Breast enlargement or gynecomastia is a condition of over-developed breasts in men that can occur at any age. Excess localized fat, excess glandular tissue, sometimes excess breast skin, and may present on one breast or both breasts. If the excess tissue is isolated to fat, liposuction alone may be enough to achieve the desired results. However, the breast tissue, which is denser than fat, can be surgically removed in some cases. The incision location will vary but may include the areola, under the breast, or at the armpit.

Gynecomastia is a condition of overdeveloped or enlarged breasts in men that can occur at any age. Gynecomastia can result from hormonal changes, heredity, obesity, or the use of certain drugs. Gynecomastia can cause emotional discomfort and impair your self-confidence. Some men may even avoid certain physical activities and confidence to hide their condition.

Gynecomastia (Breast Enlargement in Men) is characterized by:

• Excess localized fat
• Excess glandular tissue development
• Sometimes excess breast skin
• Presence unilaterally (one breast) or bilaterally (both breasts)

Men who have excess fat or glandular tissue (or a combination of both) in their chest area may feel self-conscious or embarrassed. The cause of gynecomastia is unknown, but it is common among teens and usually subsides with puberty. Other medical problems may cause gynecomastia, such as hormonal imbalance and side effects from herbal treatment or medications. If excess fat is due to obesity, it is best to reduce the size as much as possible through diet and exercise. A cosmetic surgeon can help men reduce the appearance of enlarged chests with surgery. If the issue is isolated to fat, liposuction alone may be enough to achieve the desired results. However, the breast tissue, which is denser than fat, can be surgically removed in some cases. The incision location will vary but may include the areola, under the breast, or at the armpit.

Treating Male Breast (gynecomastia) Reduction with Liposuction

The procedure for treating gynecomastia with liposuction is typically performed using local anesthesia with sedation and involves a small incision on each side of the chest. Depending on your needs and Prof. Moawad’s favored technique, incisions may be located along a portion of the edge of the areola or within the armpit. Through these incisions, Prof. Moawad will remove excess fat and/or glandular tissue while sculpting a new chest contour that looks natural to your body. This patient had liposuction to treat gynecomastia and reduce love handles. The recovery process following liposuction is typically quite tolerable. Patients are often given a compression garment to wear for the first few weeks after surgery; this helps minimize swelling and supports the healing tissues. While vigorous exercise is typically off-limits for about three weeks, many men return to work or school within several days after their procedures. However, it is crucial to understand that everyone heals at a different pace; Prof. Moawad will give you individualized instructions for recovery.

Male Breast (gynecomastia) Reduction Treated with Tissue Excision.

More severe cases of gynecomastia may require surgical tissue excision to achieve optimal results. Additionally, patients who have stretched, sagging skin around the breasts will usually require this approach. Tissue excisions allow a cosmetic surgeon to remove a more significant amount of glandular tissue and/or skin that I cannot successfully treat with liposuction alone. The location and length of the incisions depend on the extent of surgery required. Still, they are typically located around the edge of the areola (peri-areolar incision) or within the natural creases of the chest. A trained, qualified cosmetic surgeon will take care to place incisions so that the resulting scars are as inconspicuous as possible. Male breast reduction with tissue excision is typically performed as an outpatient procedure using general or local anesthesia with sedation. The recovery process is like that for liposuction; however, it is common for patients to experience soreness and some swelling. Typically, patients feel ready to return to work within one week of surgery, and a gradual return to exercise is usually permitted after the first couple of weeks.

What are the Steps of Male Breast (gynecomastia) Reduction Surgery?

A gynecomastia procedure includes the following steps:

Anesthesia

Medications are administered for your comfort during surgical procedures. The options include intravenous sedation and general anesthesia. Your doctor will recommend the best option for you.

Liposuction technique

In cases where gynecomastia is primarily the result of excess fatty tissue, I may use liposuction techniques alone. This requires the 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, then removed from the body by vacuum suction. I may use various liposuction techniques; I will define the technique most appropriate in your case before your procedure.

Excision technique

Excision techniques are recommended where I must remove glandular breast tissue or excess skin to correct gynecomastia. Excision also is necessary if the areola will be reduced or the nipple will be repositioned to a more natural male contour. Incision patterns vary depending on the specific conditions and surgical preference.

Combination of liposuction & Excision techniques

Sometimes gynecomastia is treated with both liposuction and excision.

What are the Risks of Male Breast (gynecomastia) Reduction Surgery?

The decision to have cosmetic surgery is highly personal. You will have to decide if the benefits will achieve your goals and if gynecomastia surgery’s risks and potential complications are acceptable. You will be asked to sign consent forms to ensure that you fully understand the procedure and any risks and potential complications.

• Gynecomastia surgery risks include:
• Reactions to tape, suture materials, glues, topical preparations, or injected agents
• Anesthesia risks
• Bleeding (hematoma)
• Blood clots
• Breast asymmetry
• Breast contour and I will thoroughly discuss these risks and other sensations may be temporary or permanent.
• Damage to deeper structures—such as nerves, blood vessels, muscles, and lungs—can occur and may be temporary or permanent.
• Deep vein thrombosis, cardiac and pulmonary complications
• Fatty tissue found in the breast might die (fat necrosis)
• Fluid accumulation (seroma)
• Infection
• Persistent pain
• Poor wound healing
• Possibility of revision surgery
• Unfavorable scarring

These risks and others will be thoroughly discussed before your consent. It would be best if you addressed all your questions directly with Prof. Moawad.

Who is the Right Candidate for Male Gynecomastia Surgery?

