GynecomastiaPre & Post-Op Instructions

How to prepare for your surgery

What happens at my pre-operative appointment?

On the day of your pre-operative appointment, we will review your procedure in detail and go over the surgical plan with you. We will also address any questions and concerns you may have. Please read over the procedure consent before this appointment and have any questions ready so we can discuss them.

When will I receive my aftercare instructions?

During your pre-operative visit, we will provide you with all the after-care instructions as well as necessary medication prescriptions. You will also be provided with a post-operative appointment for follow-up after your surgery.

What should I do or not do leading up to the day of surgery?

Please do not smoke (cigarettes, vape, or pipe) or use any nicotine products 4 weeks before and after your surgery. Smoking and nicotine greatly impair healing, which can cause an increased risk for infection and complications, such as delayed incisional healing or wound opening which lead to worse scarring.
Please stay away from secondhand smoke as well, as this can also cause wound healing problems. If you use nicotine products, you will need to stop 4 weeks before surgery and then you will need to undergo a cotinine test before surgery to ensure that the nicotine is out of your system.
Please do not drink alcohol before or after your surgery (until cleared by your surgeon). In addition, please do not drink alcohol while taking pain medication, as this can have serious and life-threatening side effects.
Please leave all valuables at home. If you have body piercings, kindly remove them before surgery.
Please have someone available to drive you home. Due to the lasting effects of the general anesthesia, you will be unable to operate a car after surgery. A taxi or car service is not adequate either. You will need a family member or friend who can assist you.
Shower the morning of or the night before your surgery with your normal soap and water. Do not use deodorant, lotion, cream, perfume, aftershave, oils, or makeup after bathing.
Do not take Advil, Aleve, Naproxen, Fish Oil, Garlic, CoQ10, Omega 3,6, Motrin, Excedrin, Ibuprofen, Aspirin, medications for arthritis, or any medication that contains these medications for ten days before your surgery and two weeks after.
Do not eat or drink anything after midnight the night before your surgery.
Please call our office if you have an infection of any kind before your surgery.

You may have been asked to obtain pre-operative tests at a lab facility or by your primary care physician. Your pre-operative tests (labs, X-rays, EKG, etc.) need to be completed at least three days prior to your surgery. If you have them done at your doctor’s office, the results will need to be faxed to (210) 362-1582. The surgery facility will call you the day before your surgery to let you know what time and where you should arrive.

What happens on the day of surgery?

On the day of surgery, your plastic surgeon will meet you in the pre-operative area to go over any last-minute questions or concerns you may have. Your plastic surgeon will make some preoperative markings and perform extensive checks with careful attention to detail to ensure high-quality care and safety. You will then meet the anesthesiologist and their team, as well as the members of our plastic surgery operative team.

What should I expect during my male breast reduction surgery?

During your procedure, our surgeons will be paying attention to every detail to achieve the best possible results. Your family will be updated on your status periodically and will be able to talk with the plastic surgeon in person after the procedure is completed. The incisions will be placed in a dressing or a compression bandage. Instructions on how to care for these will be given to you in your preoperative paperwork.

Tips to help speed your recovery from gynecomastia surgery

To make your recovery faster and more comfortable, we recommend that you prepare before your surgery. Some things you can do include:

Prepare a sleeping area that is easy to get to. For example, set up a couch so you will not be required to walk to an upstairs bedroom.
Keep your toiletries close by and prepare food ahead of time.
Arrange for someone to be with you the first night after surgery.
You may receive your post-operative medications at your pre-operative appointment. You should have these medications available at home before your surgery.
Review your post-surgery instructions given to you at your pre-operative appointment
The effects of the anesthesia can last for several hours, which may leave you groggy and disoriented. As a result, it is not safe for patients to drive themselves home. If you are scheduled for surgery, be sure to confirm that you have a designated driver lined up before the day of the procedure.
If you have a history of nausea or vomiting after anesthesia, please let your surgeon and your anesthesia provider know. We can prescribe anti-nausea medications and take extra steps to prevent nausea and vomiting after surgery.

How much pain will I have after my male breast reduction surgery?

