Gynecomastia is a medical term that comes from the Greek and literally means “women-like breasts”. Though few people talk about it, gynecomastia is fairly common, affecting an estimated 40-60% of men. It can affect one breast or both and though certain drugs and medical problems are linked to gynecomastia, there is no known cause in the majority of cases. For men who are self-conscious about their breasts, male breast reduction surgery can help. The procedure removes fat and glandular tissue from the breasts and in extreme cases, excess skin may also be removed. The result is a chest that is flatter, firmer and better contoured.
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If you are physically healthy, psychologically stable, and have realistic expectations, you will be a good candidate. The best candidates for surgery are those with firm, elastic skin that will reshape itself to the body’s new contours. Although most of our male breast reduction patients are adults, we do perform breast reduction on teen-aged boys, as large breasts on a teenager can be embarrassing for them and create problems with socialization. Surgery is discouraged for men who are overweight unless they have first attempted to correct the problem with exercise or weight loss. Men who drink excessive amounts of alcohol, take anabolic steroids or smoke marijuana are similarly discouraged, as these behaviors have been known to cause gynecomastia. Before performing surgery on men in those categories, these patients are instructed to stop the use of these drugs to see if the breast fullness will go away on its own.
First, your surgeon will take your medical history and inquire about medications that may increase estrogen levels. Next we will examine your breasts and check whether the excess tissue is fat or breast tissue. Further workup including checking estrogen levels and a mammogram may be indicated. If a medical problem is the suspected cause, you’ll be referred to an appropriate specialist prior to surgery.
How the Procedure is Performed
Male breast reduction procedures are performed under general anesthesia in our Boca Raton accredited in-office surgery suite on an outpatient basis. If excess glandular tissue is the main cause of the breast enlargement, it is removed either with a scalpel alone or in conjunction with liposuction. In a typical procedure, an inconspicuous incision is made on the edge of the areola or in the underarm. Working through the incision, we remove excess glandular tissue, fat and skin from around the areola and from the sides and bottom of the breast. The removal of a significant amount of tissue and skin may require larger incisions that result in more conspicuous scars.
If your gynecomastia consists primarily of excessive fatty tissue rather than glandular tissue, we will use vaser liposuction (a type of ultrasonic liposuction) rather than a scalpel to remove the excess fat. A small incision, (less than a half-inch in length) is made under the breast or in the underarm. The vaser probe is first inserted. This breaks up the fatty and fibrous tissue. A slim hollow tube, called a cannula, is attached to a vacuum pump and then inserted into the incision. The surgeon moves the cannula through the layers beneath the skin to break up the fat and suction it out.
In extreme cases where large amounts of fat or glandular tissue have been removed, skin may not adjust well to the new smaller breast contour. In these cases, excess skin may have to be removed to allow the removing skin to firmly readjust to the new breast contour.
Sometimes, a small drain is inserted through a separate incision to draw off excess fluids. Once closed, the incisions are covered with a dressing. The chest may be wrapped to keep the skin firmly in place.
What to Expect During Recovery
Following your breast reduction procedure, you will have some swelling and bruising and feel some discomfort for a few days which can be controlled with medication. Depending on the extent of tissue or fat removal, you may need to wear an elastic pressure garment 24 hours a day for the first week or two and at night for an additional two to four weeks. It may take up to three months or longer for the final results of your surgery to be apparent. Any sutures that are not absorbable will be removed in your postoperative visit 1-2 weeks following the procedure.
We recommend that you avoid sexual activity for a week or two and any heavy exercise for 3-4 weeks. You will want to avoid any activity that will risk a blow to the chest area for at least a month. If you enjoy sunbathing, we recommend that you avoid this for at least six months, as sunlight can permanently affect the skin’s pigmentation causing the scar to be darker than it would otherwise be.