Surgery for gynecomastia is performed on an outpatient basis under general anesthesia. Patients who fly in or drive more than two hours to the surgical facility stay in the hospital overnight or at a hotel convenient to the office so that they may be evaluated on the first day following surgery.

Bleeding: 
It is possible, though unusual, to experience a bleeding episode during or after surgery. Should post-operative bleeding occur, it may require an emergency treatment to drain the 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. Hematoma can occur at any time following injury. Intra- or Post-operative blood transfusions may very rarely be required. If blood transfusions are needed to treat blood loss, there is a risk of blood-related infections such as hepatitis and HIV (AIDS). Heparin medications that are used to prevent blood clots in veins can produce bleeding and decreased blood platelets.

Seroma:
Fluid accumulations infrequently occur in between the skin and the underlying tissues. Should this problem occur, it may require additional simple procedures for drainage of fluid.

Infection:
The chance of infection is very low with this type of surgery, considering that you are going to receive prophylactic antibiotics. Should an infection occur, additional treatment including antibiotics, hospitalization, or additional surgery may be necessary.

Change in Nipple and Skin Sensation: You may experience a diminished (or loss) of sensitivity of the nipples and the skin of your breast.

Permanent loss of nipple sensation can occur after gynecomastia surgery in one or both nipples. Massage during your recuperation phase helps reduce hypersensevity of the skin when the sensation returns. Changes in sensation may affect sexual response. In rare circumstances the nipple may be lost entirely due to poor circulation and/or smoking.

Pain:
You will experience pain, burning sensation, and skin irritability after your surgery. These symptoms of varying intensity and duration may occur and persist after gynecomastia. Chronic pain may occur very infrequently, sometimes from nerves becoming trapped in scar tissue and other times for no hard reasons at all.

Skin contour Irregularities:
Contour and shape irregularities including visible and palpable wrinkling and dimpling may occur. Although the majority of these resolve over time with the help of massaging, some may remain permanently. One breast may be to a degree smaller than the other as it always is in normal non-treated chests. Nipple position and shape will not be identical one side to the next, depending on the original position of your nipples, as well as how your skin shrinks. Residual skin irregularities at the ends of the incisions or "dog ears" are always a possibility when there is excessive redundant skin. This may improve with time, or it can be surgically corrected. Nipple retraction may occur after gynecomastia surgery as a result of skin shrinkage, which can be corrected.

Skin Sensitivity:
Itching, tenderness, or exaggerated responses to hot or cold temperatures may occur after surgery. Usually this resolves during healing, especially with massaging; but in rare situations it may be chronic.

Skin Discoloration / Swelling:
Bruising and swelling normally occurs following gynecomastia surgery. The skin in or near the surgical site can appear either lighter or darker than surrounding skin. Although uncommon, swelling and skin discoloration may persist for long periods of time and, in rare situations, may be permanent.

Scarring:
All surgery leaves scars, some more visible than others. Although good wound healing after a surgical procedure is expected, abnormal scars may occur within the skin and deeper tissues. Scars may be unattractive and of different color than the surrounding skin tone. Scar appearance may also vary within the same scar. Scars may be asymmetrical (appear different on the right and left side of the body). There is the possibility of visible marks in the skin from sutures. In some cases scars may require surgical revision or treatment.

Asymmetry:
Some breast asymmetry naturally occurs in most men. Factors such as skin tone, fatty deposits, skeletal prominence, and muscle tone may contribute to normal asymmetry in body features. Differences in terms of breast and nipple shape, size, or symmetry may also occur after surgery. Additional surgery may be necessary to attempt to improve asymmetry after gynecomastia.

Fat Necrosis:
Fatty tissue found deep in the skin might die. This may produce areas of dimpling or firmness under the skin. There is the possibility of palpable or visible contour irregularities in the skin that may result from fat necrosis. Additional surgery to remove areas of fat necrosis and to improve contour may be necessary.

