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These videos are from Gabriel H. Patino, MD Specialist in Cosmetic Surgery. The videos contain exclusively medical, surgical, scientific, professional, educational material. Medical confidentiality laws have been followed and all videos have been made with the prior written consent and permission of my patients. The viewer’s discretion is recommended due to nudity which can be considered as sensitive content and can be offensive or disturbing to some people. GYNECOMASTIA (Male Breast) The procedure is usually performed under tumor anesthesia and sedation by mouth. General anesthesia is available at our fully accredited IMQ outpatient surgery, but it is rarely necessary unless the patient is very anxious and or has a very low pain tolerance. After a short evaluation before the operation, you will be taken into our state-of-the-art surgical suite, your areas to be treated will be prepared and draped in a sterile manner. Your choice of anesthesia will be introduced. In addition, the tumescent anesthesia will be slowly inserted with a very small cannula. Dr. Patino uses Tumescent anesthesia in all his cases because it provides pain control not only during the procedure but for another two days after the procedure. As a result, patients experience much less pain and a much faster recovery. His patients usually walk one mile on the first day, 20 miles the second day, and 30 miles daily thereafter. The early ambulation minimizes the risk of blood clots that can be fatal. None of Dr. Patino’s cosmetic surgery patients have ever had a blood clot and none of his patients have ever died. The adrenaline in the tumescent anesthesia minimizes the risk of bleeding and bruising. None of Dr. Gabriel Patino’s patients with gynecomastia or liposuction or breast surgery have ever had bleeding complications. Microaire Power Assisted Liposuction (PAL) is a very effective treatment for Pseudo Gynecomastia (excess fat in the breast tissue). Gynecomastia (solid glandular breast tissue) usually requires open excision (removal with scissors or electrocautery) via a small incision (opening) over the areola (the brown part of the nipple) inferior (lower) edge. Sometimes this solid glandular breast tissue can be removed with special aggressive liposuction needles, which avoids the open nipple. Sometimes removal of pseudogynecomastia (excess breast fat) and gynecomastia (solid glandular tissue) can leave a depressed area. If so, Dr. Patino will fill the depressed area (bulge) the same day with a fat transfer using the fat previously removed from Pseudo Gynecomastia (excess breast fat). The treatment of these conditions that you can see usually justifies liposuction to remove as much of the excess fat and possibly also remove the solid glandular tissue. Often, however, the solid glandular tissue cannot be removed by liposuction and an open excision of this tissue is usually made the same day. Sometimes a fat transfer to the breasts can be indicated to smooth out any dents and / or irregularities and this is also done on the same day. A drain is rarely used by Dr. Patino. A compression garment is placed immediately after surgery and should be worn for the next six weeks to prevent fluid retention and improve healing. Dr. Patino personally evaluates all of his patients the next day. Follow-up times are one day, one week, two weeks and six weeks when postoperative photographs are taken. .

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