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Gynecomastia (Male Breast) Surgery
Gynecomastia (Male Breast) Surgery
Gynecomastia (Male Breast) Surgery
Believe it or not, males have breast tissue just like females! However, male breast tissue is usually significantly less than female breast tissue and does not undergo development in the same manner that female breasts develop. Gynecomastia is a common condition in men that results in enlarged male breast tissue. It can be seen in men of all ages but usually occurs during puberty or older adulthood.
Gynecomastia can occur as a result of imbalances in testosterone and estrogen, so it is important to make sure that these underlying hormonal causes are explored and treated, if necessary. It can also be caused by obesity or certain medications. Other, more serious causes of gynecomastia include diseases of the adrenal glands, pituitary glands, or other organs, so your surgeon will make sure to screen you for any of these causes. In some men, gynecomastia will resolve on its own without treatment, usually over the course of 1-2 years. However, in some cases, this breast tissue persists into teenage years and adulthood and can be a source of self-consciousness or discomfort. If you have developed more breast tissue than you would like, gynecomastia surgery or male breast surgery may be helpful for you.
Questions & Answers
Gynecomastia typically involves breast tissue growth that can be seen just below the nipple and is felt as a breast lump in the area. It may be tender to the touch, and it may be present in one or both breasts. Gynecomastia surgery involves removal of this excess breast tissue. This procedure is often combined with liposuction to help achieve the best chest contour possible. There are many decisions that need to be made when considering gynecomastia surgery, and your surgeon will discuss these in detail with you after she examines you.
The benefits of gynecomastia surgery are unique to each individual. Benefits of gynecomastia surgery may include:
- Boosting your self-esteem
- Improving chest definition
- Improving your self-confidence at the beach or in certain types of clothing
- Gaining a more masculine appearance
- Correcting mild asymmetry
In addition to deciding whether gynecomastia surgery can meet your personal goals, there are several factors to be considered in determining whether you are a good candidate for this surgery. Good candidates for gynecomastia surgery include those who:
- Want to achieve a more normal shape and contour of their chest
- Have addressed any underlying causes of breast tissue development, when applicable
- Have generally good physical and mental health
- Are nonsmokers or are willing to stop smoking before surgery
- Have realistic expectations from gynecomastia surgery
While gynecomastia surgery can address a variety of concerns, it does have limitations. It is important to know these limitations and to understand when you may be a candidate for a different type of surgery. Gynecomastia surgery cannot:
- Increase muscle volume of the chest
Gynecomastia surgery involves several important decisions when planning for surgery.
Incision Location
- Periareolar
For milder cases of gynecomastia, the incision to remove the breast tissue can be hidden along the bottom half of the border of the areola. This is nearly imperceptible when it heals and is a great option for achieving excellent aesthetic results.
- Periareolar combined with infra-pectoral border
For more advanced cases of gynecomastia, more tissue must be removed along with excess skin to achieve an aesthetic chest shape. In these cases, an incision is often required along the border of the areola in addition to an incision along the bottom part of the pectoralis major (“pushup”) muscle. This incision usually heals well and is hidden in naturally occurring shadows created by the pectoralis muscle.
Nipple Considerations
- Nipple areolar complex in good position
- Nipple areolar complex is low or drooping
For milder cases of gynecomastia, the nipple is in a good position and is flat. In these cases, the nipple does not need to be manipulated.
For more advanced cases of gynecomastia, the nipple areolar complex is often low or drooping much like a deflated breast after weight loss or pregnancy in women. In these cases, the nipple must be moved to a higher position on the chest. This may be accomplished by leaving the nipple attached to some tissue beneath it. In this case, the nipple should retain sensation. However, this method of moving the nipple upward can leave behind some bulk beneath the nipple areolar complex. An alternative method of addressing a low nipple position is through free nipple grafting. In this case, the nipple is removed from the chest wall and sewn back onto the chest as a skin graft into the desired position. While this eliminates the bulk issue of the prior method, it does cause complete numbness of the nipple, and there is an increased risk of some of the skin not surviving.
Your surgeon will discuss the pros and cons of each of these options as applicable to your case and help you make the right decision for you.
Gynecomastia surgery is an outpatient procedure performed with general anesthesia in an operating room. After your surgery, you will be placed in dressings and a compression garment. You will spend a short time in the recovery room before a friend or family member takes you home, where you should plan to rest for the remainder of the day. Be sure to arrange for someone to drive you home after surgery and to stay with you at least the first night. We will advise you on pain medication to ease any discomfort, give you detailed post-operative instructions, and schedule a follow-up appointment to check your progress.
It is normal to experience some pain and swelling in the first few days after surgery.
Incisions usually heal between 1 and 2 weeks after surgery. Depending on your type of work, you will be able to return to work usually within 1 to 2 weeks. You will have some activity restrictions initially, but most people are able to return to full activity by 6 weeks after surgery.
Your chest may require some time to assume a more natural shape. Final results are usually seen at 6 months to a year after surgery.
Every patient’s recovery is different. Your recovery may be quicker or take more time than average.
If you are planning to lose a significant amount of weight, be sure to tell your surgeon. She may recommend that you stabilize your weight prior to undergoing surgery.
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