Breast reduction - is the surgery the same for men and women?

Hello,

For the woman, breast reduction surgery is designed to relieve discomfort (frequently) and restore a youthful appearance. That youthful appearance includes the re-shaping of  smaller breasts.

For the man with gynecomastia, the operation is designed to virtually eliminate the appearance of breasts entirely. Men do not tolerate incisions to re-shape the skin envelope so the usual technique is a combination of liposuction and a smaller  "open" operation to remove firmer components under the nipple. This can at times leave some "looseness" in the skin that some patients (particularly older patients) dislike, but the reduction in volume and improved masculine appearance is the "crowd pleaser" here.

Best Regards,

John Di Saia MD

Male and Female Breast Reduction are as different as cats and dogs, even if they do share some similarities.

The breast of a man has no functional or aesthetic significance other than its presence as a reminder of our common humanity. Therefore when the male breast becomes unnaturally enlarged for any reason, it creates a "feminizing" appearance to the chest of the individual. This causes embarrassment and reluctance to reveal the chest under even the most normal circumstances at the gym or beach, for example. Surgery undertaken to reduce the unnaturally large male breast therefore involves removal of the majority of the excessive breast and fatty tissue in order to restore the natural appearance of the male breast, which is a "flat" chest. Rarely (in cases of massive weight loss), some skin and the areola diameter also require reduction.

The breast of a woman, on the other hand, has enormous social, sexual, functional, and aesthetic significance. Nevertheless, excessively large female breasts can be not only unattractive, but also can significantly impair the woman's ability to exercise, find appropriate clothing, etc. It stands to reason, therefore, that the goal of female breast reduction should be different.

The paramount goals of female breast reduction are preservation of function, preservation of sensation, improvement of aesthetics, and minimization of scars. Since the procedure is often done before women have passed through their child-bearing years, the functional purpose of the breast should be preserved. For the same reason, the appearance of the female breast should be improved as much as possible and must be maintained as "feminine" at all costs, with minimal scarring, in order to avoid a surgical outcome that is aesthetically inferior to the overly-large but un-scarred breast.

When it comes to breast reduction in men, generally more is better. For breast reduction in women, generally less is more.

There are several ways to treat gynecomastia. Liposuction is the simplest way.  

Sometimes liposuction has to be combined with a small direct excision of tissue that can be performed throught a small incision along the border of the areola.  

Sometimes, if there is alot of excess skin, such as for massive weight loss patients, then similar incisions as a female breast reduction can be performed, but they are really very different procedures.

Absolutely not.

Male breast reduction is more like a mastectomy than a breast reduction. Breast tissue in a male is removed completely; only the nipple and areola remain while achieving a desirable contour to the chest.

The goal in a female breast reduction is to remove some of the breast tissue and leave a beautifully shaped breast.

The incisions and the surgical techniques are different. Liposuction is a significant component of most male breast surgery, with small incisions around the areola to remove the remaining breast tissue. Only when there is significant skin excess are incisions made on the breast to remove skin.

Female breast reduction is done with direct tissue removal through incisions around the areola extending down the center of the breast and occasionally extending along the breast fold.

While breast reduction has been around for several years, there have been a number of recent advancements which have made this procedure not only safer but also associated with less downtime... for both men and women.

For women, breast reduction classically addresses several things:

• It reduces diameter of the areola
• It removes loose skin and tightens the breasts overall
• It raises the position of the nipple and areola
• It reduces the overall cup size of the breasts

To accomplish these endpoints, the classical breast reduction has relied on large incisions, drains, and extended downtime. In recent years, this has all changed. More and more physicians are incorporating "short scar" techniques into their practice which effectively reduce scar length and, quite often, may also reduce healing time.

In addition, for those clients who are good candidates, the VASER-assisted breast reduction has become a very popular way in which to reduce breast size--often with very small incisions which are almost unnoticeable when healed.

For men, the procedure is very different. Most men who have gynecomastia (male breast development) have far less breast tissue volume than women and, as such, are candidates for far less invasive procedures.

The standard treatment method for gynecomastia in my practice begins with VASER LipoSelection of the chestwall to effectively remove fat and better contour this area. This procedure is performed through a very small incision at the areaolar base. Following this, any residual breast tissue is then removed from beneath the areola by extending this incision and directly excising excess breast tissue.

Results are often dramatic and downtime is generally less than a week.