Gynecomastia Surgery

What is gynecomastia surgery?

Gynecomastia surgery reduces breast size in men, 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.

Plastic surgery to correct gynecomastia is technically called reduction mammaplasty.

What is gynecomastia?

Gynecomastia is a condition of overdeveloped or enlarged breasts in men that can occur at any age. The condition can be the result of hormonal changes, heredity, obesity 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
  • Sometimes excess breast skin
  • Presence unilaterally (one breast) or bilaterally (both breasts)

What are the steps of a gynecomastia procedure?

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Step 1 – Anesthesia

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

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Step 2 – Liposuction Technique

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.

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Step 3 - Excision Technique

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 will be repositioned to a more natural male contour. Incision patterns vary depending on the specific conditions and surgical preference.

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Step 4 – Combination of liposuction & excision techniques

Sometimes gynecomastia is treated with both liposuction and excision.

What You should know / Frequently Ask Questions

Gynecomastia surgery candidates include:

  • Men whose condition cannot be corrected through alternative medical treatments
  • Healthy individuals who do not have a life-threatening illness or medical conditions that can impair healing
  • Nonsmokers and non-drug users
  • Men with a positive outlook and specific goals in mind for improving the physical symptoms of gynecomastia
  • Men who are physically healthy and of relatively normal weight
  • Men who have realistic expectations
  • Men whose breast development has stabilized
  • Men who are bothered by the feeling that their breasts are too large

Adolescents may benefit from surgery, although secondary procedures may be needed in the future should breast development continue.

The decision to have plastic surgery is extremely personal, and you will have to decide if the benefits will achieve your goals and if the risks and potential complications of gynecomastia surgery are acceptable.

You will be asked to sign consent forms to ensure that you fully understand the procedure and any risks and potential complications.

Gynecomastia surgery risks include:

  • Reactions to tape, suture materials, glues, topical preparations or injected agents
  • Anesthesia risks
  • Bleeding (hematoma)
  • Blood clots
  • Breast asymmetry
  • Breast contour and shape irregularities
  • Changes in nipple or breast sensation may be temporary or permanent
  • Damage to deeper structures—such as nerves, blood vessels, muscles and lungs—can occur and may be temporary or permanent
  • Deep vein thrombosis, cardiac and pulmonary complications
  • Fatty tissue found in the breast might die (fat necrosis)
  • Fluid accumulation (seroma)
  • Infection
  • Persistent pain
  • Poor wound healing
  • Possibility of revision surgery
  • Unfavorable scarring

These risks and others will be fully discussed prior to your consent. It’s important that you address all your questions directly with your plastic surgeon.

In preparing for gynecomastia surgery, you may be asked to:

  • Get lab testing or a medical evaluation
  • Take certain medications or adjust your current medications
  • Stop smoking
  • Avoid taking aspirin, anti-inflammatory drugs and herbal supplements as they can increase bleeding

The success and safety of your gynecomastia procedure depends very much on your complete candidness during your consultation. You’ll be asked a number of questions about your health, desires and lifestyle.

Male breast reduction surgery may be performed in an accredited, office-based surgical facility, licensed ambulatory surgical center or a hospital. Be sure to arrange for someone to drive you to and from surgery and to stay with you for at least the first night following surgery.

During your gynecomastia surgery recovery period, 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 after surgery.

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

You will be given specific instructions that may include how to care for the surgical site and drains, medications to apply or take orally to aid healing and reduce the potential for infection, specific concerns to look for at the surgical site or in your general health and when to follow up with your plastic surgeon.

Be sure to ask your plastic surgeon specific questions about what you can expect during your individual recovery period.

  • Where will I be taken after my surgery is complete?
  • What medication will I be given or prescribed after surgery?
  • Will I have dressings/bandages after surgery? When will they be removed?
  • Are stitches removed? When?
  • When can I resume normal activity and exercise?
  • When do I return for follow-up care?

It’s very important to follow your plastic surgeon’s instructions and attend follow-up visits as scheduled.

The final results of gynecomastia surgery 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.

During your gynecomastia surgery recovery period, 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 after surgery.

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

You will be given specific instructions that may include how to care for the surgical site and drains, medications to apply or take orally to aid healing and reduce the potential for infection, specific concerns to look for at the surgical site or in your general health and when to follow up with your plastic surgeon.

Be sure to ask your plastic surgeon specific questions about what you can expect during your individual recovery period.

  • Where will I be taken after my surgery is complete?
  • What medication will I be given or prescribed after surgery?
  • Will I have dressings/bandages after surgery? When will they be removed?
  • Are stitches removed? When?
  • When can I resume normal activity and exercise?
  • When do I return for follow-up care?

It’s very important to follow your plastic surgeon’s instructions and attend follow-up visits as scheduled.

The final results of gynecomastia surgery 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.

If you experience shortness of breath, chest pains or an unusual heartbeat, seek medical attention immediately. Should any of these complications occur, you may require hospitalization and additional treatment.

Following your physician’s instructions is essential to the success of your surgery.

It’s important that the surgical incisions are not subjected to excessive force, swelling, abrasion or motion during the time of healing. Your doctor will give you specific instructions on how to care for yourself.

Gynecomastia surgery results are immediately visible. Over time, post-surgical swelling will resolve and incision lines will fade. Satisfaction with your new image should continue to grow as you recover from surgery.

The final results of your gynecomastia surgery may take 3-6 months to achieve. Incision lines are permanent, but will continue to fade over time.

Any surgical treatment to correct gynecomastia will require incisions. While most incision lines are concealed within natural contours, some may be visible and are a necessary result of male breast reduction surgery.

All gynecomastia surgery scars are permanent, even though some scars may be concealed in the natural contours of the breast. Your improved upper body will likely enhance your self-image and confidence, whether in a shirt and tie, a t-shirt or baring your chest at the beach.

The practices of surgery is not an exact science. Although good results are expected from your procedure, there is no guarantee. In some situations, it may not be possible to achieve optimal results with a single surgical procedure to treat gynecomastia.

Another surgery may be necessary:

  • To perform additional tightening or repositioning of the breasts
  • To treat any complications that may occur