I think I have gynecomastia and am considering a male breast reduction. Is there a standard I should apply to decide if I really need the surgery?
Gynecomastia can cause emotional distress among patients who are ashamed of their anatomic chest features. There is no optimal time to seek a consultation for gynecomastia as it is a medical condition with cosmetic implications. If it bothers you, seek a consultation. That said, I would advise patients who have pain, abnormal breast nipple discharge, cellulitis, breast mass, or armpit lymph nodes and unilateral symptoms to seek attention immediately.
Gynecomastia as you probably know is condition of enlargement of the male breast - usually there are variable amounts of fat and glandular tisse (actual breast tissue). I treat a fair amount of men for this condition, and what I have found that most cases will benefit from a combination approach consisting of liposuction (to address the fat component and feather / sculpt the chest) and direct glandular excision (through a small incision on the underside of the areola - because this will not respond to any kind of liposuction- it's way too dense). In some cases I do lipo alone, and very rarely gland removal alone. The reason for this long answer is to help you understand what factors to consider when having surgery.
1. Make sure your doctor is a Board Certified Plastic Surgeon- this is very important because they have had the appropriate training for this surgery.
2. Make sure that the doctor you select does do alot of these procedures and speak to some of his / her patients / look at before / after photos.
3. Make sure that your doctor is willing / comfortable to do whatever it takes to get you the best contour (ie, willing to do glandular excision in addition to lipo - many think that lipo alone is adequate and it's often not- i have seen many patients who were treated elsewhere with lipo with poor correction and need a revision with gland removal)
4.If this has occurred over relatively short period (a few months) of time, make sure other causes are ruled out (although rare, usually hormonal)
5. Make sure you are stable in terms of your growth (ie, if you are entering your early teens, it may change as you come out of puberty; of course if you are older (past 18 years old) it is highly unlikely to change and you should consider surgery then.
6. For more information, go to www.gynecomastia.org . This site is probably the best for information on this condition.
Male breast reduction for gynecomastia (enlarged male breast tissue) is usually an elective procedure performed for cosmetic reasons. Very rarely does a patient have such extremely large breasts or significant excess skin from their breasts that insurance covers the surgery. Most patients who seek out surgery have a moderate form of this condition which is typically treated with a combination of liposuction and direct removal of breast tissue, through a small incision at the level of the areola.
To determine the necessity of your procedure, I recommend you consult with a board certified plastic surgeon. Your surgeon will be able to ensure there is no identifiable cause of your condition (steroid use, excessive marijuana use, endocrine disorder, etc.) and outline a surgical approach best for your particular anatomy.
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