Gynecomastia is a condition of over-developed or enlarged breasts in men that can occur at any age. The condition can be the result of hormonal changes, heredity, obesity, or the use of certain drugs. Gynecomastia can cause emotional discomfort and impair your self confidence. Some men may even avoid certain physical activities and intimacy simply to hide their condition.
Gynecomastia surgery reduces breast size, flattening and enhancing the chest contours.
In severe cases of gynecomastia, the weight of excess breast tissue may cause the breasts to sag and stretch the areola (the dark skin surrounding the nipple). In these cases the position and size of the areola can be surgically improved and excess skin may be reduced.
Plastic surgery to correct gynecomastia is technically called reduction mammaplasty.
Gynecomastia is characterized by:
- Excess localized fat
- Excess glandular tissue development
- Sometimes excess breast skin
- Presence unilaterally (one breast) or bilaterally (both breasts)
Many plastic surgeons offer patient financing plans for male breast reduction, so be sure to ask.
Gynecomastia surgery costs may include:
- Anesthesia fees.
- Hospital or surgical facility costs.
- Medical tests.
- Post-surgery garments.
- Prescriptions for medication.
- Surgeon’s fee.
Your satisfaction involves more than a fee. When choosing a board-certified plastic surgeon in your area for gynecomastia surgery, remember that the surgeon’s experience and your comfort with him or her are just as important as the final cost of the surgery.
In most cases, correction of gynecomastia is not eligible for insurance coverage. However, each insurance policy varies greatly. Carefully review your policy to determine coverage. The American Society of Plastic Surgeons has published a position paper for physicians and insurers defining the recommended criteria for reconstructive cases of gynecomastia. Ask your physician for a copy of this document to submit to your insurer.
Gynecomastia surgery candidates include:
- Men whose condition cannot be corrected through alternative medical treatment.
- Healthy individuals who do not have a life-threatening illness or medical conditions that can impair healing.
- Non-smokers and non-drug users.
- Men with a positive outlook and specific goals in mind for improving the physical symptoms of gynecomastia.
- Men who are physically healthy and of relatively normal weight.
- Men who have realistic expectations.
- Men whose breast development has stabilized.
- Men who are bothered by the feeling that their breasts are too large.
Adolescents may benefit from surgery, although secondary procedures may be needed in the future should breast development continue.
In preparing for gynecomastia surgery, you may be asked to:
- Get lab testing or a medical evaluation
- Take certain medications or adjust your current medications
- Stop smoking.
- Avoid taking aspirin, anti-inflammatory drugs and herbal supplements as they can increase bleeding.
Male breast reduction surgery may be performed in an accredited, office-based surgical facility, licensed ambulatory surgical center, or a hospital. Be sure to arrange for someone to drive you to and from surgery and to stay with you for at least the first night following surgery.
Gynecomastia Procedure Steps:
Step 1 – Anesthesia
Medications are administered for your comfort during the surgical procedures. The options include intravenous sedation and general anesthesia. Your doctor will recommend the best option for you.
Step 2 – Surgical Technique
In cases where gynecomastia is primarily the result of excess fatty tissue, liposuction techniques alone may be used. This requires insertion of a cannula, a thin hollow tube, through several small incisions.
The cannula is moved back and forth in a controlled motion to loosen the excess fat, which is then removed from the body by vacuum suction.
There are various liposuction techniques that may be used; the technique most appropriate in your case will be defined prior to your procedure.
Excision techniques are recommended where glandular breast tissue or excess skin must be removed to correct gynecomastia. Excision also is necessary if the areola will be reduced or the nipple will be repositioned to a more natural male contour. Incision patterns vary depending on the specific conditions and surgical preference.
Combination of liposuction & excision techniques
Sometimes gynecomastia is treated with both liposuction and excision.
During your gynecomastia surgery recovery period, dressings or bandages will be applied to your incisions and an elastic bandage or support garment may be used to minimize swelling and support your new chest contour as it heals after surgery.
A small, thin tube may be temporarily placed under the skin to drain any excess blood or fluid that may collect.
You will be given specific instructions that may include how to care for the surgical site and drains, medications to apply or take orally to aid healing and reduce the potential for infection, specific concerns to look for at the surgical site or in your general health, and when to follow up with your plastic surgeon.
The final results of gynecomastia surgery are permanent in many cases. However, if gynecomastia resulted from the use of certain prescription medications, drugs (including steroids), or weight gain you must be fully free from these substances and remain at a stable weight in order to maintain your results. Please discuss this with your physician before making changes to your prescription medications.
If you experience shortness of breath, chest pains, or unusual heart beats, seek medical attention immediately. Should any of these complications occur, you may require hospitalization and additional treatment. Following your physician’s instructions is essential to the success of your surgery.
It’s important that the surgical incisions are not subjected to excessive force, swelling, abrasion, or motion during the time of healing. Your doctor will give you specific instructions on how to care for yourself.
Gynecomastia Surgery Risks and Safety:
Gynecomastia surgery risks include:
- Reactions to tape, suture materials, glues, topical preparations or injected agents.
- Anesthesia risks.
- Bleeding (hematoma).
- Blood clots.
- Breast asymmetry.
- Breast contour and shape irregularities.
- Changes in nipple or breast sensation may be temporary or permanent.
- Damage to deeper structures – such as nerves, blood vessels, muscles, and lungs – can occur and may be temporary or permanent.
- Deep vein thrombosis, cardiac and pulmonary complications.
- Fatty tissue found in the breast might die (fat necrosis).
- Fluid accumulation (seroma).
- Persistent pain.
- Poor wound healing.
- Possibility of revisional surgery.
- Unfavorable scarring.
These risks and others will be fully discussed prior to your consent. It’s important that you address all your questions directly with your plastic surgeon.