Male Breast Reduction (Gynecomastia)

Gynecomastia is a medical term that comes from the Greek words for "women-like breasts." Though this condition is rarely talked about, it's actually fairly common, affecting 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.

The Best Candidates for Gynecomastia

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.

Gynecomastia Surgery

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. The definition of the pectoralis muscle is usually much improved.

The initial consultation with Dr. Bolitho is very important. He will need a complete medical history, so check your own records ahead of time and be ready to provide this information. Dr. Bolitho will examine your breasts and check for causes of the gynecomastia. If a medical problem is the suspected cause, you'll be referred to an appropriate specialist.

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, Dr. Bolitho's office will obtain written pre-authorization for the surgery.

Surgery for gynecomastia is most often performed as an outpatient procedure. The surgery itself usually takes about an hour and a half to complete. However, more extensive procedures may take longer.

Correction of enlarged male breasts may be performed under general, or in some cases, under local anesthesia plus sedation. Dr. Bolitho 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 surgically removed. The surgical removal 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 armpit. 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 your gynecomastia consists primarily of excessive fatty tissue, liposuction alone may be all that is necessary. In cases that require more than liposuction, a small drain is inserted through a separate incision to draw off excess fluids. A compression garment will be provided for you to ensure the skin adheres to the chest wall.

After Surgery

Whether you've had surgical excision or liposuction, you will feel some discomfort for a few days after surgery. However, discomfort can be controlled with medications prescribed. 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.

To help reduce swelling, you'll be instructed to wear an elastic pressure garment continuously for four weeks. 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.

Dr. Bolitho will likely advise you to avoid heavy exercise for about three weeks. In general, it will take about a month before you're back to all of your normal activities.

The results of the procedure are significant and permanent. If your expectations are realistic, chances are good that you'll be very satisfied with the results of the surgery.

Potential Risks & Side Effects

As with any surgery, there are risks associated with gynecomastia. 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.