Gynecomastia

Gynecomastia is a condition of overdeveloped or enlarged breasts in men that can occur at any age. The condition can be the result of hormonal changes, heredity, obesity, marijuana, anabolic steroids, tumors and other prescription medications. Gynecomastia can cause emotional discomfort and impair self-confidence. Some men may even avoid certain physical activities and intimacy simply to hide their condition.

Gynecomastia is characterized by:

• Excess localized fat
• Excess glandular tissue development
• Sometimes excess breast skin
• Involve one or both breasts

Gynecomastia surgery reduces breast size in men, 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.

Gynecomastia surgery candidates include:

• Men whose condition cannot be corrected through alternative medical treatments
• Healthy individuals who do not have a life-threatening illness or medical conditions that can impair healing
• Nonsmokers 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

Typically, gynecomastia surgery is performed as an outpatient procedure under general or local anesthesia. There are various techniques used for this surgery and they are largely dependent on your body composition. During your consultation, Dr. Webb will discuss the best options for your desired outcome, based on your individual anatomy and medical condition.

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. Liposuction techniques include removal of tissue alone as well as laser-assisted liposuction for skin tightening. Dr. Webb will define the technique most appropriate in your case prior to your procedure.

Excision techniques are recommended where glandular breast tissue under the areola or excess skin must be removed to correct gynecomastia. Incisions (and thus scars) are necessary if the areola will be reduced or the nipple will be repositioned to a more masculine contour. Incision patterns vary depending on the specific conditions and surgical preference.

Sometimes gynecomastia is treated with both liposuction and excision. After your initial exam, Dr. Webb will be able to give you an idea of which procedure would be best for you to achieve your optimal result.

After the surgery, bandages will be applied underneath a compression garment for support and to help minimize swelling. Occasionally, small tubes are placed to drain fluid and reduce swelling. For the first few days, you’ll have some lifestyle restrictions and will need a little extra help at home. You will need to wear the compression garment for a few weeks and avoid exercise until Dr. Webb approves it. Some swelling and discomfort is a normal part of the healing process and you will be given pain medication or directed to take an anti-inflammatory at home to manage your discomfort. Most patients can return to full strenuous activity 3-4 weeks postoperatively, depending on what they had done.

Excess breast tissue in men can severely impair one’s confidence and self-image and the impact often goes unnoticed by parents and partners. For more information, contact our office and schedule a private consultation with board certified plastic surgeon, Dr. Lindsey Webb, to learn if you are a candidate for gynecomastia surgery.