Male Breast Reduction

Submitted by steven on Thu, 08/18/2011 - 12:48

Gynecomastia Surgery

Gynecomastia is the medical term for male breast enlargement. This can range from a small amount of extra tissue to a female looking breast. Gynecomastia can make it embarrassing to wear a tight shirt or to take your shirt off at the beach or in intimate situations. Since there is both breast tissue and fat, losing weight doesn’t solve the problem. The good news is that in most situations, surgery can give you a chest you can feel good about. Most of the time, gynecomastia is “idiopathic” (meaning we don’t know the cause), and surgery will remove the breast tissue and correct the problem without any need for medical treatment. About 15% of the time, though, there is a medical cause (like hormonal imbalance, a medication side effect, a genetic condition, or marijuana use) and surgery alone is not the answer. It is important to see your family doctor before coming to see me in case you are in that 15% of males who need medical treatment to remove the cause of breast enlargement.
Techniques:

In all plastic surgery, you trade getting the shape you want for putting up with scars. If you have a small chest with pretty tight skin, the incisions will be small and the recovery pretty quick. If you have large, sagging breasts, there will be more incisions and a longer recovery. At your consultation, I’ll evaluate your anatomy and expectations and come up with a personalized approach that will give you the shape you want with an amount of scarring that you’re comfortable with.

 

Type I – a small amount of fat
Type II – firm tissue in addition to fat
Type III – extra tissue as well as loose skin

Type I – Treated with Liposuction

If you have a small amount of fat and no firm breast tissue or sagging skin, liposuction alone may work for you. You can use twilight anesthesia (when you’re asleep but breathing on your own) or general anesthesia (with a breathing tube). I inject a fluid that numbs the chest and controls bleeding. Then, the fat is sucpioned out through small incisions, hidden in a crease in the armpit and/or at the bottom of the chest. You go home the same day wearing a garment to help prevent swelling and to prevent a fluid collection under the skin. Some pink tinged fluid will leak out of the incisions for about a day or so, and you’ll probably be sore for about a week. You will need about 2-4 days off work if you have a low physical activity job, longer if your job is more strenuous. The incisions may stay red or raised for a few months but will eventually (in 1 or 2 years) heal to an almost imperceptible line.

Type II – Treated with Excision of Tissue

If you feel firm tissue deep to your nipple and areola when you pinch your chest, then there is more breast gland tissue than fatty tissue, and liposuction alone will probably not give you the result you want. To get the best result, a small incision is made around the bottom edge of your areola (the dark circle around the nipple). The breast tissue is directly cut out, and then liposuction is used to help remove fat and feather the contour around the area that was excised. Everything in the Type I section applies, but you will also have a small drain tube in place to help remove extra fluid the body produces after surgery (this will stay from 2-10 days after surgery depending on how much is coming out). You’ll need about 3-5 days off a low physical activity job and about two weeks off strenuous activity like exercise. The scars here tend to heal well and are barely noticeable since they are in an area of natural color change on your body.

Type III – Treated with Excision of Tissue and Extra Skin

If you have sagging skin with stretch marks or if your chest is large enough that there will be excess skin after the tissue is removed, then you may need to consider skin excision. In order to remove extra skin, scars need to be placed on the front of the chest. This is often only in the area around the areola, but sometimes incisions are needed on the front of the chest in order to remove enough skin. Just like in Type II treatment, you will have drains after surgery. You’ll need about a week off work (longer if your job is more physical) and you’ll need to limit your activity for 2-4 weeks after surgery. The scars usually heal well but are not as easily hidden as in Type I or II treatment.

Risks
  • Unfavorable scarring
  • Bleeding (hematoma) - may require drainage or surgery to stop the bleeding
  • Fluid collection (seroma) - may require drainage in the office or operating room
  • Infection – you may require antibiotics, admission to the hospital, or surgery
  • Changes in nipple or breast sensation - may be temporary or permanent
  • Chest contour irregularities Potential partial or total loss of nipple and areola.