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Many people are surprised that enlarged breast tissue can be a problem for many men and adolescent boys. Although some adolescent boys go through a period where their breast tissue can temporarily enlarge somewhat, when it is significant or persists it can understandably cause severe anxiety. Rarely, there can be hormonal problems that cause the enlargement and in these cases endocrine evaluation is necessary prior to any surgery. In adult men, the cause may be related to certain medication use, drug use, or in rare cases endocrine or malignant causes. In many cases there is no apparent cause at all. But the biggest group of patients I see with gynecomastia in Santa Barbara are body builders who use, or have used, anabolic steroids which can cause permanent gynecomastia.
There is more than one way to treat gynecomastia. It is important to have this problem treated by a plastic surgeon, as I have seen severe contour complications following surgery by pediatric surgeons or general surgeons who may be good surgeons, but don't have the aesthetic sense or the experience to sculpt the male breast tissue with a minimally invasive procedure and a small discrete scar. There is now a laser alternative in Santa Barbara with Dr. Mackenzie using SmartLipo or Cellulaze that can in some cases eliminate the small areolar scar and is very effective for gynecomastia. These minimally invasive procedures may also allow the procedure to be done more easily using only local anesthesia, avoiding the expense and recovery of general anesthesia.
Suction-assisted gynecomastectomy, typically involves removing some of the breast volume with liposuction (or with laser), and then making a small discreet incision within the areola near the nipple, and removing the remaining fibrous breast tissue directly. The surgery usually takes under two hours. A compression wrap is applied for a couple weeks, whether the procedure is done with surgery or laser, and arm and chest activity (weight lifting) needs to be stopped during that time.
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