How long should you rest post op?

[westham]

Hello, I'm new here! I've recently decided to swallow my pride and have surgery after having gynecomastia for the last 2 years, was just wondering if anyone knows how long you shoud wait before doing physical activities after the op? I'm a fireman and can only take 2 weeks annual leave at a time would this be enough time before going back to work? Also  is there anyone who has had surgery who can reccomennd a surgeon in the London area?

Going off the subject a bit I was just wondering if anyone might have any ideas as to why I have gynecomastia?....... I used to be a 14.5 - 15 stone muscular rugby player, having recieved too many injuries I gave it up and took to less physical sports. In this time a lost nearly 2 stone....but gained a pair of breasts! Now.... to my limited knowledge - Steroids, cannabis, excessive alcahol and obesity are the main causes, and apart from the odd beer I dont fall under any of these catagories. Does weight loss cause man boobs?  I'm intersted to learn about the condition, also to stop it from comming back if i go through with the op.

[phantom]

Hello westham

First off you will be pleased to learn that you are in good company - not just in this forum, but with the rest of the global male population.  Around six out of ten men have a varying degree of breast (or gland or glandular) tissue.  Some guys have more than others and some have enough to make either their nipples protrude or even fill out the pectoral area to give a woman-like breast appearance.  And that is what gynaecomastia means.  It comes from the Greek Gynos (of woman) Mastis (breast).

Gynaececomastia is cause by breast or gland tissue and/or fat tissue.  It's each on their own or a combination of both that can give an unsatisfactory looking chest.  It's all very, very subjective.  Some guys on this forum have very slightly raised nipples.  For others, they have very well formed breasts that could easily get away with being hung on a woman.  For the record, I was a 'c' cup with an overhang.  My surgeon described me as moderate to severe.

What causes gynaecomastia?  Many things, but it is usually related to hormones, age and body fat.  Some boys are born with a condition called Hypogonadism (low testosterone).  Without getting into the science, this means they do not produce enough testosterone at puberty and very often may develop more than their fair share of breast tissue at puberty (which often occurs late for them, if at all!)

Hypogonadism can occur in adulthood by various causes, some you have already mentioned.  There is a possibility that as your physical exercise has diminished, so has your lean body tissues, your muscles.  This in unlikely to result in an increase in your breast tissue, but if your body shape changes for the worse, you may find your pectoral area may have developed a 'sag' any may be giving you a breast like appearance.

Also as men age, their testosterone levels diminish significantly and subsequently gain more fat - a typical symptom of testosterone or androgen deficiency.

The point here is there could be all kinds of reasons as to why you may have developed gynaecomastia.  Before you consider surgery, it's essential you discuss this with your GP.  Increasingly GPs are getting clued up on this subject area.  But some are not.  Explain your concerns and ask to be referred for some hormonal checks with either and Endocrinologist (hormone specialist) or Urologist (urinary tract specialist).  It all depends on your local hospital who deals with hypogonadism.

Hopefully all test results will come back normal.  If not, that need further discussion before you can consider surgery as it's important to make sure everything is in order to prevent the risk of gynaecomastia returning after surgery!

Once you have the all clear, then you can set about looking into surgery.  This is not something to be rushed into.  It takes time to decide who you want to do it ie. NHS or private?  If you go private, which surgeon etc.

Recovery varies from person to person.  Most guys can resume normal life within 3/4 days.  As a fireman, your physical life is way above normal.  You have a duty of care to the general public and your GP would probably sign you off for at least four weeks.  I am guessing this as my surgeon said that I would not be able to resume normal activity at the gym for four weeks.  This is something you would need to ask your GP and surgeon.

If you are worried about revealing why you will be off work to your employer, you can ask your GP to write a sick note explaining minor surgery to chest wall.  That way you would get your statutory sick leave without it affecting your annual leave.

The name of the surgeon most mentioned in the London area is Dr. Karidis, website is at http://www.nipntuck.co.uk/

I don't know how well a reputation he has for male chest procedures though, this is something you need to look into.

I always advise going to see at least three surgeons and choose the one you get on with most face to face.  This is more important than location and cost of surgeon.

I live in Manchester, but decided to use Mr Levick in Birmingham (website at foot of my posts) over two other surgeons I went to see in Manchester and London.

Experienced surgeons that have a high caseload of male chest procedures are far and few between, so it's essential to get the right man (or woman) to do the job right, first time!

