another effective treatment for gynecomastia is avoiding offending medications or recreational drugs derived from marijuana, which promote increased levels of estrogen. However, the overwhelming treatment option is surgery.

The most definitive treatment remains male breast reduction surgery. This surgery has a profound effect on a patient’s self-esteem and usually changes the patient’s lifestyle in a very positive way. Before fixing the abnormality the patient can feel uncomfortable and self-conscious in regard to the appearance of his breasts. This results in clients avoiding activities that show their bare chest such as swimming or sun tanning at the poolside. While male breast reduction is straightforward, involving direct excision of glandular tissue and liposuction of the fat in the periphery, its anesthesia approach may differ.

Is Awake Gynecomastia Safe And Comfortable?

It might be surprising to know that the gynecomastia procedure can be performed under local anesthesia only, termed awake gynecomastia surgery. With the recent advances in surgical techniques and patient care the majority of the gynecomastia are currently treated under local anesthesia with unprecedented safety and excellent outcome. Using a solution of lidocaine and epinephrine in lactated ringers, the areas of surgery would be infiltrated with large amounts of fluid and adequate numbness and comfort can be achieved. If needed the pre-operative markings where incisions are planned can be infiltrated with more concentrated lidocaine in case an incision is needed. A final modification of numbing during awake gynecomastia surgery is the ability to block the entire chest region using a regional block, called the pec minor major fascial block. In this procedure, knowledge of nerve anatomy that travels through fascial planes is taken advantage of. Using ultrasound guidance, the regional nerves are infiltrated with local anesthetic solutions to achieve comfort during the recovery period.

Treating gynecomastia under local anesthesia is done with unprecedented safety and comfort. Not only the vasoconstrictor effect of the epinephrine causes the bleeding exceedingly low but also avoiding the general anesthesia medications and their potential side effects is of utmost importance. The procedure could be done in an ambulatory setting and the patient is usually discharged home 20 to 30 minutes after the procedure. Perhaps the most benefit of awake gynecomastia is that you can return to work very soon. This is because the effects of general anesthesia require prolonged periods of recovery The shortening of the recovery period likely makes awake gynecomastia most attractive to our male clients who need to return to their work as soon as possible.

Our surgeons specialize in awake gynecomastia surgery. Contact us today for a personalized consultation.