After surgery, you will likely experience some discomfort. The goal of pain medications is to reduce this pain, but it is important to understand that it may not remove all discomfort. A good measure of whether you need more pain control is if you can take a deep breath without severe pain.

If you wait until your pain is unbearable to take the next dose of medication, it will take longer to get your pain under control again. Therefore, it is important to stay ahead of your pain by taking medication as prescribed and keeping an eye on your discomfort level. By doing so, you can ensure that your post-operative recovery is as comfortable as possible.

What medications can I take after my surgery?

You may resume your home medications after surgery; however, blood thinners should not be taken until cleared by the surgeon. You will be given a prescription for pain medication. If you are prescribed medications that contain acetaminophen, do not exceed the recommended dosage of 3500 milligrams per day. Do not drive, operate heavy machinery, or make important decisions while taking narcotic pain medications.

What medications will I be taking, and are there any side effects?

We will prescribe pain medications for recovery after surgery but do not prescribe long-term pain medications and do not do more than one refill for any pain medications. If you have pain that is beyond what is usually anticipated for your surgery and there is no surgical reason that can be found, we will help by referring you to one of the many pain management specialists that we work with. Otherwise, you may be prescribed some of the following:

Narcotic medication: Narcotic medications may cause constipation. Ensure you have adequate (>25 grams/day) of fiber in your diet and drink at least 64 oz. of water daily.
Stool softener: You may also wish to take an over-the-counter stool softener such as MiraLAX or Colace once or twice daily.
Ibuprofen: You may alternate your narcotic medication with Ibuprofen 600 mg every 6 hours and/or Gabapentin 300 mg three times a day. Take ibuprofen with food to protect your stomach from irritation.
Anti-nausea medication: If you have a history of nausea or vomiting after anesthesia, you may be prescribed an anti-nausea medication (Ondansetron) which can be taken as needed.

Before prescribing any narcotic medications, we are required to check the Texas controlled substance history database (Texas Prescription Monitoring Program). If you currently have a pain medication contract with another physician or are currently on narcotic medications, we will have to coordinate your medications with that physician.

How do I care for my surgical site?

You may shower 48 hours after your surgery. Do not scrub the incisions. Just let the water run over them and gently dab them dry afterward. Apply gauze or ointment over the surgical site daily as needed for light drainage. We will advise you not to immerse your incisions in baths or hot tubs until at least 2 weeks after surgery. More specific instructions will be provided during your pre-operative visit.

Drain Care:

Sometimes it is necessary to place a drain after surgery. The purpose of a drain is to remove excess fluid from the surgical area. You will need to empty the bulbs and measure the output whenever the bulbs are half full or at least twice a day.

You will be given a sheet to record how much is coming out of the drains. Bring this sheet to your follow-up appointment. In general, drains remain in place until there are less than 30 mL (oz.) out of the drain for two days in a row.

Please Call Immediately if:

Please call if you have the following signs/symptoms:

temperature greater than 100.5 F
bleeding or pus draining from the wound site. If you have bleeding, apply direct pressure to the area for 20 minutes
increasing pain that is not controlled on oral pain medications
increasing redness or size at the surgical site
your drain is not holding the suction
if your incisions come apart
Any other concerns

For non-emergency questions:

During business hours (8 AM – 4:30 PM), call (210) 658-3555.
After hours and on weekends/holidays: call (210) 658-3555, and you will be forwarded to the on-call surgeon.
If you are having any serious problems or symptoms, such as difficulty breathing or chest pain, call 911 or proceed to your nearest emergency room.

Will I have any activity restrictions?

Restrictions after your procedure include:

No vigorous activity, this includes no pushing, pulling, bouncing, housecleaning, yoga, running, or heavy lifting greater than 5 lbs. until your follow-up appointment.
Avoid activities that raise your blood pressure or heart rate.
You should not lay in bed and be sedentary for long periods of time

You will be encouraged to walk around and perform light activities after your surgery.

When will my clinic appointment be scheduled?

Your clinic appointment will be scheduled at your pre-operative appointment before surgery. If you need to change your appointment time or date, please contact our clinic at (210) 658-3555. The surgeon may adjust any of the above guidelines and instructions based on the patient and the type of surgery performed