Male Breast Reduction (Gynecomastia)
Commonly referred to as “man boobs”, enlarged male breasts (either one or both breasts) can result in self esteem issues that my lead to the wearing of heavy shirts and sweaters and the avoidance of athletic activities that may reveal the condition to others.
This can especially hold true for adolescent males who may be the subject of teasing from their contemporaries and thus experience social trauma. However, this is not an unusual condition and is present in an estimated 40-60 percent of the male population.
What Is the Cause of Gynecomastia?
In some cases, gynecomastia is linked to genetics, meaning that individuals with a family history of the condition may be more susceptible. Identifying the root cause of gynecomastia is essential for determining the most effective treatment approach.
The causes of gynecomastia can be varied and in a significant number of cases the causes can be unknown. Gynecomastia is primarily caused by an imbalance of hormones, specifically an increase in estrogen or a decrease in testosterone. This hormonal shift can occur naturally during puberty, aging, or as a result of certain medical conditions.
Other contributing factors to gynecomastia can be the use of steroids, medications containing the use of estrogen, alcohol, hormonal imbalances and heredity factors. In some cases, gynecomastia is linked to genetics, meaning that individuals with a family history of the condition may be more susceptible.
The results are an increase in fat and glandular tissue in the breasts that cannot be addressed with diet or exercise. In some cases, exercise may even make the condition more noticeable.
Who Is a Good Candidate for Gynecomastia Surgery?
An initial consultation with a qualified cosmetic surgeon is essential to determine if this procedure is right for you. Good candidates for surgery include those who have firm and elastic skin that will allow for effective re-shaping of body contours.
Gynecomastia surgery should be performed when the patient has passed puberty and fully mature, physically and emotionally. This will also allow the opportunity for the condition to correct itself, as it does in some cases by age 18 or 19. Exceptions to this may be in cases where the emotional trauma is severe. This should be discussed, with the plastic surgeon, in a free consultation with the patient and parents in order to make an informed decision.
Non-Surgical Alternatives for Gynecomastia Treatment
For men who are hesitant about undergoing surgery, non-surgical options for gynecomastia treatment may be worth exploring. In cases where gynecomastia is primarily caused by excess fat rather than glandular tissue, lifestyle changes such as diet modification and targeted chest exercises may help reduce the appearance of male breasts.
Additionally, hormone therapy can be an option for individuals whose gynecomastia is caused by a hormonal imbalance, particularly high levels of estrogen or low testosterone.
There are also non-invasive treatments such as CoolSculpting® (cryolipolysis), which uses controlled cooling to eliminate fat cells without surgery. However, these methods may not be as effective as gynecomastia surgery, particularly in cases where glandular tissue is the primary cause of enlargement.
What Happens During the Procedure?
The procedure depends on the extent of the gynecomastia. In some cases, liposuction is indicated and in others, the surgical removal of excess fat, glandular tissue and skin is necessary.
The procedure is similar to a female breast reduction, in this respect. The procedure is performed using either local or general anesthesia and takes between three and four hours. The procedure is usually performed on an outpatient basis.
Liposuction would be used in cases where the cause of the gynecomastia is simply fatty deposits in the breast area as opposed to excess skin and glandular tissue. In the liposuction procedure, small incisions are made near the nipple and the excess fat is suctioned out through a thin hollow tube (cannula). The results, although permanent, may be less noticeable should subsequent obesity occur.
In he case of surgical removal of glandular tissue, an incision is made at the lower edge of the areola and the glandular mass is removed through this site. This area is subsequently contoured (sometimes with the assistance of liposuction).
In rare instances where the excess skin also needs to be removed, incisions are made underneath and around the areola as they would be in a female breast reduction or breast lift. The incisions are then sutured and bandages will be applied to protect the area.
Gynecomastia Surgery Recovery
It is advised that the patient have someone to drive him home after the gynecomastia surgery due to the effects of the anesthesia. Downtime is limited with the procedure and the patient usually returns to work within a week – longer in cases of strenuous work activity. There will be some pain along with bruising and swelling and the doctor will typically prescribe pain medication for this.
Also an elastic pressure garment will be prescribed for 3-6 weeks in order to assist with the healing process. There should be also be no exposure of the surgical area to the sun for 6 months after surgery. The patient will enjoy a more firm and contoured chest that can later be further enhanced with exercise.
Complications and Side Effects of Gynecomastia Surgery
Complications and side effects from gynecomastia surgery are rare, but can include an adverse reaction to anesthesia, bleeding, infection and excess fluid accumulation under the skin.
The amount of scarring is dependent on the procedure, but is usually minimal. There can also be asymmetry issues involving size of the breasts and placement of the nipples.
In some cases, additional surgery may be indicated in order to correct asymmetry issues. The most important thing to note is that even though complications are relatively rare, the possibilities should be discussed, in detail, with your doctor prior to surgery.
Costs of Gynecomastia Surgery
The costs of gynecomastia surgery are dependent on the extent of the procedure and the credentials of the cosmetic surgeon. Costs are usually broken down into three major components: the surgeon’s fee, anesthesia and facility fees.
The total costs and fees should be discussed with your doctor prior to surgery, but in general, the expenditure will run between $2500-$3200.
You should also consult your health insurance provider regarding coverage. However, gynecomastia surgery is not usually covered by medical insurance. But most surgeons offer multiple options for financing in order to make the procedure more affordable.
What to Expect from Gynecomastia Surgery Results
One of the most common concerns among men considering gynecomastia surgery is how long the results will last. The good news is that, for most patients, male breast reduction surgery provides permanent results as long as a stable weight is maintained.
Since the excess glandular tissue and fat are surgically removed, the likelihood of gynecomastia returning is low. However, significant weight gain, hormonal imbalances, or the use of certain medications (such as anabolic steroids) could potentially lead to the recurrence of enlarged male breasts.
To maintain optimal results, patients are encouraged to adopt a healthy lifestyle that includes regular exercise and a balanced diet.
Things to Know Prior to Surgery
Before making the decision to have gynecomastia surgery, there are several things that you need to determine. First of all, it’s important to know the qualifications of the surgeon who will be performing the procedure. When choosing a surgeon, you should look for a board-certified plastic surgeon. The surgeon chosen should have extensive experience in all types of breast surgery.
Please note that the type of certification is important. There are more than 150 self-designated boards, but only a handful that are designated by the American Board of Medical Specialties (ABMS), such as the American Board of Plastic Surgery. You should also request to see a sizable number of before and after photos as well as obtaining patient references.
Choosing the Right Surgeon for Male Breast Reduction
Selecting the right plastic surgeon is a critical step in ensuring successful gynecomastia surgery. Prospective patients should seek out board-certified plastic surgeons who specialize in male breast reduction and have extensive experience performing the procedure.
During the consultation, it’s important to ask about the surgeon’s credentials, training, and success rate with gynecomastia patients. Additionally, reviewing before-and-after photos of previous patients can help set realistic expectations.
A good surgeon will also provide a thorough evaluation to determine the underlying cause of gynecomastia and recommend the best course of treatment. Taking the time to choose a qualified and experienced surgeon can make a significant difference in achieving natural-looking, symmetrical results.