- read about gynecomastia surgery
- see before and after photos-videos
- alternatives, risks, benefits & recovery
Gynecomastia means enlargement of the male breast. The definition has nothing to do with what causes the enlargement or what tissue it is composed of. It is most common around puberty and can involve one or both sides. Most commonly the enlargement is centralized in the breast but occasionally it is not. It is present to some degree in about a third of the male population. The majority of cases are physiological or drug induced. Drug induced gynecomastia just requires cessation of the causative drug. If the gynecomastia is resistant to treatment or is the adolescent type but persistent gynecomastia surgery is required.
The type of surgery depends on the type of tissue contributing to the breast enlargement.
- glandular: requires surgical removal of glandular tissue
- fatty-glandular: requires surgical removal of glandular tissue with or without removal of adjacent fat to give the best overall shape
- simple fatty: requires diet/exercise for weight loss, possibly removal of the fat
Health insurance coverage for the procedure is highly variable. Some plans cover removal of the gland but not liposuction of the fat provided the problem does not resolve after stopping medications that can cause gynecomastia. In California state law mandates coverage if there is severe right vs. left asymmetry or alot of excess skin i.e. a visible abnormality easily seen by the average person and recognized as such.
This 29 year old, 5’9″, 186 lb. patient had liposuction, direct excision of the gland tissue and 2cm elevation of the nipple-areola (crescent mastopexy) for his fatty-glandular gynecomastia. 250cc of liposuction fluid was injected into each side of the chest. 300cc was liposuctioned from the left and and 250cc from the right. Some of the excess tissue was gland and that cannot be removed by liposuction so it was removed by direct excision.
In order to achieve a natural look after surgery and a happy patient the surgeon must evaluate the skin, fat and gland contributions before surgery. In this case the excess skin was addressed by the simple removal of a 2cm high crescent of skin above the nipple-areola. The after photo is 6 weeks after surgery and there is still some residual swelling in the lower half of the chest.
This patient had gynecomastia after massive weight loss. The surgery was performed via an incision around the areolae so there is little visible scar on the chest skin.
This 21 year old patient had direct gynecomastia excision without liposuction.
Video: Gynecomastia Surgery
Gynecomastia surgery can enhance your appearance and your self confidence. Realistic expectations are important to be happy with any surgery. As each patient is an individual, different results can be expected in each patient.
If the gynecomastia is induced by reaction to a medication stopping the medication may resolve the gynecomastia. Otherwise the only treatment is fat and gland removal and if necessary removal of excess skin. The non-invasive fat removal like freezing fat will not work if there is a significant glandular component to the tissue.
As with any type of surgery there is the risk of infection or bleeding. Additionally there is the risk of seroma or blood fluid collections under the skin, residual right left asymmetry, uneven surface contours, complete or partial loss of the nipple complex and diminished nipple sensation.
The benefits are not being self conscious shopping for clothes or when in a bathing suit at the beach, not having to wear layered loose clothes to hide your gynecomastia and not hiding in the gym locker room. For younger patients it may put an end to bullying behavior by classmates. Being pleased with your new appearance can be a major incentive to changing your lifestyle, diet and exercise regularity in order to maintain your new look.
In order to have a well perceived result patients need to have the proper expectations going into surgery and the appropriate patient specific surgery needs to be employed. Dr. Stone has seen a number of patients initially treated elsewhere unhappy with their result because the fat and gland components were addressed but the skin component was not addressed. Your surgeon needs to look at the whole package before surgery and address the whole package during surgery.
The most important part of recovery is exercise and activity restrictions for 3 to 4 weeks after surgery after which patients gradually return to their pre-surgery exercise routines. Being to active too early after surgery can easily lead to seromas that adversely affect the end result.
Dr. Aaron Stone
Call today for a consultation!120 South Spalding Dr, Suite 330
Beverly Hills, Los Angeles,CA 90212