60 MAY/JUNE 2016
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Surgical Aesthetics
SURGICAL
AESTHETICS
CHEST REDUCTION
Male chests, like female, are typically not symmetrical. Pointing out differences to the patient in consultation can help him visualize expected outcomes.
BEFORE AFTER
BEFORE AFTER
PHOTOS
COURTESY
OF
BABAK
DADVAND,
MD
there are certain medications that can make a patient more
prone to developing gynecomastia, such as certain antide-
pressants and antipsychotics, some heart medications and
anti-seizure medications, and even some hair loss medications,
such as fi nasteride."
Dr. Dadvand also asks about the patient's testicles. Are
they both where they need to be and are they roughly the
same size? Patients may also have additional symptoms, such
as pain in their chest or drainage from the nipples. "Certain
types of discharge, especially if it's a milky fl uid, might be a
clue that there is an underlying hormonal imbalance and can
even be from a tumor in the brain called prolactinoma."
If the answers are negative but he has suspicions that
there might be an underlying cause, Dr. Dadvand orders a
hormone panel. "If this is normal, they fall into the category
of idiopathic gynecomastia and it is safe to proceed with
surgery with very little chance of the gynecomastia coming
back," he says.
MAPPING THE PROCEDURE
In cases of true vs. pseudogynecomastia—too much fatty
tissue—patients require surgical debulking of the breast
tissue. If there is excess fat in addition to excess tissue,
liposuction may be performed in combination with surgical
removal of the breast tissue. "It's extremely rare for me
to do only liposuction," says Dr. Blau. "According to the