"I Closed My Eyes, Opened Them, and the Surgery Was Over"

As something memorable during surgery, they wrote one line.

"That the sedation takes effect faster than I expected."

To give the answer first, with sedation the medication goes in through a vein, so the effect appears quickly. From the patient's side, many feel it as their memory cutting off within a few breaths.

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 part of the operating room that patients actually remember is the few minutes from entering until the anesthesia takes hold. The moment of greatest tension is also not during surgery but these few minutes.

They wrote that there was almost no pain, but that was their case. I cannot tell you that you will feel no pain in gynecomastia surgery. The extent of excision and liposuction differs, and how much pain people feel also differs from person to person. In my clinical experience, it is often greatest in the first few days after surgery and then gradually decreases.

As their first impression of the clinic, they wrote about the consultation. Their answer was that the early consultation helped a great deal.

The items we check in a gynecomastia consultation are set. How developed the glandular tissue is, how much fat is mixed in, where it falls on the Simon grade, and whether it meets the criteria for national health insurance coverage. We check by visual inspection and palpation, adding ultrasound if needed. Only when this process is finished is it decided how far I can speak about the extent of excision and the shape that will remain.

Narrowing the scope in consultation reduces what the patient has to bear on the day of surgery. That seems to be the part this person pointed to when they mentioned the early consultation.

The anesthesia takes a few minutes to take hold, but the part patients have to get through comes after. In my case, I explain it like this. About one week after surgery, light cardio is possible; from two weeks, the inner wounds have stabilized to some degree, and shoulder stretches can help drain the swelling. From four weeks, light weight training, and by about six weeks most people regain most of their pre-surgery exercise capacity.

Starting weights at four weeks is not a fast schedule but the usual course. However, adjustments are needed depending on the extent of excision and the course, so it is better to confirm and decide when to resume at an examination.

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

"I want to wear the clothes I want without worrying about what others think."

This is the most common answer from people who come in with gynecomastia. Light-colored T-shirts, thin summer shirts, fitted clothes. However, you need to wear a compression garment for a certain period, so this is a story for after that period. You can plan the timing of surgery by looking at the wearing period and the care schedule afterward together.