Raleigh-Durham Male Breast Reduction doctors

There is currently no recommended, FDA-approved medical (i.e. non-surgical) treatment for gynecomastia. While gynecomastia may spontaneously regress in some instances, in most adolescent and adult males the breast tissue development is a permanent change that must be treated surgically. In the few cases where a definite cause can be identified, such as low testosterone levels or exposure to a particular medication, the gynecomastia almost always persists after the causative factor is corrected or eliminated. Because gynecomastia is so different from person to person, it is absolutely critical that the surgical approach to this problem is carefully individualized.

'Pure glandular' gynecomastia ('puffy nipples') in most cases can be treated by direct tissue excision alone. There is no fatty tissue excess and no significant skin excess. The glandular breast tissue enlargement is located immediately behind the nipple and areola, and is removed through an incision placed at the inferior border of the areola. The incision can be limited, in most cases, from about the 4 o'clock to the 8 o'clock position of the areola. The color difference between areolar skin and chest skin serves to conceal this incision quite nicely for most patients. In many cases the scar is completely invisible after just a few weeks or months of healing.

The most common form of gynecomastia ('mixed glandular / adipose') requires ultrasonic liposuction and in some cases direct breast tissue excision as well. Ultrasonic liposuction involves the use of ultrasonic energy to emulsify fat (turn it from solid to liquid) after the infiltration of tumescent solution and before the aspiration of fat. The ultrasonic energy is delivered using a solid probe that is extremely effective at breaking up the dense, fibrous breast tissue behind the nipple-areola complex. In some cases it is effective enough to eliminate the need to make an incision at the areolar border to directly remove breast tissue following ultrasonic liposuction. This practice employs the VASER® ultrasonic liposuction system developed by Sound Surgical Technologies, Inc. A specialized VASER® probe designed specifically for gynecomastia has made the device even more effective for this particular procedure.

Whenever possible, it is preferable to avoid skin excision and the scars that result from it. If the surgery leaves obvious scars and the patient is very self-conscious about them, then the patient has merely traded one reason to never take off their shirt ("man-boobs") for another (scars that show you had surgery for your "man boobs'). In some cases this requires a staged surgical approach. In the first procedure, breast tissue is removed by ultrasonic liposuction with or without direct tissue removal - but only up to the point where a deflated or 'saggier' breast appearance is not produced. Several months are allowed to pass so that the final liposuction result can be evaluated. During this time, the skin tends to retract for two reasons: a significant portion of the distending breast and adipose tissue has been removed, and the energy produced by the ultrasonic liposuction device has stimulated further tissue and skin retraction.

You are at this stage too early out to determine-it may be some swelling in that area-very difficult to see from photos

So many gynecomastia patients have shared with me the self-consciousness, embarrassment, frustration and psychological stress that they have endured because of breast enlargement. Most never feel comfortable taking off their shirt at the beach or at the pool or wearing a snug-fitting shirt. Many use compression vests in an attempt to reduce the unsightly appearance of gynecomastia. Every patient I see feels that it has adversely affected his comfort and confidence in social situations. And many describe a feeling of discomfort and embarrassment with regard to sexual intimacy. If you have experienced any or all of these issues personally, I want to assure you that (1) you are not alone and (2) essentially every case of gynecomastia can be significantly improved, and most can be corrected completely.

The most common form of gynecomastia (‘mixed glandular/adipose’) requires ultrasonic liposuction and, in some cases, direct breast tissue excision as well. I believe that ultrasonic liposuction is without question the ideal approach to the majority of gynecomastia cases. Ultrasonic liposuction involves the use of ultrasonic energy to emulsify fat (turn it from solid to liquid) after the infiltration of tumescent solution and before the aspiration of fat. The ultrasonic energy is delivered using a solid probe that is extremely effective at breaking up the dense, fibrous breast tissue behind the nipple-areola complex. For this procedure, I use the VASER ultrasonic liposuction system produced by Sound Surgical Technologies Inc. VASER is a specialized probe developed specifically for gynecomastia.

Ultrasonic liposuction is often effective enough to eliminate the need to make an incision at the areolar border to directly remove breast tissue. This treatment method also appears to produce a degree of desirable skin retraction that is generally not seen with conventional liposuction techniques. This allows some patients who formerly would have required skin excision to be treated with a more limited and less invasive approach.

Whenever possible, I attempt to avoid skin excision due to scarring associated with this type of procedure. If the surgery leaves extensive scars, and the patient is very self-conscious about them, then the patient has merely traded one reason to never take off his shirt (‘man boobs’) for another (scars that show he had surgery for his ‘man boobs’). For that reason, I have treated a large number of patients by means of a staged surgical approach. In the first procedure, breast tissue is removed by ultrasonic liposuction with or without direct tissue removal – but only up to the point where a deflated or ‘saggier’ breast appearance is not produced. Several months are allowed to pass so that the final liposuction result can be evaluated. During this time, the skin tends to retract for two reasons: much of the distending breast and adipose tissue has been removed, and the ultrasonic liposuction energy has stimulated further tissue and skin retraction.

Take your time researching your surgeon. Look at several websites, go on several consultations, speak to other patients and of course view many many before and after photographs. Find a plastic surgeon who performs gynecomastia surgery often and with whom you feel comfortable.