Awake Gynecomastia Surgery

Introduction to Awake Gynecomastia Surgery

Is awake gynecomastia surgery possible? The answer is yes, but first, we should discuss the components of gynecomastia and potential treatments to appreciate when awake gynecomastia surgery is appropriate.

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. The enlargement of breast tissue involves overgrowth of both the mammary glands as well as generalized chest fat. 

To address gynecomastia, a few options are available. First, losing weight can result in some improvement in breast appearance 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 chest. This results in clients avoiding activities that show their bare chest such as swimming or sun tanning at the poolside. Male breast reduction is straightforward and involves direct excision of the glandular tissue and liposuction of the chest fat in the periphery. Both of these procedures can be performed while you are awake.

Awake Surgery Candidates

Awake surgery, also known as awake craniotomy, is a specialized surgical technique performed on patients while they are awake and conscious. This procedure allows surgeons to actively monitor brain function and prevent potential damage during the surgery.

The criteria for determining whether a patient is a candidate for awake surgery involve several factors. Firstly, the patient’s physiology plays a crucial role. They need to have a stable and well-maintained general health condition, including vital signs such as blood pressure, heart rate, and lung function. This ensures their ability to tolerate the procedure without risking complications.

Secondly, the patient’s medical history is taken into account. Any pre-existing medical conditions or chronic illnesses need to be evaluated to determine their impact on the surgery and the patient’s ability to withstand the procedure. Previous surgeries, reactions to anesthesia, or neurological conditions are particularly important considerations in determining the candidacy for awake surgery.

Lastly, the specific treatment being performed plays a significant role in making the determination. Awake surgery is often used in brain tumor removal, epilepsy treatment, or deep brain stimulation procedures. The location, size, and complexity of the target area are assessed to determine if the patient can actively participate and communicate effectively during the surgery.

In summary, the candidacy for awake surgery depends on factors such as the patient’s physiology, medical history, and the specific treatment being performed. Assessing these variables is crucial in determining whether a patient is suitable for this specialized surgical technique.

Is Awake Gynecomastia Safe And Comfortable?

It might be surprising to learn that the gynecomastia procedure can be performed under local anesthesia, termed awake gynecomastia surgery. With the recent advances in surgical techniques and patient care the majority of the gynecomastia cases are currently treated under local anesthesia with unprecedented safety and outcomes.

Using a solution of lidocaine and epinephrine mixed in lactated ringers, the areas of surgery is first infiltrated with large amounts of this fluid until adequate numbness and comfort can be achieved. If needed the pre-operative markings where incisions are planned can also be infiltrated with more concentrated lidocaine. 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 do the vasoconstrictor effects of the epinephrine limit bleeding, but the local anesthetic also avoids general anesthesia medications that have their own potential side effects.

Awake Gynecomastia Surgery Recovery

The procedure could be done in an outpatient setting in about an hour and a half and the patient is usually discharged to home within 20 to 30 minutes following the procedure. Perhaps the most beneficial aspect of awake gynecomastia is that you can return to work soon after your procedure. Patients may typically return to work following a long weekend. This is in contrast to gynecomastia surgery performed under general anesthesia which requires a more prolonged period of recovery ranging in 5 to 7 days. The shortening of the recovery period likely makes awake gynecomastia most attractive to our male clients who often need to return to work as soon as possible.

Conclusion: Awake Gynecomastia Surgery

In conclusion, awake gynecomastia surgery offers a viable option for individuals seeking to address the issue of enlarged male breasts. The variability of pain and discomfort is an important consideration for patients, as it can range from mild to moderate depending on individual pain thresholds. However, these sensations can generally be managed with appropriate pain medications and discomfort usually subsides within a few days to a week.

Additionally, understanding the duration of the recovery period is crucial for individuals planning to undergo awake gynecomastia surgery. While each patient’s recovery time may vary, typically it takes about one to two weeks for swelling and bruising to fully subside, allowing patients to resume their normal activities. This relatively short recovery period compared to traditional surgical methods makes awake gynecomastia surgery a convenient solution for those seeking a swift return to their daily routines.

Furthermore, the visibility of scarring is an important consideration for patients contemplating awake gynecomastia surgery. With the use of small incisions and advanced surgical techniques, scarring is minimized and often fades significantly over time, resulting in minimal noticeable marks or scars. This less invasive approach enhances the cosmetic outcome of the procedure, allowing individuals to feel more confident and comfortable with their bodies.

Lastly, adhering to postoperative care instructions is of utmost importance for optimal results. Patients must follow their surgeon’s recommendations regarding medication, wound care, and activity restrictions. By doing so, complications can be minimized, and the healing process can occur effectively, leading to the best possible outcomes.

In summary, awake gynecomastia surgery offers a safe and effective treatment option for patients seeking to address enlarged male breasts. Considerations such as pain and discomfort, recovery period, scarring, and postoperative care must be taken into account to ensure a successful procedure and a satisfying outcome. By selecting the right surgeon and following their guidance, patients can achieve the desired results and regain their self-confidence.

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