Gynecomastia, enlarged male breasts.

Kenneth Bermudez, MD

Article by
San Francisco Plastic Surgeon

Gynecomastia is a medical term that originates from the Greek words for "women-like breasts." This condition is far more common than many realize. Gynecomastia affects an estimated 40 to 60 percent of the male population. It may affect only one breast or both. Although certain drugs such as anabolic steroids, medications containing estrogen, alcohol, marijuana, etc., and medical conditions including cancer, impaired liver function, to name a few, may cause or contribute to enlarged male breasts, it is widely accepted that a large percentage of cases derive from unknown sources.

Men of any age who are healthy and emotionally stable are considered good candidates for male breast reduction surgery. The best candidates are those who have firm, elastic skin that will reshape to the body’s new contours. In some instances, surgery may be discouraged for overweight men who have not first tried an exercise and diet regimen.

Enlarged male breasts can be reduced by liposuction and/or by cutting out excess glandular tissue. The procedure for male breast reduction takes an average of two hours, usually on an outpatient basis, using general or local anesthesia. If excessive glandular tissue, fat and skin is present, it will be removed.

Surgery may be performed alone or in conjunction with lipoplasty, where the suction device will typically be inserted through the existing incisions. For the removal of excess fatty tissue alone, liposuction may be all that is needed; in such cases, scars will be small and barely visible.

Results are permanent, although subsequent obesity can create a gynecomastia-like effect. Some of the benefits of surgery include a firmer, flatter, more contoured chest which may give the male patient a boost in self-confidence. There is little downtime, and you may return to work within one week usually, unless you are involved in strenuous activities.

There will be scarring around the nipple of the breast (areola) from this procedure but will fade over a period of time and be less visible. There will be some post-operative bruising, swelling, and burning sensation. To assist with the healing process, the patient will wear an elastic pressure garment for 3-6 weeks and must avoid exposing scarred areas to the sun for at least 6 months.

Other considerations include temporary numbness or lack of sensation that could last up to a year. Infrequent complications may include infection, skin damage, fluid accumulation, bleeding, scarring or pigment changes. Post-operative asymmetry, while rare, is possible; a second procedure may be needed to remove additional tissue.