Gynecomastia is a medical term that comes from the Greek words for women-like breasts. Though this oddly named condition is rarely talked about, it’s actually quite common. Gynecomastia affects an estimated 40 to 60 percent of men. It may affect only one breast or both.
Though certain drugs and medical problems have been linked with male breast over-development, there is no known cause in the vast majority of cases.
For men who feel self-conscious about their appearance, breast-reduction surgery can help. The procedure removes fat and or glandular tissue from the breasts, and in extreme cases removes excess skin, resulting in a chest that is flatter, firmer, and better contoured.
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Gynecomastia surgery is a highly individualized procedure and you should do it for yourself, not to fulfill someone else’s desires or to try to fit any sort of ideal image.
In cases where gynecomastia is primarily the result of excess fatty tissue, liposuction techniques alone may be used.
This procedure is a good option for you if:
- You are physically healthy and of relatively normal weight
- You have realistic expectations
- Your breast development has stabilized
- You are bothered by the feeling that your breasts are too large
Surgical correction of gynecomastia is best performed on:
- Men whose condition cannot be corrected through alternative medical treatments
- Healthy individuals who do not have a life-threatening illness or medical conditions that can impair healing
- Non-smokers and non-drug users
- Men with a positive outlook and specific goals in mind for improving the physical symptoms of gynecomastia
When male breast-reduction surgery is performed by a qualified plastic surgeon, complications are infrequent and usually minor. Nevertheless, as with any surgery, there are risks. These include infection, skin injury, excessive bleeding, adverse reaction to anesthesia, and excessive fluid loss or accumulation. The procedure may also result in noticeable scars, permanent pigment changes in the breast area, or slightly mismatched breasts or nipples. If asymmetry is significant, a second procedure may be performed to remove additional tissue. The temporary side effects of male breast reduction include loss of breast sensation or numbness, which may last up to a year.
Excision techniques are recommended when glandular breast tissue or excess skin must be removed.
The initial consultation with your surgeon is very important. Your surgeon will need a complete medical history, so check your own records ahead of time and be ready to provide this information. First, your surgeon will examine your breasts and check for causes of the gynecomastia, such as impaired liver function, use of estrogen-containing medications, or anabolic steroids. If a medical problem is the suspected cause, you’ll be referred to an appropriate specialist.
Your plastic surgeon may, in extreme cases, also recommend a mammogram, or breast x-ray. This will not only rule out the very small possibility of breast cancer, but will reveal the breast’s composition. Once your surgeon knows how much fat and glandular tissue is contained within the breasts, he or she can choose a surgical approach to best suit your needs.
Incision patterns vary depending on the specific conditions and the surgeon’s preference.
Don’t hesitate to ask your surgeon any questions you may have during the initial consultation- including your concerns about the recommended treatment or the costs involved. Treatment of gynecomastia may be covered by medical insurance, but policies vary. Check with your health insurance provider to be sure. If you are covered, make certain you get written pre-authorization for the treatment recommended by your plastic surgeon.
Your surgeon will give you specific instructions on how to prepare for surgery, including guidelines on eating, drinking, and taking certain vitamins and medications. Smokers should plan to stop smoking for a minimum of one or two weeks before surgery and during recovery. Smoking decreases circulation and interferes with proper healing. Therefore, it is essential to follow all your surgeon’s instructions.
Plastic surgery to correct gynecomastia is technically called reduction mammaplasty, and reduces breast size, flattening and enhancing the chest contours. In severe cases of gynecomastia, the weight of excess breast tissue may cause the breasts to sag and stretch the areola (the dark skin surrounding the nipple). In these cases the position and size of the areola can be surgically improved and excess skin may be reduced.
Medications are administered for your comfort during the surgical procedure. The choices include intravenous sedation and general anesthesia. Your doctor will recommend the best choice for yo
In cases where gynecomastia is primarily the result of excess fatty tissue, liposuction techniques alone may be used. This requires insertion of a cannula, a thin hollow tube, through several small incisions. The cannula is moved back and forth in a controlled motion to loosen the excess fat, which is then removed from the body by vacuum suction. There are various liposuction techniques that may be used; the technique most appropriate in your case will be defined prior to your procedure
The areola can be reduced, or the nipple repositioned for a more natural chest contour.
Excision techniques are recommended where glandular breast tissue or excess skin must be removed to correct gynecomastia. Excision also is necessary if the areola will be reduced, or the nipple repositioned to a more natural male contour. Incision patterns vary depending on the specific conditions and surgical preference.
Any surgical treatment to correct gynecomastia will require incisions. While most incision lines are concealed within natural contours, some may be visible and are a necessary result of breast reduction surgery.
Whether you’ve had excision with a scalpel or liposuction, you will feel some discomfort for a few days after surgery. However, discomfort can be controlled with medications prescribed by your surgeon. In any case, you should arrange to have someone drive you home after surgery and to help you out for a day or two if needed.
You’ll be swollen and bruised for awhile–in fact, you may wonder if there’s been any improvement at all. To help reduce swelling, you’ll probably be instructed to wear an elastic pressure garment continuously for a week or two, and for a few weeks longer at night. Although the worst of your swelling will dissipate in the first few weeks, it may be three months or more before the final results of your surgery are apparent.
In the meantime, it is important to begin getting back to normal. You’ll be encouraged to begin walking around on the day of surgery, and can return to work when you feel well enough–which could be as early as a day or two after surgery. Any stitches will generally be removed about 1 to 2 weeks following the procedure.
Your surgeon may advise you to avoid sexual activity for a week or two, and heavy exercise for about three weeks. You’ll be told to stay away from any sport or job that risks a blow to the chest area for at least four weeks. In general, it will take about a month before you’re back to all of your normal activities.
You should also avoid exposing the resulting scars to the sun for at least six months. Sunlight can permanently affect the skin’s pigmentation, causing the scar to turn dark. If sun exposure is unavoidable, use a strong sunblock.
Gynecomastia surgery can enhance your appearance and self-confidence, but it won’t necessarily change your looks to match your ideal. Before you decide to have surgery, think carefully about your expectations and discuss them frankly with your plastic surgeon.
The results of the procedure are significant and permanent. If your expectations are realistic, chances are good that you’ll be very satisfied with your new look.
“I never would have considered plastic surgery until after I had my children. Afterwards, I wanted to feel as I did before my children. Dr. Bishop was one of the several plastic surgeons I consulted regarding my surgery. He was by far the most caring and concerned physician I had seen. He listened to what I wanted to accomplish from this surgery. The end result was more than I could have imagined. I feel wonderful. His staff was so friendly and accommodating. I felt so confident having him as my doctor. He is the only one I would refer to my friends and family.”