Surgery for Gynecomastia

Gynecomastia is a common diagnosis in men.  The incidence of gynecomastia peaks in three age groups; young children, adolescents, and seniors. 

A thorough history and physical is important in the workup of gynecomastia.  Physicians look for physiologic causes of gynecomastia by performing a physical examination of the liver, adrenal glands, pituitary, and testicles.  Further lab tests will reveal hormonal or endocrine abnormalities.

The good news is that the workup for gynecomastia is usually normal.  If that is the case, most physicians will wait 12 months before recommending surgery.  The surgical options are liposuction or surgical excision.

The decision to pursue surgery is based on three factors:

• The position of the nipple
• The amount of skin redundancy
• The amount of tissue excess

Consult with a qualified surgeon familiar with gynecomastia surgery.

A patient with gynecomastia needs to have a detailed examination including review of any medications that the patient is taking.
Gynecomastia that occurs during puberty or one that is related to medications can be reversible.

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Assuming you are not overweight and fit, sounds like you might have some glandular breast tissue, that will not respond to excercise / weight loss. Rather than repeat what Dr Berman has said (I like him, treat a fair amount of gynecomastia). I agree with him 100% - definitely take his advice.