Gynecomastia is a condition defined as unusually enlarged breasts affecting men of all body types. It typically consists of disproportionately large and fatty, “glandular breasts,” similar to that of a woman’s breast, where there is a variable amount of true breast tissue, ranging from a larger collection of breast gland directly behind the nipple in a thin muscular individual to a full-sized female type, rounded breast usually found in heavier individuals. This is an increasingly common concern for men who desire that angular, defined, sexy, muscular chest. Gynecomastia procedures are among the most common cosmetic surgeries performed for men of all ages.
Gynecomastia
Gynecomastia is caused by an unusual sensitivity of the breast tissue to circulating hormones. Environmental effects may also contribute to this, such as certain medications, anabolic steroids, and marijuana use.
The American Society of Plastic Surgery, has reported an increase of procedures for gynecomastia of 36 percent since 2000. Our office has seen a significant increase in the past several years as more millennial men seek treatment. Men’s concerns about their self-esteem and masculinity are often defined by this issue. It often develops in adolescence, where boys are ridiculed, which affects their self-esteem. This is true of adult men as well: The embarrassing term “man boobs” causes men to hide their chest in a “T” shirt at the pool or other times where they would be shirtless. It can affect men’s sexuality. It can’t be exercised away; while you can reduce body fat with diet and exercise, the gynecomastia-affected breast may be resistant, even with a muscular chest. In obese or heavier men, the fatty tissue of the breast will diminish with weight loss but this commonly leaves loose skin with deflated breasts and persistent residual breast tissue.
Your Gynecomastia Treatment
Over the past 20 years or so, gynecomastia has been traditionally treated by liposuction and, in most cases, breast gland removal. The fat is suctioned through small hidden incisions, usually along the side of the chest and through the areola (the brown skin surrounding the nipple). The glandular breast tissue is also removed within the areola, which hides the scar nicely.
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BodyTite™ Radiofrequency System
Dr. Stephens uses the BodyTite® Radiofrequency System combined with liposuction and breast tissue removal to produce skin tightening. BodyTite® provides significantly more skin tightening than previous technologies or traditional liposuction alone. When the glandular breast tissue is removed, it is sent to the pathologist for evaluation to rule out the rare possibility of cancer. (Four percent of breast cancers are found in men).
More severe forms of breast enlargement will require a full excision of a ring of skin or “donut” around the areola or even a more extensive surgical breast lift in cases of massive weight loss and extra skin. All attempts are used to minimize scars, though, and the BodyTite® has proven very effective.
Who are good candidates?
Good candidates must be medically and emotionally healthy and have a realistic idea of their outcome in consultation with Dr. Stephens, and have a stable weight and a reasonable BMI. They must stop smoking for two months if there are any plans to remove breast tissue, and a surgical reduction is planned.
They should have any medical causes ruled, including a mammogram if indicated by an unusual presentation where there is a consideration for breast cancer. It is usually best in most cases where indicated and wait until puberty has passed or the gynecomastia has stabilized or resolved spontaneously. Rapidly growing male breasts or unilateral significant breast growth should undergo the proper investigations, including mammograms and a consultation with an endocrinologist to rule out endocrine disease or breast cancer.
How Is Male Breast Reduction Performed?
Most patients will have minimal discomfort following the procedure, which is done under a tumescent local numbing solution combined with sedation or a light general anesthetic if a more extensive procedure is necessary. The procedure is performed on an outpatient basis in our AAAASF Accredited and State Licensed, Ambulatory Surgical Center (ASC).
A compression vest is used for two weeks following the procedure, but the pain and downtime are minimal and usually subside within a few days. Most men can be back in the gym within a month following surgery.
Frequently Asked Questions About Male Breast Reduction
What causes gynecomastia?
Male breasts can become enlarged due to several factors. Commonly, the issue can develop due to imbalances in how the breast tissue responds to normally circulating hormones. Sometimes gynecomastia can occur due to a fall in the level of testosterone and an increase in the metabolism of certain types of estrogens. Additionally, some medications, recreational drugs, and anabolic steroids are known to cause gynecomastia. Last but not least, gynecomastia can result from medical conditions, such as obesity, hyperthyroidism, liver failure, malnutrition, and tumors.
Can exercise and diet help with male breast reduction?
Physical exercise and diet can go a long way in reducing the amount of fat in the body, including the fat that would be enlarging your breasts. However, working out and eating healthy food while improving the male breast does not necessarily result in gynecomastia going away.
If your breasts have been enlarged by glandular breast tissue, the only way to remove the tissue is through gynecomastia surgery. No matter how hard you work at the gym, you will not get rid of the excess breast tissue through exercise.
How painful is male breast reduction surgery?
Like any surgical procedure, gynecomastia surgery will cause some discomfort. However, the procedure will be done under local or general anesthesia, and therefore, you will not experience any pain during surgery. Although you may experience some discomfort during recovery, it is often nothing compared to the embarrassment brought by gynecomastia and the physical burden of carrying the extra weight caused by the issue.
Does male breast reduction surgery have any side effects?
Like any other surgical procedure, gynecomastia surgery is not without some risks. For instance, it can lead to pain, scarring, bleeding, and blood clots. The procedure can also lead to loss of nipple sensitivity. Scar healing is variable in surgery. However, the chances of a serious complication are low, especially if the procedure is done by a seasoned surgeon.
Will insurance cover male breast reduction surgery?
Medical insurance policies vary concerning what they cover. However, when it comes to gynecomastia surgery, most insurance policies only contribute if gynecomastia is causing physical pain. Because this surgery is most often performed for strictly cosmetic reasons, it is often not covered by insurance.
How long will my male breast reduction results last?
The results of gynecomastia surgery are usually long lasting, if not permanent. However, male breasts can become enlarged again after gynecomastia surgery because the goal is to leave a small amount of residual breast gland to maintain and optimize the shape of the male breast. Relapse mostly occurs in patients who fail to maintain a stable weight and those who use anabolic steroids after gynecomastia surgery. Therefore, once you have undergone this surgical procedure, you will need to lead a healthy lifestyle to maintain your new chest contour for many years to come.
Will there be scars?
Since the procedure involves making some incisions, there will be some scars left. However, the incisions will be small, and they will be made in the edges of the areola, meaning that they won’t be too visible. Small incisions for the BodyTIte® and liposuction are also hidden from the view of the breast. In any case, the benefits of male breast reduction are so enormous that most men don’t worry about the small scars that the procedure might leave.
Interested in Gynecomastia Surgery?
Dr. Stephens is a seasoned and highly regarded plastic surgeon who has performed hundreds of successful gynecomastia procedures with very happy men now with restored confidence in their body image. To learn more about how you can regain your desired improvement, please email a request for a consultation with Dr. Stephens at info@stephensplasticsurgery or call our office at 425.455.0444 to schedule your appointment.