Gynecomastia surgery candidates include:

• 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-smoker and non-drug users
• Men with a positive outlook and specific goals in mind for improving the physical symptoms of gynecomastia
• Physically healthy men and of average weight
• Men who have realistic expectations
• Men whose breast development has stabilized
• Men who are bothered by the feeling that their breasts are too large

Adolescents may benefit from surgery, although secondary procedures may be needed in the future should breast development continue.

Who Is Not a Candidate for Male Breast (gynecomastia) Reduction Surgery?

• A man who wishes to use gynecomastia surgery to reduce his weight
• A gentleman who is in poor physical condition or is taking medication or recreational drugs that may interfere with healing

What Should I Expect During A Consultation for Male Breast (gynecomastia) Reduction Surgery?

During your gynecomastia surgery consultation, be prepared to discuss:

• Your surgical goals
• Medical conditions, drug allergies, and medical treatments
• Current medications, vitamins, herbal supplements, alcohol, tobacco, and recreational drug use (including steroids)
• Previous surgeries

Your gynecomastia surgeon may also:

• Evaluate your general health status and any pre-existing health conditions or risk factors
• Perform diagnostic testing to determine the underlying cause of gynecomastia; this may include examining your endocrine function.
• Examine your breasts and may take detailed measurements of their size and shape, skin quality, and placement of your nipples and areolas
• Take photographs for your medical records
• Discuss your options
• Recommend a course of treatment
• Discuss outcomes of gynecomastia correction and any risks or potential complications
• Discuss the use of anesthesia during your procedure

The consultation is the time to ask Prof. Moawad questions. It’s imperative to understand all aspects of your surgical procedure. It’s natural to feel some anxiety, whether excitement for your anticipated new look or a bit of preoperative stress. Don’t be shy about discussing these feelings with Prof. Moawad.

How Should I Prepare for Male Breast (gynecomastia) Reduction Surgery?

In preparing for gynecomastia surgery, you may be asked to:

• Get lab testing or a medical evaluation
• Take certain medications or adjust your current medications
• Stop smoking
• Avoid taking aspirin, anti-inflammatory drugs, and herbal supplements as they can increase bleeding.

The success and safety of your gynecomastia procedure depend very much on your complete candidness during your consultation. You’ll be asked several questions about your health, desires, and lifestyle. Male breast reduction surgery may be performed in an accredited, office-based surgical facility, licensed ambulatory surgical center, or a hospital. Be sure to arrange for someone to drive you to and from surgery and stay with you for at least the first night following surgery.

What Should I Expect During Male Breast (gynecomastia) Reduction Surgery Recovery?

During your gynecomastia surgery recovery period, dressings or bandages will be applied to your incisions, and an elastic bandage or support garment may be used to minimize swelling and support your new chest contour as it heals after surgery. A small, thin tube may be temporarily placed under the skin to drain any excess blood or fluid that may collect. You will be given specific instructions that may include how to care for the surgical site and drains, medications to apply or take orally to aid healing and reduce the potential for infection, specific concerns to look for at the surgical site or in your general health and when to follow up with Prof. Moawad.

Be sure to ask Prof. Moawad specific questions about what you can expect during your recovery period.

• Where will I be taken after my surgery is complete?
• What medication will I be given or prescribed after surgery?
• Will I have dressings/bandages after surgery? When will they be removed?
• Are stitches removed? When?
• When can I resume regular activity and exercise?
• When do I return for follow-up care?
• It’s crucial to follow Prof. Moawad’s instructions and attend follow-up visits as scheduled.

The results of gynecomastia surgery are permanent in many cases. However, if gynecomastia results from the use of certain prescription medications, drugs (including steroids), or weight gain, you must be entirely free from these substances and remain at a stable weight to maintain your results. Please discuss this with your physician before making changes to your prescription medications.

Recovering from Male Breast (gynecomastia) Reduction Surgery at Home

1. If you experience shortness of breath, chest pains, or an unusual heartbeat, seek medical attention immediately. Should any of these complications occur, you may require hospitalization and additional treatment.
2. Following your physician’s instructions is essential to the success of your surgery.
3. Surgical cuts mustn’t be subjected to excessive force, swelling, abrasion, or motion during the time of healing. Your doctor will give you specific instructions on how to care for yourself.

What Results Should I Expect after Male Breast (gynecomastia) Reduction Surgery?

Gynecomastia surgery effects are immediately visible. Over time, post-surgical swelling will resolve, and incision lines will fade. Satisfaction with your new image should continue to grow as you recover from surgery. The results of your gynecomastia surgery may take 3-6 months to achieve. Incision lines are permanent only will continue to fade over time.

Life After Male Breast (gynecomastia) Reduction Surgery

After gynecomastia surgery, you should notice an immediate improvement in the shape and appearance of your chest. While you may feel sore for a few days, pain is usually minimal.  While Prof. Moawad will prescribe some pain medication, many men find that over-the-counter options, such as Tylenol, are enough. If you are given a compression garment, wear it. This will enhance your comfort and help your chest heal optimally. While every patient’s healing process is unique, most patients feel ready to return to work just a few days after a male breast reduction, depending on the nature of their work. Some men experience a loss of sensation in the treated areas after a male breast reduction, but this is always temporary. Any loss of consciousness should gradually return over the months following your procedure.

Maintaining Your Improved Chest Contour

Male breast reduction results are meant to be permanent – the excess fat, glandular tissue, and skin removed are gone for good. However, it’s essential to maintain a healthy lifestyle. Significant weight gain, steroid use, or certain medical conditions could result in a recurrence of gynecomastia. Additionally, drugs that influence testosterone levels could also affect your results. An experienced, board-certified cosmetic surgeon can help you learn what to do to maintain your results for the long term.

I can determine the specific risks and the suitability of this procedure for a given individual only at the time of consultation. All surgical procedures have some degree of risk. Minor complications that do not affect the outcome occur occasionally. Major complications are rare.