Advanced Art of Cosmetic Surgery:  Thomas M. DeWire, MD, FACS, Surgery Center and Spa,  3974 Springfield Road, Glen Allen, VA, 23260, Richmond, Virginia, USA

GYNECOMASTIA:

You may be surprised that gynecomastia information is one of my most frequently visited pages, so there are a lot of men out there with the same concerns.  
This surgery is usually done under local anesthesia with or without a mild sedation in the office.  It is easier to treat the condition in men who are close to ideal body weight (i.e. gynecomastia NOT mostly due to being overweight).  The risks are those of most surgeries, and include bleeding (usually minor), infection (rare), scarring (usually mild), blood or fluid build-up (uncommon),  contour irregularities (unusual), need for touch-up (uncommon), and dissatisfaction (also uncommon if the patient has a realistic expectation).   Cost is currently $3
700 for Surgery/supplies/anesthesia in the office, but may be higher depending upon the particular problem. We recently moved into new facilities, with certified ORs, and still maintain a fee structure below that of the surrounding hospitals. If you have further questions, let me know.  We  currently have a relationship with MBNA bank for unsecured financing loans for qualified cosmetic surgery patients, although many patients achieve suitable financing, at reasonable rates, via their credit unions or home equity loans.  Please call the office for details concerning the MBNA program.  

  
An informative online version of my brochure is found at:  www.plasticsurgery.org/surgery/gyne.htm
You should also inform the office of any health problems that you have, including medications, allergies, and smoking history. If traveling from out of town, I will need to review photos from frontal, both sides, and both 45 degree oblique angles, from neck to mid abdomen, to assess suitability, and you would need to plan to spend at least 3-5 days in Richmond, for consultation, surgery, and follow-up, with possible need to return at a later date for follow-up.  If you have further questions, let me know.

 


 About Sending Photos:    Please send five views, and any special views that show problems if you are inquiring about revision surgery.  The photos should be taken in good lighting, against a dark background, and framed from neck to waist in all views, so that overall body proportion and symmetry can be assessed.  If you send digital photos, please use JPEG  (.jpg) format, and simply attach them individually, rather than sending a Zip file.  Polaroids or similar types are fine by mail, also, but seldom show as good detail, and may delay reply somewhat.
PRE-OP QUESTIONS:
]] SURGERY DATE:
]] NAME: 
]] FULL ADDRESS:
    Street:
    Apt:
    City:                State:             Zip:
]] Phone Number(s) with Area code:
    Home:  (      )
    Work:  (       )
    Cell:    (       )
    Pager: (       )
]] Preferred Stable E-mail Address:
]] Age: 
]] Date of Birth:
]] Social Security number (needed for OR posting):
]] Height:
]] Wt:
   
]] Do you smoke?                How much and how many years?
You will be urged to quit if you smoke, and will not be a candidate for
surgery if a major breast lift, facelift, or abdominoplasty is contemplated due the much higher
complication risk in smokers.
]] Do you have any medical conditions such as: Diabetes, high blood pressure,
or heart disease?
]] List any medications you take regularly and dosages and their reason (include aspirin, anti-inflammatories, vitamins, homeopathics):

]]Have you ever, or are you currently using anabolic steroids for bodybuilding reasons?              They increase the risk of bleeding complications.

 

]] Are you allergic to any medicines?
]] Is there a family history of breast cancer or breast disease?
FOR LIPOSUCTION AND TUMMY TUCK PATIENTS:  (Be sure to send photos of all areas of concern from front, back and sides)
]]Which areas of concern do you think will benefit from liposuction?:
]]Have you had liposuction before?
}}Have you had any abdominal or leg surgery in the past?:        What?:
]]]]Please send these answers back to me, and I will save them for your file.

To cut data, use the cursor to highlight it with the left mouse key depressed, and click Ctrl-C.  To paste it, place the cursor on the new document and click Ctrl-V.  Answers can now be added to the pasted document.


PRE-OP REQUIREMENTS and RECOMMENDATIONS:
]] Some patients may require lab work or an EKG before surgery, this will need to be coordinated for patients from out of town, especially if they are having surgery in the Office Surgical Suite.  Hospital patients will have these tests at the hospital, as warranted.
]] To limit risk of bruising and bleeding:  No aspirin, ibuprofen (Advil;Motrin;Nuprin) or other arthritis pill, or any combination medicine (such as cold or flu pill) that contains them for 7 days pre-op.
Vitamin E and Vitamin C should be stopped for 3-4 weeks pre-op due to potential for increased bleeding and impairment of clotting.
]] Stop any homeopathic medicine (herbal teas; Ginseng, St.John's Wort) for at least 4 weeks pre-op, because they are unregulated regarding side effects, and many may impair clotting, or interfere with serum chemistry pre-op.
]] Do not drink alcohol for 24 hrs. pre-op
]] Do not shave axilla for 10 days (Breast augmentation patients only), or groin hair (lipo patients), until the AM of surgery to limit risk of ingrown hair.
]] Arrive for surgery with an empty stomach and nothing by mouth for 8 hrs pre-op (except cardiac meds with a sip of water)
]] Wear a loose garment that buttons in front to the hospital or office the day of surgery (e.g. a sweat suit)
]] Do not wear jewelry to the hospital or office for surgery
]] If you are from out of town bring light snacks, saltines, baggies for ice chips, lifesavers or hard candy, mild soda (e.g. ginger ale) or juice to keep in your hotel room, along with books, or magazines.
]] For Abdominal Liposuction or Tummy Tuck patients, extra care should be taken to clean the belly button with soap and water and a q-tip with each shower for a week before surgery.
]] Patients who smoke, should obviously quit smoking for several weeks ahead of time to prevent impairment of wound healing, and heightened discomfort associated with Nicotine, Carbon monoxide poison gas in smoke.

Revised:  October 29, 2007 04:05:40 PM