"Complications, loss of sensation." That is what was written in the box asking what worried them most before surgery. This is someone who had done their reading beforehand. Both are questions we get often in the consulting room.
Starting with sensation: the area around the areola can feel dull for a while after surgery. That is because the glandular tissue is removed from directly beneath it. In most cases it returns over time, but the pace differs from person to person, and the two sides can feel different. So we tell patients in advance before we begin. Experienced without knowing, it feels like an abnormal symptom; experienced knowing, it is part of recovery.
Questions about complications are usually about shape. During surgery we check and adjust how much to leave and where the border falls so that the area where glandular tissue was removed remains even — but the point at which a patient can judge that result is much later. Until swelling and bruising subside, both how it feels to the touch and how it looks keep changing. Bruising usually fades within about two weeks, and the remaining swelling takes longer to settle. Wearing the compression garment for the prescribed period and setting several follow-up dates are both for this stretch.
In the box about memories of the surgery, they wrote a single line: "I opened my eyes and it was over." Anesthesia is handled separately by the anesthesiology doctor, and I enter the operating room after the patient is under. Having almost no stretch that the patient remembers is normal.
For their first impression of the clinic, they wrote two things: kindness, and detailed guidance. This is someone whose answers are short overall, yet they took the trouble to note those two. For what they wanted to do after surgery, they chose wearing something other than a rash guard at the pool. Many people who come in for gynecomastia bring up swimming. It is a setting clothes cannot cover. Getting into water, though, comes after the wound has healed and the suture site is stable. If you have summer plans, we can align the timing at a visit.
To others with the same concern, they left the thought that it is better to do it while you are younger, even by a year. That is their view, and age is not the criterion that determines whether surgery is appropriate. That is something to judge after confirming tissue condition and symptoms at an examination. In the last box, they wrote, "Thanks to you, I've seen the light. Thank you." We received those words gladly.
