Gynecomastia Surgery or Male Breast Reduction
Male breast surgery, including male breast reduction, chest liposculpting, and pectoral implants is becoming more popular than ever. Male breast reduction surgeries offer one of the highest patient satisfaction rates we see. The freedom to feel great with your shirt off increasingly makes Gynecomastia Surgery one of the fastest growing procedure rates for patients undergoing cosmetic surgery in Florida.
Gynecomastia refers to male breast enlargement caused by excess breast tissue. This excess breast tissue can range from a small amount of firm tissue, which may cause discomfort around the nipple to larger amounts that create a female like breast appearance. Excess fat and skin and an enlarged areola can also contribute to an undesirable appearance.
Gynecomastia can make it embarrassing to wear a tight shirt, to take your shirt off at the beach, or in intimate situations. Since there's usually both excess breast tissue and fat, losing weight often does not solve the problem. Unfortunately liposuction alone works in only rare, mild cases.
The good news is that in most situations, male breast reduction 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 removes the breast tissue and corrects the problem without any need for further treatment.
About 10-15% of the time, 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 for your male breast reduction. It is important to see your family doctor before coming to see me in case you are in that group of males who need medical treatment to remove the cause of breast enlargement.
Techniques for male breast reduction:
- Type I Male breast reduction – a small amount of fat
- Type II Male breast reduction – firm tissue in addition to fat
- Type III Male breast reduction – loose skin in addition to tissue/fat
Individual results from procedures cannot be guaranteed, and may vary between patients.
Type I – Male Breast Reduction 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. This is better for sculpting than true reduction in size. The procedure takes 1-2 hours and is done in the operating room with IV sedation or General Anesthesia.
I inject a fluid that numbs the chest and controls bleeding during male chest liposuction. Then, the fat is suctioned out through small incisions, hidden in a crease in the armpit and/or at the bottom of the chest. Ultrasound assisted liposuction is beneficial due to the fibrous nature of the fat. It helps break up fat while preserving connective tissue and vessels, making it easier to remove more fat in an even way.
You go home the same day wearing a garment to help prevent swelling and to prevent a fluid collection under the skin. The garment is worn at all times except when showering for 2-3 weeks. Most patients continue to wear it for several months on and off to minimize episodes of swelling.
Some pink tinged fluid will leak out of the incisions for about a day or so, and you’ll probably be really sore for 2-3 weeks. You will need at least 2-3 days off work if you have a low physical activity job, and up to 2 -3 weeks off if your job is strenuous. The incisions may stay pink and look conspicuous for a few months but will eventually (in 1 or 2 years) heal to an almost imperceptible line. There is a chance the skin will not tighten fully for some patients and skin removal might be needed for the best result.
Type II – Male Breast Reduction Treated with Excision of Tissue
This is often the most common male breast surgery for heavy users of testosterone or marijuana and patients with a genetic tendency toward gynecomastia. If you feel firm tissue deep to your nipple and areola, then there is more breast tissue than fat, and liposuction alone won’t give you the result you want.
To get the best result from your male breast reduction, 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 contour the edges.
There will be silicone drain tubes less than the diameter of a pencil in place to prevent buildup of fluid after surgery. These are removed between 3 and 14 days after surgery depending on how much fluid is coming out). You’ll need 4-7 days off a low physical activity job and 2-4 weeks off strenuous activity. The scars tend to heal well and are barely noticeable since they are in an area of natural color change on your body. Temporary tenderness is common at the incision site and occasionally around the entire chest and can last for several months.
Type III – Male Breast Surgery Treated with Excision of Tissue and Extra Skin
This is the most common male breast reduction surgery after massive weight loss. If you have sagging skin, stretch marks, or a long distance between your nipple and collarbone, then there will be excess skin after the tissue is removed, then you need to consider skin excision.
In order to remove extra skin, scars need to be placed on the front of the chest. This is sometimes only around the areola, but in some patients incisions are needed in the breast fold and around the areola in order to remove enough skin. In some cases these patients will choose to have pectoral implants inserted under the chest muscle in order to create the desired outcome after their gynecommastia surgery. This is often the best approach for creating dramatic results in more sever gynecommastia cases.
Just like in Type II Male breast reduction treatment, you will have drains after surgery. You’ll need 1-2 weeks 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 of Breast reduction for men
- Unfavorable scarring from Male breast reduction
- 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.
Cost of Male breast reduction
The cost of male breast reduction can depend on many factors including whether or not skin is excised or if only liposuction is necessary. The first typical cost of male breast reduction is anesthesia, which can run between $800 and $2500 depending on the length of the procedure. The second cost of male breast reduction is a facility fee, which can range from $500-$2500, again depending on the length of the procedure. The last cost of male breast reduction is the surgeons fee, which can range from $2500-6500 depending on the amount of fat, tissue, and skin.