Sutures:
Most surgical techniques use deep sutures. You may notice these sutures after your surgery. Sutures may spontaneously poke through the skin, become visible or produce irritation that requires removal.

Recurrence: 
There can be a recurrent breast and adipose tissue growth after breast reduction surgery depending on your hormone levels and extent of weight gain. Delayed Healing
Wound disruption or delayed wound healing is possible. Some areas of the breast skin or nipple region may not heal normally and may take a long time to heal. Areas of skin or nipple tissue may die due to poor circulation and/or smoking. This may require frequent dressing changes or further surgery to remove the non-healed tissue. Smokers have a greater risk of skin loss and wound healing complications.

Allergic Reactions:
In rare cases, local allergies to tape, suture materials and glues, blood products, topical preparations or injected agents have been reported. Serious systemic reactions including shock (anaphylaxis) may occur to drugs used during surgery and prescription medications. Allergic reactions may require additional treatment.

Damage to Deeper Structures:
There is the potential for injury to deeper structures including nerves, blood vessels, muscles, and lungs (pneumothorax) during any surgical procedure. The potential for this to occur varies according to the type of procedure being performed. Injury to deeper structures may be temporary or permanent.

Surgical Wetting Solutions :
There is the possibility that large volumes of fluid containing dilute local anesthetic drugs and epinephrine that is injected into fatty deposits during surgery may contribute to fluid overload or systemic reaction to these medications. Its occurrence is rare. Additional treatment including hospitalization may be necessary.

Shock :
In rare circumstances, your surgical procedure can cause severe trauma, particularly when multiple or extensive procedures are performed. Although serious complications are infrequent, infections or excessive fluid loss can lead to severe illness and even death. If surgical shock occurs, hospitalization and additional treatment would be necessary.

Surgical Anesthesia:
Both local and general anesthesia involve risk. There is the possibility of complications, injury, and even rarely death from all forms of surgical anesthesia or sedation. The chance of this is much less than the chance of a fatal car accident. Unsatisfactory Result
Although good results are expected, there is no guarantee or warranty expressed or implied, on the results that may be obtained. You may be disappointed with the results of gynecomastia surgery.

Asymmetry in nipple location or unanticipated breast shape and size may occur after surgery. Unsatisfactory surgical scar location visible deformities at the ends of the incisions (dog ears), loss of function, wound disruption, poor healing, and loss of sensation may occur. It may be necessary to perform additional surgery to improve your results. Also, the goal of the surgery is to reduce breast size, and not to give you a chest of an athlete or a body builder. Therefore, you might not be fully satisfied with having a flattened chest with no well formed Pectoralis Muscles. It is your responsibility to develop these muscles by proper training if you seek such chest physic.

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 both blood clots (pulmonary emboli), fat deposits (fat emboli) or partial collapse of the lungs after general anesthesia. Pulmonary and fat emboli can be life-threatening or fatal in some circumstances. Inactivity and other conditions may increase the incidence of blood clots traveling to the lungs causing a major blood clot that may result in death. It is important to discuss with your physician any past history of blood clots or swollen legs that may contribute to this condition.

Cardiac complications are a risk with any surgery and anesthesia, even in patients without symptoms. If you experience shortness of breath, chest pains, or unusual heart beats, seek medical attention immediately. Should any of these complications occur, you may require hospitalization and additional treatment.

I ask all my gynecomastia patients to wear a postoperative compression vest around-the-clock (except for bathing and garment washing) for the first two weeks following surgery and for half the day (either daytime or nighttime) for an additional two weeks. Many patients find the garment to be quite comfortable and wear it for longer than the prescribed amount of time.

Most gynecomastia surgery patients take one to three days off work, depending on the extent of their surgery. Patients who undergo the less invasive, retro-areolar gynecomastia surgery are allowed to return to vigorous physical activity about two weeks later, while patients undergoing more extensive procedures are required to wait for at least four weeks.