Male Breast Reduction

Gynecomastia:  Male Breast Reduction
“Men actually have breast tissue, too, and sometimes it can grow abnormally and need surgical correction…”

Male breast enlargement, or gynecomastia, is a normal occurrence around the time of puberty.  The slight enlargement of the firm kernel of breast tissue which is present directly under the nipple and areola (the dark skin around the nipple) generally only lasts one to two years and disappears into the mid to late teens.  If it doesn’t disappear, or if male breast enlargement occurs at other times during life, it should be investigated by a physician to make sure there is no male breast cancer, testicular or other cancer, hormonal imbalance or other underlying illness.  Some medications can cause gynecomastia and it can occur with anabolic steroid use and use of marijuana.  Sometimes the breast enlargement can be slight or only on one breast.  Sometimes the enlargement is associated with excess skin and sagging of the breast tissue.  Enlarged male breasts can make a man-or a teenage boy-feel extremely self-conscious.  They may avoid activities such as swimming or surfing, or any activity during which they would normally take their shirt off.

Male breast reduction, technically known as gynecomastia surgery, is designed for such  men. The procedure may require the removal of just glandular tissue, or may require removal of breast glandular tissue and surrounding fat, and sometimes even glandular tissue, surrounding fat and loose skin. The goal is to give the man a normal looking male chest, without the feminine appearance of breasts, chest skin sagging or malposition of the areolae.

Consultation & Preparation

In your initial consultation, it’s important to discuss your expectations frankly with Dr. Guy, and to listen to her opinion.  Dr. Guy will examine and measure your breasts and chest, and will probably photograph them for reference during surgery and afterwards. She will discuss the variables that may affect the procedure-such as your age, the size and shape of your chest,  whether or not you need a simple glandular excision or additional surrounding liposuction or skin excision.  Normally, incisions and scars are minimal and hidden in the areolar skin.  If excess skin excision is required, more scarring and possibly visible scarring may be required.

Dr. Guy may require you to have an evaluation by an endocrinologist (hormone specialist) prior to any surgery, to rule out medical causes of the enlargement which might allow the breasts to be treated by medicine alone, without surgery.  You’ll also get specific instructions on how to prepare for surgery, including guidelines on eating and drinking, not smoking, and taking or avoiding certain vitamins and medications.

While you’re making preparations, be sure to arrange for someone to drive you home after your surgery and to help you out for a few days if needed.  The procedure is performed as an out-patient, but a responsible adult is required to drive you home and look after you for at least 24 hours after the surgery.  Male breast reduction is nearly always performed under general anesthesia. You’ll be asleep through the entire operation.

The Plastic Surgery

Techniques for gynecomastia excision vary, but the most common procedure involves a small incision along the edge of the areola.  If liposuction is also needed, a tiny, separate incision may be required to adequately suction the fatty part of the tissue reduction.  Extra scars on the lighter skin on the chest are rarely needed, but may be used if excess sagging skin needs to be tightened.

Stitches are usually located around the areola and heal quite well.  And occasionally, when only fat needs to be removed, liposuction alone can be used to reduce breast size, leaving even more minimal scars.

Recovery & Results

After surgery, you’ll be wrapped in an elastic bandage or a surgical vest over gauze dressings. A small tube may be placed in each breast to drain off blood and fluids for the first day or two.

You may feel some pain for the first couple of days-especially when you move around or cough-and some discomfort for a week or more. Your surgeon will prescribe medication to lessen the pain.

The bandages and drains will be removed a day or two after surgery, though you’ll continue wearing the surgical wrap or vest for two to six weeks, until the swelling and bruising subside and to produce a smooth contour to the chest . Your stitches will be removed in one to three weeks.

You may experience random, shooting pains for a few months. You can expect some loss of feeling in your nipples and chest skin, caused by the swelling after surgery. This usually fades over the next six weeks or so. In some patients, however, it may last a year or more.

Although you may be up and about in a day or two, your chest may still ache occasionally for a couple of weeks. You should avoid lifting or pushing anything heavy for two weeks and limit any exercise during that time.  Ask Dr. Guy when you can resume heavy exercise or weight lifting.