Male Breast Reduction (Gynecomastia)
What is Gynecomastia?
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 overdevelopment, 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.
If you're considering surgery to correct gynecomastia, this page will
give you a basic understanding of the procedure--when it can help, how it's
performed, and what results you can expect. It can't answer all of your
questions, since a lot depends on your individual circumstances. Please
be sure to ask your doctor if there is anything about the procedure you
The best candidates for gynecomastia correction
Surgery to correct gynecomastia can be performed on healthy, emotionally
stable men of any age. The best candidates for surgery have firm, elastic
skin that will reshape to the body's new contours.
Surgery may be discouraged for obese men, or for overweight men who have
not first attempted to correct the problem with exercise or weight loss.
Also, individuals who drink alcohol beverages in excess or smoke marijuana
are usually not considered good candidates for surgery. These drugs, along
with anabolic steroids, may cause gynecomastia. Therefore, patients are
first directed to stop the use of these drugs to see if the breast fullness
will diminish before surgery is considered an option.
All surgery carries some uncertainty and risk
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 effects of breast reduction include loss of breast sensation
or numbness, which may last up to a year.
Many men have gynecomastia --
enlarged, female-like breasts--causes
by excess glandular tissue or fat
Planning your surgery
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
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.
Don't hesitate to ask your surgeon any questions you may have during the
initial consultation- including your concerns about the recommended treat-
ment or the costs involved. Treatment of gynecomastia may be covered by
medical insurance--but policies vary greatly. Check your policy or call
your carrier to be sure. If you are covered, make certain you get written
pre-authorization for the treatment recommended by your surgeon.
Preparing for your surgery
Your surgeon will give you specific instructions on how to prepare for
surgery, including guidelines on eating, drinking, and taking certain vitamins
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
Where your surgery will be performed
Surgery for gynecomastia is most often performed as an outpatient procedure,
but in extreme cases, or those where other medical conditions present cause
for concern, an overnight hospital stay may be recommended. The surgery
itself usually takes about an hour and a half to complete. However, more
extensive procedures may take longer.
Type of anesthesia
Correction of enlarged male breasts may be performed under general,
or in some cases, under local anesthesia plus sedation. You'll be awake,
but very relaxed and insensitive to pain. More extensive correction may
be performed under general anesthesia, which allows the patient to sleep
through the entire operation. Your surgeon will discuss which option is
recommended for you, and why this is the option of choice.
If excess glandular tissue is the primary cause of the breast enlargement,
it will be excised, or cut out, with a scalpel. The excision may be performed
alone or in conjunction with liposuction. In a typical procedure, an incision
is made in an inconspicuous location--either on the edge of the areola or
in the under arm area. Working through the incision, the surgeon cuts away
the excess glandular tissue, fat and skin from around the areola and from
the sides and bottom of the breast. Major reductions that involve the removal
of a significant amount of tissue and skin may require larger incisions
that result in more conspicuous scars. If liposuction is used to remove
excess fat, the cannula is usually inserted through the existing incisions.
Glandular tissue must be cut out,
usually through a small incision
near the edge of the areola.
If your gynecomastia consists primarily of excessive fatty tissue, your
surgeon will likely use liposuction to remove the excess fat. A small incision,
less than a half-inch in length, is made around the edge of the areola--the
dark skin that surrounds the nipple. Or, the incision may be placed in the
underarm area. A slim hollow tube called a cannula which is attached to
a vacuum pump, is then inserted into the incision. Using strong, deliberate
strokes, the surgeon moves the cannula through the layers beneath the skin,
breaking up the fat and suctioning it out. Patients may feel a vibration
or some friction during the procedure, but generally no pain.
In extreme cases where large amounts of fat or glandular tissue have been
removed, skin may not adjust well to the new smaller breast contour. In
these cases, excess skin may have to be removed to allow the removing skin
to firmly re-adjust to the new breast contour.
Sometimes, a small drain is inserted through a separate incision to draw
off excess fluids. Once closed, the incisions are usually covered with a
dressing. The chest may be wrapped to keep the skin firmly in place.
Fatty tissue can be removed by
liposuction. A small, hollow tube
is inserted through a tiny incision,
leaving a nearly imperceptible scar.
After your 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
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.
Your new look
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
Following surgery for gynecomastia,
the patient has a more masculine