How bad is my gynecomastia? How much do you think surgery would be ? (Photo)

Hi there,You have quite large gynaecomastia, which is enlargement of the male breast.Mostly this is simply inherited, or weight related.  Occasionally hormone imbalances or some medications can cause it.  A checkup from your family doctor may be needed to rule these out.The usual treatment of gynaecomastia is surgical removal of the breast tissue.The results however, are all about the skin.  If the skin is elastic, and not too plentiful, and if the amount of removal isn't too much then none of your skin needs to be removed.  This means that you can have very close to scarless surgery. Most of the excess tissue can be removed by liposuction, and the rest through a small incision at  the edge of the nipple. The skin will then take up and not look loose.You are at risk of having loose skin after removal of the breast tissue.  If that occurs, then skin removal results in a long scar across the chest, which is quite visible.  How do you reduce your risk of excess skin?1. You are very overweight.  Lose weight.  I'm serious.  You must do this, and it will solve a fair bit of your chest problem, and allow the skin to shrink back naturally to an extent. It won't remove the need for surgery, but it might remove the need to leave you visibly scarred. If you don't lose the weight and get lean, you've no chance of a good result in my opinion.2. Visit a board certified plastic surgeon in your area to discuss techniques of correction.  I think that the more your excess tissue can be removed by liposuction to your entire chest, the less the chance of needing skin removal.3. A personal examination is needed by the surgeon to properly assess your skin elasticity, and their experience will further inform you as to whether you have skin elastic enough to retract and recover after the tissue removal.  I hope you do all this, it will make a huge difference to your life quality and body comfort, and I wish you very well with it.Howard Webster.

Hi and thanks for the question. You have significant gynecomastia. Because the condition has continued to worsen over the years, it is my opinion that you should see an endocrinologist to make sure that you don't have a hormonal imbalance.If your endocrine work up is negative than I would suggest a combination of liposuction and direct excision of the gland through a periareolar approach. It is very likely that you will be left with residual excess skin that may or may not require further surgical correction. I personally like to wait to see how much that skin will retract before proceeding with skin removal.Search for a surgeon certified by the American Board of Plastic Surgery with years of experience. Look at many, many before and after photos. Make sure that the photos that you are shown belong to patients of the surgeon that you are considering, not his/her partner or the clinic. Given the opportunity to view countless before and after photos will give you a very good idea to the consistency of the work. Are you being shown a few good results? The situation is analogous to the baseball player who hits a home run once in a while as opposed to the player who has a high batting average because he is consistent every time he steps up to bat.You need to be able to speak with the surgeon's previous patients. There is nothing like a one to one sharing of info. RealSelf has done a wonderful job in allowing dialogue among patients.Next, is the surgeon an individual who can earn your trust? Trust is key. You want to be guided along your journey by someone whom you trust. Trust is earned by being candid and truthful. It should not be easily given to the title of MD.How many years has he/she been performing cosmetic surgery? Do you want an experienced surgeon or one that has had limited experience? How about the center, clinic or facility? Are they accredited by a national organization or do they just have State approval. Understand that at the current time, there are three nationally recognized organizations responsible for the highest levels of patient safety, AAAASF, AAACH and JCHO. You owe it to yourself to position yourself for the best possible results but under the most stringent safety regulations.How about anesthesia? Will you have a medical doctor certified by the American Board of Anesthesiology or a certified nurse anesthetist (CRNA)? Understand that there is no substitute for research. Cosmetic surgery, no matter how simple it may be to the patients, are invasive procedures and as such carry certain risks and complications. Research, research and then research some more. I wish you the best on your journey. I hope that the info provided has been helpful. Should you require any further clarification, do not hesitate to contact our institute. I answer all questions personally, not through patient coordinators or other marketing individuals. Good Luck