Hi, this is Dr. Bernard Beldholm
and I'm a body contouring surgeon.
I help men and women, but in this particular instance,
I help men with gynaecomastia get a chest flat
and be able to take their shirts
off and be proud of their physique.
Now, today we're going to talk
about the gynaecomastia operation.
Now, there are a couple of videos
of actual operations on my YouTube channel as well.
So check those out, but I'm going to go
through, in a few steps, what you can expect,
what the procedure involves
and just to get a sense of what you can get out of it.
Now, before we do that, there are a lot of men that come,
well, it's two groups, a couple of groups.
One is the teenager that had gynaecomastia,
that after the teenage years, it hasn't gone away.
It's a common group I see.
The second one is the group that are bodybuilders
that have taken anabolic steroids
and basically developed the gland that needs to be removed.
And I guess the third group is overweight men
that have a chest that looks a little bit more female
and they want to have that fixed.
So those are the sort
of broad three groups that I deal with and help.
Now, one question that I always get is,
"Can you do this stuff without surgery?"
Now, for the bodybuilders, there are a lot of
testosterone-blocking medications that they use.
They are, the research says,
they're really not that effective.
If you get the gland, if you get gynaecomastia then really
it's very difficult to get rid of it with medication.
And then certainly, the literature shows
that all the testosterone-blocking medications,
antagonists, all that stuff,
it's really not that effective to get rid of it.
If you're overweight and have obviously a chest wall
that looks a little bit more female,
then losing weight is one option.
If you've been a teenager with gynaecomastia
that hasn't gone away, it's very difficult to
get rid of it with normal medication.
I'm going to have a separate video about how you can get
through gynaecomastia without surgery.
But in this video, I'm going to focus on the surgical side.
So what is the surgery like?
Well, it's usually quite a quick procedure.
Now again, there're always risks with surgery.
So read the disclaimer and we'll go through that
in another video about the risks of surgery.
But in this video, it's usually a straightforward operation.
An hour and a half, two hours at the most.
It's in three steps.
So it's done with general anesthetic in a private hospital.
You have liposuction on the chest wall.
And that feathers in the gland.
So one of the big, common problems that happen
at the gynaecomastia surgery is if you just cut the gland
out and do nothing else, you end up with a depression
in the chest wall and that can look really bad cosmetically.
It's causes a saucer deformity.
So it's like a saucer in your chest wall
and really doesn't look good.
So the liposuction feathers in the result to make sure
that the edges are nice and smooth.
Also, it can sculpt a bit more of a muscle for you
and get rid of the side bits that are very common as well.
So we sort of try to sculpt the chest wall
with VASER liposculpture.
The second step is to remove the gland.
So that's done underneath the nipple
and then you just basically cut the gland off.
And then the third stage is to get
what's called hemostasis, or buzz all the bleeders and
make sure that the blood vessels are not bleeding
by the time you wake up.
I do tend to use drains. Drains are
little plastic tubes that come out of the chest wall.
Usually, it's through the liposuction hole
so you don't actually get an additional hole for the drain.
The reason for that is
that you do tend to get a lot of fluid with the liposuction.
And also if you have a little bit of bruising, a little bit
of bleeding, a little bit of what's called oozing of blood,
the drains will take that away
so that you have less bruising
and less swelling after the operation.
So I do tend to use drains afterwards.
Usually, they come out the next day.
You can either go home the same day
or stay in the hospital overnight.
Either one is fine.
In a separate video, we'll go through the Medicare item
numbers and health insurance and stuff like that.
So, but an hour and a half operation.
Usually very good recovery, a little bit
of discomfort the first few days, but then
you'll get back to normal quite quickly after the operation.
So in my personal opinion, why would you put
up with something that's so embarrassing for men?
I get a lot of men coming in
that have had gynaecomastia for a lot of years,
maybe even 10, 20 years,
and they've been embarrassed. Never gone to beach,
never taken their shirt off, embarrassed in the gym.
Why would you want that when you can fix it with an hour
and a half operation?
Thank you for listening.
Remember, surgery always carries risks.
And get a second opinion if you are considering surgery.
But if you want something done
about your gynaecomastia, come and see me.
This has been Dr. Bernard Beldholm talking
about the operation for gynaecomastia.