"It Was Better Than I Expected"

When I asked about their worries before surgery, they wrote this.

"Pain, whether the surgery would go well. It was better than I expected."

To give the answer first, pain after gynecomastia surgery is greatest in the first few days after surgery and then gradually decreases. Because it is not surgery that cuts muscle but surgery that excises glandular tissue and removes fat by liposuction, the character of the pain is closer to a muscle ache where the whole chest feels stiff than to the pain of a cut. If you think of the day after exercising too hard for the first time in a while, it is not very different.

However, the extent of excision and liposuction differs from person to person, and so does how much pain one feels. That it was fine is this person's course, and it is hard to state uniformly from which day it becomes bearable.

When I asked about memories during surgery, they answered this.

"I woke up from the anesthesia and got up, and had no memory of the surgery."

Because surgery is performed under sedation, patients are asleep while it takes place. The anesthesiology team is in charge of anesthesia, and I, as the operating surgeon, enter the operating room after the anesthesia is complete. So the operating room experience patients remember is generally just the few minutes from entering until the anesthesia takes hold. Having no memory does not mean something went wrong; it means things went as planned.

The other thing they worried about was whether the surgery would go well. That judgment is difficult right after surgery, because swelling remains and you are wearing a compression garment.

In my case, I check the course at set points and look at items such as seroma, hematoma, and asymmetry between left and right at the same time. Think of the judgment about shape as being settled over several months as the swelling goes down and the skin settles. That is why, in many cases, how you get through the weeks afterward shapes the result more than the surgery itself.

What determines the shape is not how much was removed but what was left and how much. Gynecomastia is a mix of grown glandular tissue and accumulated fat, and the ratio of the two differs from person to person.

If only liposuction is done for someone with a high proportion of glandular tissue, a firm lump remains and can be felt when touched. Conversely, if the glandular tissue is removed entirely, the area under the areola sinks like a pressed-in saucer. So directly under the areola we leave tissue at a certain thickness, and we taper the edges so they blend into the surrounding fat layer. A gentle curve needs to remain over the pectoralis major so that it does not look awkward not only when you are dressed but also when you are not.

For what they wanted to do after surgery, they wrote this.

"Wear smaller clothes."

When the volume at the front of the chest decreases, the silhouette of tops changes first. However, right after surgery it is hard to check because of swelling and the compression garment, and many people feel it only after the swelling has settled to some degree. How quickly the swelling goes down also differs from person to person depending on the extent of excision and liposuction.

Whether the clothes fit is more accurately checked after that period has passed.