Gynecomastia surgery is also known as male breast reduction surgery or male breast tissue excision. It is a procedure for men who have over-developed or enlarged breasts. For that reason, male breast reduction surgery is done to reduce the appearance of unusually large male breasts. This type of procedure is normally performed on an outpatient basis for cosmetic reasons.
The gynecomastia procedure normally involves the excision of glandular tissue with or without liposuction to remove excess fatty tissue when present.
Gynecomastia is classified into four grades, based on the severity of the condition.
Grade I: Small enlargement with no loose skin
Grade II (A): Moderate enlargement with no loose skin
Grade II (B): Moderate enlargement with extra skin
Grade III: Marked enlargement with extra skin
In moderate to severe cases, gynecomastia surgery is a good option for improving the shape of the chest.
Gynecomastia Surgery Walk-Through
- Preparation: When getting ready for gynecomastia surgery, you should refrain from taking any medications that might thin the blood during the two weeks before the procedure. So, medications to avoid include anti-inflammatory drugs, aspirin, and herbal supplements. Because it inhibits healing, you are also encouraged to avoid smoking for at least two weeks before and after surgery. Medical clearance by an independent physician is necessary if you are over the age of 45.
- Anesthesia: Options for anesthesia include a local anesthetic, general anesthesia, or intravenous sedation. Most gynecomastia surgeries done under a general anesthetic.
- Surgical options for gynecomastia correction include breast tissue excision, liposuction, or a combination of the two. Dr. Vallecillos will discuss which option is best for you.
Liposuction alone can be used in cases where excessive fatty tissue is the only cause of the gynecomastia. As a result, with the liposuction, I will make tiny incisions in the skin. The picture below shows the usual location of the incisions. Next, I insert a cannula through the incision to remove excess fat and reshape the breast to create a more youthful and athletic look.
In contrast, if you have excess of glandular breast tissue and skin (usually Grades IIB and III), or where the areola and nipple need to be reduced or repositioned, I will excise the tissue to correct the gynecomastia. Some patients have both glandular breast tissue and excess fat in the chest. For the reason, it is not uncommon that I will perform excision and liposuction together for best results.
After the gynecomastia surgery, your chest be re-sculpted with a more youthful, athletic look.
Gynecomastia Surgery FAQs
What causes gynecomastia ?
Gynecomastia is caused by hormonal changes in the body that lead to an imbalance between testosterone and estrogen. There are several causes of gynecomastia. For example, gynecomastia is commonly seen puberty. During puberty, male hormones naturally spike. Additionally, gynecomastia can also be caused by abnormal hormonal changes. As an example, gynecomastia is commonly seen with testicular cancer and liver disease, as well as obesity. Lastly, other hormonal causes of gynecomastia include taking supplements and medications. Examples include taking anabolic steroids, smoking marijuana, and prostate cancer medications.
Who is a candidate for gynecomastia surgery?
Adult males who suffer from excess breast tissue or fatty enlargement of the breasts are candidates for gynecomastia surgery.
What is the recovery time for gynecomastia surgery?
Recovery time for gynecomastia surgery depends on the procedures performed. For example, if you only require removal of glandular tissue, most regular activities may be resumed the day after surgery, On the other hand, if you require removal of glandular breast tissue with liposuction, downtime can be greater. In these cases, strenuous activity may be restricted for up to a month. During recovery, you will wear a compression garment to help reduce swelling. The compression garment should be worn consistently for the first month after surgery. Bruising and swelling caused by gynecomastia surgery normally disappears within two weeks, but may take up to several months.
Are there risks or side effects with gynecomastia surgery?
Gynecomastia surgery carries very low risk. For example, infection and bleeding occur less than 1 % of the time. Some men may experience size asymmetries between the two breasts, although this happens extremely rarely with experienced surgeons. Also, removal of breast tissue alone may leave depressions or dents in the chest which is expected. Because of this, liposuction can be done at the same time to prevent the dents. Lastly, you should minimize sun exposure to the chest area for at least six months following gynecomastia surgery to prevent darkening of the skin or hyperpigmentation.
How long do the results last?
Gynecomastia surgery produces permanent results, assuming the procedure is successful in removing all of the glandular breast tissue. In rare cases, gynecomastia can come back.
Gynecomastia Surgery after Prostate-Cancer Treatment
Gynecomastia is very common if you have undergone Prostate-Cancer Treatment with hormone therapy. These treatments are also known as “androgen deprivation therapy”. Male breast tissue can develop after hormone therapy because the hormone balance is shifted towards estrogen, which causes the male breast tissue to grow.
As a Prostate cancer patient, if you are undergoing androgen deprivation therapy you may experience breast tenderness with enlargement. If you develop gynecomastia that doesn’t go way following prostate cancer treatment, gynecomastia surgery is an option and should be considered as a permanent solution.
Gynecomastia questions to ask
Prior to considering gynecomastia surgery, you should ask plenty of questions in order to have a good understanding of the procedure and what to expect after surgery. The American Society of Plastic Surgeons provides a list of such questions which I recommend reviewing.