Gynecomastia is not uncommon among body builders. With close attention to some unique patient characteristics, breast reduction surgery achieves great aesthetic outcomes in bodybuilders with gynecomastia enlargement of the male breast according to a analysis in the February issue of Plastic and Reconstructive Surgery the official medical journal of the American Society of Plastic Surgeons (ASPS). ASPS Member Surgeon Mordcai Blau MD a plastic surgeon in private practice in White Plains N Y reviews his comprehensive exposure with gynecomastia surgery in bodybuilders. He highlights central patient characteristics and technical issues consisting of the causal role of anabolic steroids and hormone supplements. Dr Blau s coauthor was Ron Hazani MD a plastic surgeon in Beverly Hills, Calif. “Focus on Gynecomastia Surgery in Bodybuilders” An expert in male breast reduction, Dr Blau has performed gynecomastia surgery in mostly bodybuilders and other patients with good physique. The new report focuses on such patients followed up for one to five years after surgery. The men ranged in age from 18 to 51 years 15 percent were competitive bodybuilders. All were free of hormonal or other diseases that can cause gynecomastia. In some cases gynecomastia developing in adolescence usually a temporary condition became permanent after the patient started using steroids or hormone containing supplements. For several reasons gynecomastia surgery in bodybuilders calls for a different approach Dr Blau believes. In contrast to other groups of gynecomastia patients who tend to be overweight or obese, bodybuilders usually don’t need removal of excess fat or skin. However, they do need special attention to prevent bleeding and scarring. Bleeding risk is higher because of increased blood flow in the highly developed chest muscles. Steroids and unregulated supplements, including protein shakes. vitamins. and fish oils may also increase bleeding risk. Emphasis should be on complete removal of breast gland tissue. Bodybuilders are perfectionists with regard to their physique and chest aesthetics, hence their level of expectations is higher, Dr Blau writes. He performs the procedure through a one inch incision made on the underside of the areola surrounding the nipple .In outlining his surgical technique Dr Blau highlights the need for complete removal of all breast gland tissue. After surgery pathology reports usually show excessive development hypertrophy of the gland tissue although a few patients had precancerous cells. Most patients are extremely satisfied with their surgical results, Dr Blau reports. He also notes that the vast majority of patients continued to use anabolic steroids Because the gland was completely removed there were no problems with recurrent gynecomastia Complications were uncommon and generally minor There was a six percent rate of hematomas blood collections causing pain swelling and bruising. Dr Blau notes this problem became less common after he began providing stricter instructions regarding preoperative and postoperative care stopping all use of steroids and supplements before surgery and resuming exercise gradually after surgery. Plastic surgeons may see increased interest in gynecomastia surgery among bodybuilders and other men with good physique.
Dr Angelchik treats men for gynecomastia regularly. Nutrition and fitness are a core part of his practice and body builders feel especially comfortable with his knowledge and expertise. Patients are encouraged to make a consultation if they are considering gynecomastia surgery.
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