What You Need to Know about Gynecomastia Surgery

By: Dr. Sean Kelishadi, M.D. FACS


When we hear the words “breast surgery,” or even “breast reduction surgery,” it is not uncommon for our minds to automatically think about women. This is an unfortunate oversight, because there are a very large number of males in the US diagnosed with a condition called Gynecomastia. The question is, what can be done about this condition, and how can it improve your quality of life?

What is Gynecomastia? And does it happen exactly?

In the male breast, excess tissue and/or fat may develop in some individuals. Use of certain prescription and recreational drugs, including steroids, can cause enlarged male breasts (gynecomastia) at any time from puberty onward.

What are the options for treatment?

Liposuction removes excess fat that is unresponsive to diet and exercise, thereby achieving more-proportionate and more-pronounced contours to look trimmer and more attractive.  Ultrasound-, Power- or VASER-assisted techniques may be employed to facilitate fat removal.

Direct Excision of Gynecomastia may be performed for dominant breast masses or thick breast tissue that can not be liposuctioned. The excised tissue is sometimes sent to pathology for testing. Direct excision can also be performed for the majority of the breast tissue including fatty tissue through an incision around a portion of the areola. A drain may need to be placed into the breast skin envelope to accelerate healing and reduce the risk of fluid accumulation.

Mastopexy for rare, extreme cases.  Mastopexy involves removal of skin and a small amount of breast glandular tissue, repositioning of the nipple and improvement of the breast position with lifting. Several incision approaches may be used, including scars around the areola, in the inframammary fold, and vertically between the areola and the fold.

Direct Excision of Gynecomastia plus Liposuction is the preferred cutting edge technique utilized in most cases.  This combination strategy is performed to minimize scars and also provide the best contour and aesthetic outcome. With this approach, liposuction is used to remove fatty tissue and also contour the borders of the breast with the axilla and abdomen.  Additionally, the liposuction cannula can help break up a well-defined inframammary fold, which is a feminizing feature of enlarged male breasts; in men, this area should “blend” with the abdomen.  The hard, thick, glandular tissue can be removed via direct excision through a small incision usually concealed within the inferior border of the areola.

What should you expect for recovery?

Surgery to treat gynecomastia is usually an outpatient procedure. When your driver takes you home, you will be wearing compression garments and you should continue to wear them for a few weeks to encourage optimal healing. Further information follows:

Walking is permitted and healthful while you recover, especially during the first week when you will need to avoid strenuous activities.

Your recovery time and amount of bruising and swelling will depend on numerous factors such as what strategies were employed for your surgery, your health, your age, and if any other concomitant procedures were performed.

You may be able to return to work in about a week, or even less, depending on the extent of your procedure(s) and the physical demands of your job.

Your deep sutures will dissolve over 2-6 months to support your incisions during the most-critical stages of wound healing and collagen remodeling; any external sutures you see will be removed within two weeks. For the next several months, the connective tissue in your skin will keep contracting (using the beneficial effects of scars contracting over time--scars can be on the inside where you can’t see them, too!) and adjusting to the removal of fat and tissue that has taken place.

Final results should show your trimmer contours in 1-6 months and can be long-lasting through a consistent program of a healthful diet and appropriate exercise.

What are the costs and risks associated?

The cost of the procedure varies based on the complexity of your treatment, time needed for anesthesia and use of facilities.  This along with the associated risks of the custom-tailored procedure are best discussed in person during your consultation as each person’s situation is unique.  It isn’t uncommon for such a condition to alter the quality of one’s life. Gynecomastia has affected many men by means of their self-esteem, their sex lives, as well as their activities. There is no need to continue to be ashamed; instead, take control and embrace a better feeling you.

For more information on Orange County Plastic Surgery procedures used to treat Gynecomastia, contact us today to schedule a consultation and we will address all your questions and concerns.

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* All information subject to change. Images may contain models. Individual results are not guaranteed and may vary.