Every surgical procedure involves a certain amount of risk. It is important that you understand the risks involved with gynecomastia surgery. An individual’s choice to undergo a surgical procedure is based on the comparison of the risk to potential benefit. Although the majority of men do not experience the following complications, you should discuss each of them with your surgeon to make sure you understand the risks, potential complications and consequences of gynecomastia surgery.
Bleeding- It is possible, though unusual, to experience a bleeding episode during or after surgery. Should post-operative bleeding occur, it may require emergency treatment to drain accumulated blood or blood transfusion. Do not take any aspirin or anti-inflammatory medications for ten days before surgery, as this may increase the risk of bleeding. Non-prescription “herbs” and dietary supplements can increase the risk of surgical bleeding.
Infection- An infection is quite unusual after this type of surgery. Should an infection occur, treatment including antibiotics or additional surgery may be necessary.
Scarring- All surgical incisions produce scarring. The quality of these scars is unpredictable. Abnormal scars may occur within the skin and deeper tissue. Excessive (Keloid/Hypertrophic) scarring is uncommon following cosmetic surgery. It is most common in those with a family history of excessive scarring; in patients that already have such scars; and in Afro-Caribbeans. However, generally a patient’s individual tendency to such scarring cannot be diagnosed in advance. It is important to realise that the rate at which scars heal and fade varies considerably from patient to patient.
Permanent skin discoloration- This is rare after most forms of surgery. Small areas may very occasionally be noted after liposuction / gynecomastia; although the risk of this is less with more modern techniques. Permanent staining may result if the patient sunbathes or uses ultraviolet sun beds whilst any visible skin bruising remains.
Seroma- This is a localised swelling within the tissue that is comparatively rare following cosmetic surgery. Occasionally, it may be necessary to perform a relatively minor procedure to drain the collection of fluid.
Skin sag- By and large this is entirely predictable pre-operatively. So long as patients with poor tone pre-operatively are informed of this likelihood, most will accept the potential limitations.
Asymmetry- In most cases, almost identical volumes of fat are removed from corresponding areas of the same size. However, in regions where there exist significant asymmetries pre-operatively, these will be very much improved following lipoplasty. However, there can be no guarantee that the areas will be identical following surgery.
Delayed healing- Wound disruption or delayed wound healing is possible. Some areas of the skin may not heal normally and may take a long time to heal. Smokers have a greater risk of skin loss and wound healing complications.
Skin Loss- Rarely, but significantly more common in smokers, areas of the wound may break down, resulting in areas of skin loss.
Nipple areola necrosis- Very occasionally, following gynecomastia surgery, the blood supply to the nipple may be compromised. The nursing staff are watching for this during the first 24 hours. It is relatively rare for the nipple not to survive even when there has been some compromising of its blood supply
Additional Surgery Necessary
Should complications occur, additional surgery or other treatments may be necessary. Even though risks and complications occur infrequently, the risks cited are particularly associated with gynecomastia surgery. Other complications and risks can occur but are even more uncommon. The practice of medicine and surgery is not an exact science. Although good results are expected, there is no guarantee or warranty expressed or implied, on the results that may be obtained.
Deep Venous Thrombosis, Cardiac and Pulmonary Complications:Surgery, especially longer procedures, may be associated with the formation of, or increase in, blood clots in the venous system. Pulmonary complications may occur secondarily to blood clots (pulmonary emboli), fat deposits (fat emboli) or partial collapse of the lungs after general anaesthesia. Pulmonary and fat emboli can be life threatening or fatal in some circumstances. Air travel, inactivity and other conditions may increase the incidents of blood clots travelling to the lung causing a major blood clot that may result in death. It is important to discuss with your surgeon any past history of blood clots of swollen legs that may contribute to this condition. Cardiac complications are a risk with any surgery and anaesthesia, even in patients without symptoms. If you experience shortness of breath, chest pain or unusual heart beats, seek medical attention immediately.Should any of these complications occur, you might require hospitalisation and additional treatments.
Smoking, second-Hand Smoke Exposure, Nicotine Products (Patch, Gum, Nasal spray):Patients who are currently smoking, use tobacco products, or nicotine products are at a greater risk for significant surgical complications of skin dying, delay in healing and additional scarring. Individuals exposed to second hand smoke are also at potential risk for similar complications attributable to nicotine exposure. Additionally, smokers may have a significant negative effect from anaesthesia and recovery from anaesthesia, with coughing and possibly increased bleeding. Individuals who are not exposed to tobacco smoke or nicotine containing products have a significantly lower risk of this type of complication.
It is important to refrain from smoking at least six weeks before surgery and until your surgeon states it is safe to return, if desired.
Sun Exposure – Direct or Tanning Salon- The effects of the sun are damaging to the skin. Exposing the treated areas to sun may result in increased scarring, color changes, and poor healing. Patients who tan, either outdoors or in a salon, should inform their surgeon and either delay treatment, or avoid tanning until the surgeon says it is safe to resume. The damaging effect of sun exposure occurs even with the use sun block or clothing coverage.
Intimate Relations after Surgery:Surgery involves coagulating of blood vessels and increased activity of any kind may open these vessels leading to a bleed or hematoma. Increased activity that increase your pulse or heart rate may cause additional bruising, swelling and the need for return to surgery and control of bleeding. It is wise to refrain from sexual activity until your surgeon states it is safe.
Medications:There are many adverse reactions that occur as the result of taking over the counter, herbal, and/or prescription medications. Be sure to check with your surgeon about any drug interactions that may exist with medication that you are already taking. If you have an adverse reaction, stop the medication immediately and call your surgeon for further instructions. If the reaction is severe, go immediately to the nearest hospital. When taking the prescribed pain medication after surgery, realize that they can affect your thought process. Do not drive, do not operate complex equipment, do not make any important decisions and do not drink any alcohol while taking these medications. Be sure to take your prescribed medication only as directed.