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Male Breast Reduction (Gynecomastia)

What is Gynecomastia Correction (Male Breast Reduction)?

Male breast reduction is known as “gynecomastia correction”. This procedure is designed to remove excess breast (glandular) tissue and fat from the chest area of men, creating a smoother, firmer contour. Occasionally, removal of excess skin is also required, depending on the degree of gynecomastia and amount of breast droop. Gynecomastia correction has tremendous psychological benefits, and can significantly improve a man’s quality of life.

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What Causes Gynecomastia?

Gynecomastia is quite common, and can affect one or both breasts. It can generate self-consciousness or embarrassment for a man. Although gynecomastia can result from obesity, some medical problems, hormone imbalances, medication or drug use (marijuana), in the majority of cases the cause is unknown.

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Who is a Good Candidate for Gynecomastia Correction?

Good candidates for a male breast reduction include men of any age who are healthy, in good physical shape, are emotionally stable, and as close as possible to their ideal body weight (or a stable weight following major weight loss). The best candidates for surgery have firm, elastic chest skin that will reshape to its new contour after surgery.

You may not be an appropriate candidate for gynecomastia surgery if you are a smoker, have an inadequately treated major medical problem or if you do not have good overall “health” as described above. If you are significantly overweight, you may be advised to lose some weight before surgery to allow the best cosmetic outcome and to avoid complications. Men who drink alcohol in excess, who use anabolic steroids or who smoke marijuana are not considered good candidates for surgery. It is prudent to first discontinue the use of these substances for 4-6 months before considering gynecomastia surgery.

Your past medical history and current medical status will be evaluated at your consultation. You may be asked to see your Primary Care Physician for a full physical examination and appropriate laboratory tests prior to being medically cleared for surgery.

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What Are The Different Types of Gynecomastia Correction Surgery?

Male breast tissue is usually a combination of excess glandular (breast) tissue and adipose tissue (fat). Occasionally there is also excess or droopy skin. Correction of gynecomastia therefore addresses these issues as they occur on an individualized basis. Outpatient surgery can take an hour or two to perform or sometimes longer if more extensive surgery is required.

Excision of Excess Male Breast Tissue

Surgical removal of excess breast tissue is usually approached by way of an inconspicuous incision underneath the areola at its junction with the chest skin. Glandular tissue and/or fat are removed beneath the areola and in the breast region. Surgical excision may be performed alone or in conjunction with liposuction.

Liposuction Correction of Gynecomastia

Liposuction is often used to remove both fatty tissue and some glandular tissue from the male chest. Often, a special type of liposuction that uses ultrasound (ultrasonic liposuction, known as “UAL” or “VASER”) is employed. Small incisions a few millimeters in diameter are made at the edge of the areola or in the underarm area. Please see our section on Liposuction to learn more about this procedure. If there is also a firm “button” of glandular tissue beneath the nipple and areola, surgical excision of this region may also be required.

Extended Male Breast Reduction

For the extremely enlarged and droopy male breast, a more significant breast reduction may be indicated. Extended male breast reduction involves removal of considerable breast tissue, fat and skin. This procedure may require larger incisions and create more conspicuous scars, as for female breast reduction surgeries. If liposuction is also used to remove excess fat in these cases, the cannula is usually inserted through the incisions used for reduction. Occasionally, a drain is inserted through a separate incision to remove excess wound fluid during healing. Men with the most severe degree of gynecomastia are usually candidates for this type of surgery.

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What is the Recovery Like After Gynecomastia Surgery?

Incisions from gynecomastia correction are closed with dissolving sutures (stitches) and are usually covered with a soft dressing. The chest is wrapped with a compressive garment to encourage skin contraction to its new contour.

You may experience some mild discomfort over the first week, for which you are prescribed oral pain medication. Mild swelling of the chest area and bruising will resolve within two to three weeks.

You will be seen at the office for your first dressing change a few days after surgery. At this visit, your drains will be removed (if drains were placed) and you will be encouraged to continue wearing compression for up to six few weeks to facilitate the best chest contour. We usually provide your necessary postoperative garments after surgery. You do not need to specifically purchase any special garments unless your surgeon specially instructs you to do so.

You may shower after your first dressing change, and you can return to work when you feel ready, often within a day or two after surgery. You should avoid sexual activity for a week or two, and heavy exercise for about three to four weeks. Try to avoid participating in sports or activities that risk a blow to the chest area for a few weeks after surgery. Any discomfort you may experience will begin to fade as you heal over the first month.

Wearing your compressive garment under your clothing will facilitate resolution of swelling, known as “edema”. It can take three months, up to a full year for you to fully appreciate the effects of your surgery. Be patient, and allow your body to recover at its own pace.

You should avoid exposing your incisions directly to the sun for at least six months, up to a year. Tanning of the scars can cause “hyperpigmentation”, or semi-permanent darkening of the incisions. If sun exposure is unavoidable, use a sunblock of at least SPF 30 on your incisions, even under light clothing. Please see our Scar Therapy section for more guidance on postoperative management of scars.

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Please visit our patient gallery to see before and after male breast reduction results!

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At your initial consultation, your surgeon will spend a great deal of time getting to know you personally and taking a complete medical history. As Plastic Surgeons who perform a great deal of breast surgery, we intimately understand how a man’s body image is often related to his chest contour. We aim to help you achieve the result you are looking for! We will explore your reasons for seeking gynecomastia correction, examine your chest, and if you are an appropriate candidate for surgery, your options will be described in detail.

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Dr. Karen M. Horton, M.D. - Plastic Surgery, Physicians & Surgeons - Medical-M.D., San Francisco, CA