What Are the Chances of Full Sensation After Massive Gynecomastia Surgery?

The treatment of gynecomastia involves removing the tissue that is causing the chest to look puffy or enlarged. In most cases this involves removing 100% of the breast tissue. However, sometimes a very small amount of tissue may need to be left behind to avoid any contour abnormalities. For this reason, it is always discussed with patients that if they continue steroid use after surgery there is a chance that gynecomastia may return, albeit to a lesser degree.

As with all cosmetic surgery, results will be rewarding if expectations are realistic. With any surgical procedure, there are some risks which your doctor will discuss with you during your consultation.There are three types of surgical treatment options available that treat gynecomastia. Your board-certified plastic surgeon will recommend the type best suited for you. The most important decision to be made before performing any surgical procedure is determining whether you are an ideal candidate. Weight, and more specifically body mass index (BMI), need to be considered when deciding. For instance, studies have shown that patients with BMI > 30kg/m sq (placing them in the obese category) have a higher complication rate. Therefore, it is important for patients to be as close as possible to their normal body weight prior to surgery. Not only will this decrease risks of complications, but will also enhance the aesthetic results. Further, normal body weight is different from one patient to another.

It sounds like you may have a severe case of gynecomastia with excessive skin and sagging.  There are many techniques to resect excess skin and breast tissue.  Some may have higher risks of losing nipple sensation.  For example, if you require a free nipple graft technique, you likely would lose all nipple sensation.  Consult with a board certified plastic surgeon.  Good luck
and be safe.John T.
Nguyen, MD, FACS, FICSDouble Board
Certified Plastic Surgeon

Chances are very likely that you will loose erogenous sensation but have a reasonable chance of recovering protective sensation after significant gynecomastia surgery. For most men the surgery is worth it and few complaints about this loss of sensation occur, quite the opposite situation for most women. 

In all likelihood, it is probable that you will lose nearly all sensation to the nipples with a full correction of your gynecomastia. Some cutaneous sensation and deep pressure sensitivity (not true nipple sensation) may recover over a two year period.

The chances of regaining full sensation after massive gynecomastia surgery vary among individuals. While some experience a complete return of sensation, others may have persistent changes. It’s essential to discuss potential outcomes and risks with your surgeon before the procedure. Factors such as the extent of surgery, individual healing processes, and nerve involvement can influence sensation recovery.

The chance of losing sensation following gynecomastia surgery is dependent
on the technique used.  The more invasive
the surgery, the more likely that nerves will be injured, which would lead to
more numbness.  One of the advantages of
liposuction in treating gynecomastia is that the nerves tend to be preserved
more than if a periareolar incision is made and the tissue cut out as one
piece.  Interestingly, even when the
entire nipple and areola is removed and reapplied as a skin graft, eventually, sensory
nerves will grow up into the graft and restore some sensation.I hope this answers your question.  Good luck!

Hi 1866anon,Thanks for the post.  There is always a risk of nipple sensation changes with gynecomastia surgery, but typically they are  temporary in cases where there is no skin excess and nipple position is normal. In larger breasts there is usually associated excess skin and low riding nipples. These can not be predictably corrected with just liposuction and breast tissue removal. If you are indeed an F cup then I would imagine that your breasts have excess skin and are ptotic (i.e. droopy). To truly correct this would require skin excision and nipple repositioning, whether be it a free nipple graft or leaving the nipple attached to underlying tissue. When performing these larger procedure the risk of nipple sensation changes is much higher.  Only you can determine what is more important to you: better chest contour or nipple sensation.Sincerely,Dr. Dadvand

You should consult an experienced board certified plastic/gynecomastia surgeon. See his web sites and his many before and after pictures, and if it is not necessity to perform nipple grafting(I have never had to performed nipple grafting in all my 30 years in practice,including for the very sever cases of gynecomastia) which may be in your case. The long term impact on your sensation may not be major, about 10% chance for a sbstential reduced sensation.

Without evaluating you it is hard to say.  If you have rather large breasts, some surgeons would do a free nipple graft type of resection and then you definitely would lose sensation.  Even if you have a "pedicled' type reduction, you can lose sensation.

Gynecomastia is extremely common. Although the vast majority of teens outgrow it, it persists in a very large number of men and is a life time source of shame. Because Gynecomastia (Man Breasts) comes in different degrees, no one therapy and mode of treatment can adequately correct the full spectrum of Man Boob anomalies; Obviously, a small prominence of the breast would be a lot easier to correct than having sagging, large breasts hanging over ones chest.

While many cases of gynecomastia can be treated with Liposuction (especially VASER liposelection), in cases of a large skin envelope and hanging breasts formal mastectomies must be done to flatten the chest. The nipples may be moved higher on the chest by leaving them attached to deeper breast tissues OR they may need to be placed higher up as full-thickness skin grafts. Under such circumstances the sensation to the nipples may well be compromised.

If you are not willing to take the chance of scarring and decreased sensation to correct F cup breasts, by all means, you should NOT have this procedure. But be aware that there is NO other, less invasive operation that can handle this large skin excess and flatten your chest. Good Luck

Peter A Aldea. , MD