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FREQUENTLY ASKED QUESTIONS

1. How long do I need to remain off of work after surgery?

It depends on the type of work that you perform. If a person works in a relaxed office setting, usually only four to six days is necessary. If heavy or strenuous work is involved, 10-14 days is more ideal.

2. How long do I need to remain off exercise?

A minimum of four to six weeks is extremely important for proper recovery. Our goal is to reduce swelling, and have the skin contract and re-adhere to the underlining chest wall. If too much swelling occurs, it will significantly slow down this process. Furthermore, excessive strenuous activity too soon after your procedure can lead to serious post-op complications.

3. How long do I wear the compression garment?

It is necessary to wear your compression garment for six weeks to manage the post- op swelling that occurs after surgery. I feel the compression to the chest area greatly assists in creating the new chest contour. More extensive procedures may require an increase in the length of time a garment is worn.

4. Does insurance cover gynecomastia surgery?

Insurance rarely covers gynecomastia surgery. I have dealt with insurance companies on multiple occasions for severe cases and have been very disappointed with the results. The surgical correction of gynecomastia is considered by insurance companies to be a cosmetic procedure, hence not medically necessary. In very few cases, insurance may cover the procedure if it is caused by another medical problem, such as a medically-diagnosed syndrome or hormone-secreting tumor.

5. How long must I stay in town if I do not live close to your practice?

If you live outside of the immediate area, five to seven days is an adequate amount of time to stay in town. Please refer to the "Out of Town" section for further details.

6. How much does it cost?

The cost depends on the severity of your condition and the amount of surgical time required for your procedure. Average cost ranges from $7,800 to $9,000. This includes the surgical fee, anesthesia, operating room and all follow up care. Some patients may need a two-stage procedure, which could incur additional costs.

7. What happens if I am not happy with my result?

This is a very important question, one I take quite seriously. My primary objective is always my patient's happiness. I have a keen artistic sense and always aim for perfection. However, if your results fail to meet your expectations and you feel they are inadequate, then I will gladly perform corrective surgery as necessary. I am very sensitive to your feelings and I want you to be happy with your result. In the case that a corrective procedure is necessary, my surgical fee is waived for up to one year, and the patient is responsible for the anesthesia and operating room costs. It is very seldom that I need to return to the surgery center for a correction, and oftentimes minor touch-ups can be done in the office at no charge.

8. How much scarring is there after surgery?

There will be an incision around the areola, approximately one inch in length, as well as a liposuction incision in the underarm, measuring approximately three millimeters. The incision scar diminishes within the year following your procedure and becomes insignificant. In most cases, once the scar has had time to fade it is undetectable.

9. Will the gynecomastia come back?

The glandular component will not return unless you stimulate the tissue with steroids or other drugs, in which case it can become enlarged again. The surgery removes most, but not all, of the glandular tissue. We surgically excise the gland and fibrofatty tissue to achieve the best cosmetic result.

10. Can liposuction be done alone?

Yes, liposuction alone can produce a good result, but only if you have pseudogynecomastia. As mentioned earlier, liposuction does not remove glandular tissue and as such is not the most effective approach.

11. What type of anesthesia is utilized?

General anesthesia is utilized for gynecomastia surgery. Our in-house anesthesiologist, Dr. Gaynor, is an expert in the practice of outpatient surgery and anesthesia. He uses a state of the art device called a laryngeal mask anesthesia (LMA). The LMA is a mask that covers the respiratory passage and passes gas down the "windpipe" without inserting an intubation tube. The LMA device allows the patient to breathe on his or her own and not be paralyzed during the procedure. By using the LMA and short acting drugs, the patient is able to walk to the recovery room following the procedure. However, at my surgical facility we have stopped this practice to reduce the potential complication of post-op bleeding.

12. Do I need to stay overnight?

No, you do not need to stay overnight after surgery. Gynecomastia surgery is an outpatient procedure, meaning that after a couple hours of monitored recovery time you can go home or to a hotel. Another responsible person must pick you up and stay with you for the first night.

13. Can I drive myself home?

No, you cannot drive yourself home after surgery. You have undergone general anesthesia and will need assistance for the first 24 hours. You will not be discharged from the surgery center until your designated driver arrives to take you home or to a hotel.

14. Why do I have to wear a vest after surgery?

The vest creates compression for the "dead space" created by the removal of the glandular and fibrofatty tissue. The skin will adhere to the underlying tissue and the swelling will be greatly reduced. It is extremely important to follow instructions regarding wearing the vest after surgery.

15. Do I need to lose weight before I have the procedure?

No, your weight may be a concern of yours, but it will not affect the surgery. If you have pseudogynecomastia ("fatty tissue"), then this will naturally reduce with weight loss.

16. How old do I need to be?

Each case is individually evaluated. There is no set minimum or maximum age requirement for this procedure. I have operated on adolescents as young as 15 years of age, but each case was carefully evaluated and discussed among multiple physicians. I have also operated on men in their 60s and older. Age is not a factor if you are in good health.

17. If I want other procedures, such as liposuction of the abdomen or flanks, is it possible to have them done at the same time?

Yes, we commonly perform multiple procedures at the same time.

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All men with enlarged breasts are candidates but the more extreme cases of gynecomastia will require more extensive surgery and possibly skin excision. It is important for the patient to be healthy and emotionally stable. Men whose gynecomastia is exacerbated by drugs should take this into consideration prior to surgery.

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450 Sutter Street, Suite #2433, San Francisco, CA 94108
165 Rowland Way, Suite #300, Novato, CA 94945