Breast Reduction for Men

Surgical/Procedure name:
Gynecomastia

Common name:
Breast Reduction for Men

Introduction

Also known as gynecomastia, breast reduction for men is the surgical correction of over-developed or enlarged breasts in men.

Gynecomastia, a condition of over-developed or enlarged breasts in men, is common in men of any age. It can be the result of hormonal changes, heredity conditions, disease 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 intimacy simply to hide their condition.

Gynecomastia is characterized by:

Excess localized fat

Excess glandular tissue development

A combination of both excess fat and glandular tissue

Gynecomastia may be present unilaterally (one breast) or bilaterally (both breasts)

The Remedy

In cases of obesity, weight loss can alter the gynecomastic condition, but for many it will not eliminate it. For all other causes, surgery is the only known physical remedy. Once the physical encumbrance is lifted, psychological scars still need to be addressed. One must come to terms with one's body, accept it, and heal the wounds from the past.

Is Surgery right for me?

Gynecomastia surgery is a highly individualized procedure and you should do it for yourself, not to fulfill someone else’s desires or to try to fit any sort of ideal image.

This procedure is a good option for you if:

You are physically healthy and of relatively normal weight

You have realistic expectations

Your breast development has stabilized

You are bothered by the feeling that your breasts are too large

Procedural Steps

What happens during gynecomastia correction surgery?

Plastic surgery to correct gynecomastia is technically called reduction mammaplasty, and reduces breast size, flattening and enhancing the chest contours. In severe cases of gynecomastia, the weight of excess breast tissue may cause the breasts to sag and stretch the areola (the dark skin surrounding the nipple). In these cases the position and size of the areola can be surgically improved and excess skin may be reduced.

Anesthesia

Medications are administered for your comfort during the surgical procedure. The choices include intravenous sedation and general anesthesia. Your doctor will recommend the best choice for you.

Liposuction

In cases where gynecomastia is primarily the result of excess fatty tissue, liposuction techniques alone may be used. This requires 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, which is then removed from the body by vacuum suction.There are various liposuction techniques that may be used; the technique most appropriate in your case will be defined prior to your procedure.

Excision

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

Sometimes gynecomastia is treated with both liposuction and excision.

Recovery

After surgery, 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. A small, thin tube may be temporarily placed under the skin to drain any excess blood or fluid that may collect.

Results

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

Questions and Answers

Is this a dangerous condition?

No, not really. Often though if the gynecomastia is really significant, teens will sometimes try to avoid situations where they have to take their shirts off. They maycome off as being shy, they may be socially isolated--avoid sports and girls--just because they're embarrassed about the appearance of their chest.

What is gynecomastia?

Literally, the term "gynecomastia" refers to female-like breasts. Of course, this is in guys--female-like breasts in women are desirable. But in guys they're not welcome.

Is gynecomastia common?

A number of studies have looked at the frequency of gynecomastia in the general population, and the incidence may be as high as 60 - 70%. What is found is that it occurs most commonly in three age groups: Newborns, adolescents, and older men.

Why does gynecomastia happen only to males at certain age groups?

The bottom line with gynecomastia is that it occurs due to an abnormality in the ratio of testosterone to estrogens in the body. When this ratio is low, the estrogen effect is h4er and stimulates the growth of the tissue around the breast. The testosterone which is most important is that which is not bound to protein in the blood, in other words, the free serum testosterone. This has been found to be lower in boys with gynecomastia compared to those without, while all the other hormone levels were about the same.

If this is caused by estrogens, does the tissue actually look like women's breast tissue?

It does to a certain extent, in that it is made up of ducts and fat and other elements which are found in women's breasts. At the same time, it looks different to a pathologist who is looking at the tissue under a microscope--it doesn't really form glands to make milk as it does in women.

Now, why would a pathologist look at the tissue--is this a type of cancer?

No, gynecomastia is not cancer. It is a benign disease, even though its quite depressing for men who get it.

Could it be cancer?

A lump in the breast should always cause some concern, though breast cancer in men is very unusual--less than 1%, and this is generally in older men. Gynecomastia often occurs on both sides, so if a breast mass occurs on only one side, it may be more suspicious for cancer. It would be extremely unusual to see male breast cancer on both sides at the same time. Sometimes a patient's history may give a clue as to whether or not the lump could be cancer. In other cases, a mammogram or ultrasound may be required. Sometimes a biopsy of the tissue must be done to be sure it isn't cancer.

Is there any way to predict who will get gynecomastia and who won't?

Unfortunately, no.

Which is better--excision or liposuction?

Liposuction is a great tool when the condition is mostly caused by fatty tissue, because this is easily removed this way. In steroid related gynecomastia, the tissue under the nipple can be very dense, and I find that this must be cut out.

How visible are the scars after excision?

Usually, they're barely perceptible.

What are other risks of the surgery?

Problems which can occur include bleeding or hematoma formation, which can require a second operation for drainage of the collection of blood. This is more common in steroid users due to the high degree of vascularity of the chest wall. Infections are very unusual. The nipple sensation is usually altered after the operation, and in rare instances the nipple loses it's blood supply and dies. In this case, it has to be removed and replaced as a skin graft, but it doesn't look great when this is done. Depressions or contour irregularities can also occur.

How long does the surgery last?

The surgery takes about one and a half hours.

Can I go right back to the gym after surgery?

No. It is recommend that patients avoid training the chest for four weeks. They should start that third week with light weights, maybe machines, even, just to get the blood flowing and so on. Gradually, heavier weights can be used. By not training chest for three or four weeks, they can avoid development of a fluid collection or other problem in the are of the surgery. After that, they should start back in slowly to avoid injury. Most patients are back to normal six weeks after their surgery, but their sanity has been maintained since they've been training all along.