Hope that helps.

[westham]

Thanks for that Phantom, I just learned more about the condition in your reply than hours of reading stuff from many different websites.  I can't remember the last time I went to a docor, what if the doc say's I dont need to see an endocrinologist or urologist, do I have a right to demand to have these tests?
As far as what you said about going on the NHS, I never even new that sort of op was available on the NHS! I take it the only difference is the waiting time before actually having the op?
What about the surgery you've had? are you satisfied with the results?

[phantom]

Your GP will probably ask you a number of hormone related questions.  He/she will want to know if there has been any other psychological/physiological changes such as changes in mood and libido, your ability to hold and maintain an erection and frequency of erections - have they diminished at all.  Have any of the above changed since you noticed the change in your chest?  Please, please don't be embarrassed with your GP, he's as bothered about asking intimate questions as you are getting cats that are stuck up trees!

Many guys on here find it useful posting a picture of there chest on this site.  Whilst none of us are professionals, we tend to know a hell of a lot more about the subject than the average GP and we've definitely seen more chests affected with gynaecomastia than any GP!  You can generally expect a genuine set of opinions on here.

I know many of us don't like to ask or tell our GPs what we want, we don't want to undermine their position.  Go to your GP, tell them you think you may have developed gynaecomastia.  Tell them that you are even considering surgery, but want to make absolutely sure there is not an underlying hormonal issue before you consider surgery.  Ask if getting a few tests done with and Endo would help.  If they say no, then ask why.  Let us know on here what the outcome is then I can advise you what to do next.  Please don't be tempted to seek surgery before you have got the hormonal bit out of the way, I've read too many heart-breaking stories where guys have gone full-steam ahead only to be haunted by the boob returning.

The NHS route to surgery can be a real minefield.  I have read stories where a guy goes to their GP, they are referred and see a surgeon a few weeks later.  Next thing they are operated on and sent home, all under three months and the guy is very happy with the result.  This really is the exception and not the rule.

Some guys have had no success with the NHS.  It is very circumstantial.  You need a sympathetic GP for starters.  You then need an experienced surgeon and as I have said, they are very far and few between.  You then need to find a surgeon that will agree to the surgery.  Some NHS surgeons will only perform surgery in extreme cases.  Even then they may try to put the patient off by dwelling on the risks rather than the benefits.  Other NHS surgeons  are not so bothered by 'clinical standards' and won't give the patient such a hard time.

I believe any guy with a genuine case of gynaecomastia has a good chance of getting the surgery on the NHS if he is persistent.  It may take many months, usually over a year to get to the operating table and you don't have much choice as to who gets to chop away at you.

Obviously the reverse is true of going private.  You pick the surgeon, you pick the date and often the work is backed up with guarantees.

Am I satisfied with my surgery? F*cking delighted mate.  Mr Levick is probably the most experienced surgeon in the UK for male chest procedures - he even had the surgery done on himself so he completely understands his patients.  On meeting him you'd think you were talking to a guy at a local pub, he's that laid back.

As I mentioned, I was quite a significant case and was told that there was a higher chance for the need for a second surgery.  To date, my chest is very flat and I can now wear whatever I want without feeling as if I have boobs.  Because there was an 'overhang' with my chest, there is still a line of fat and scar tissue causing a slight sag.  Mr Levick wants to see me again in July (six months post op) to see how the tissue settles.  If there is room for improvement, he said he'll 'hoover out' whatever needs to be removed - at no charge as you pay for the treatment of gynaecomastia, not the amount of work involved.

Now go see your GP and let us know how you get on!

[westham]

Thanks again phantom, I'm going to make an appointment with the doc tommorow.  Will get some photo's of my chest and post them on the site, will be interseting to hear your opinions, (although the boys at work are quite vocal on their opinions in the locker room anyway!)
Interesting to hear what you said about libido, mood, etc although its not a problem now, it was for 3 months or so last year (apologies if this is too much information!)

Thanks again for your advice and knowledge, this site has made me feel better already.  Not really good at expressing emotions etc, and it may sound a bit cheesy, but reading other peoples experiences on this forum does make you realise that you're not the only one dealing with this condition.

[westham]

he's as bothered about asking intimate questions as you are getting cats that are stuck up trees!

P.S Just for the record, I have never in my whole career dealt with any cat up a tree, completley off subject I know, just thought I'd let you know!