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?
When to Get Male Breast Reduction Surgery?
Doctor Answers (31)
Variety of treatment options for Gynecomastia
Gynecomastia has many variation in appearance and can affect the composition of the breast with differential involvement of:
Depending on what needs to be treated, the surgical options will differ and consist of:
- Ultrasonic Assisted Liposuction
- Gland excision
- Skin excision
No one treatment is sufficient for all the forms of gynecomastia and treatment will advised based on the findings during your examination.
The vast majority of patients can be managed with liposuction and limited glandular excision. Mild forms can be treated with liposuction alone, whereas advanced cases will need liposuction, glandular excision and a variety of skin pattern excision for removal of cutaneous redundancy. These skin removals can be a simple crescent of skin or range up to wide exicisions extending to the back for management of lax skin extending circumferentially around the chest. Occasionally staged excision (2 procedures) is advised in the most advanced cases.
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 -- Improving the Male Chest through Surgery
There are two important components of gynecomastia or enlarged chest tissue in men. The important thing for your surgeon to determine is how much of the enlargement consists of actual glandular tissue and how much is related to surrounding fat. As every patient has variable amounts of these, there is no set standard and you should seek an evaluation by a qualified plastic surgeon in order to help you make a decision about surgery.
Liposuction can often be used to address the excess fat in the chest but it may not be adequate to deal with the enlarged glandular tissue which often needs to be excised directly, so a combination of the two techniques will probably be required.
Less frequently, there is also a component of excess skin, which may also need to be removed. In this case the end result would involve significantly more scarring so it is very important that your surgeon discuss this with you.
Another important issue relates to the medical aspects of enlarged mammary glands in men. If the enlargement occurs over a relatively short period of time, one needs to consider the cause of such a change. Abnormal increase in hormonal production can lead to enlargement of the chest tissue and this must be evaluated. Your surgeon may want to perform laboratory exams to check hormone levels. Also a good genital exam should be performed if a hormonal cause is suspected.
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Timing for Male Breast Reduction
When to get Male Reduction (Gynecomastia Reduction) - Best Candidates are healthy men, whose condition cannot be corrected through exercise, weight reduction or other non-surgical treatments. Appropriate preconditions for surgery are the stabilization of breast development (no further breast enlargement) and localized areas of excess breast tissue and fat.
Gynecomastia or breast enlargement in men can be corrected by a variety of plastic surgical techniques. This condition often creates a psychological poor self perception and many males of all ages do not take their shirts off because of this stigma. Candidates are men or in some cases male teenagers who have over-developed or enlarged breasts which may occur as the result of hormonal changes or hereditary conditions.
Larry Nichter, MD, FACS
If your gynecomastia is bothering you it may be a good time to visit with a Board Certified Plastic Surgeon who does a lot of these procedures. You should see lots of pictures of their results. My patients range from very minor to more major gynecomastia. The decision should be made after you understand all of the risks and benefits and decide if it is right for you. If you are considering this, the best results come when the skin is still young, and more elastic. By the time men are in their 40's, the skin may not retract as well as when the procedure is done at a younger age. Best Wishes to you.
Decision for gynecomastia surgery
Deciding to get gynecomastia surgery
If the volume of gynecomastia is not improving through either diet/excercise or modification of any supplements being taken then there is no point in waiting longer to have it corrected. If this is the case and the extra chest tissue bothers you I recommend that you evaluate your options for getting it corrected.
All the best
Is Gynecomastia surgery necessery is a Good Question
It is a decision you,and you alone, have to make according to your personal needs. When you ask such a question you might not be ready for surgery. Just think about it, Gynecomastia surgery is not for everybody only for man who "really suffer" from the fact their breast are enlarged ,aesthetically,physically and/or psychologically. It is surgery and there is no standard that should apply to decide if you really need the surgery. Some man have an enlaged breast,yet they don't suffer from it,DO THEY NEED SURGERY?NO, Others may have only slightly enlaged breasts and they suffer,DO THEN NEED SURGERY? MAYBE YES. I hope this will at least help you to make the right decision. Good Luck. You can addional facts from wikipedia.
Considerations of Gynecomastia Surgery
Many men can live with gynecomastia and have a happy, normal life. Just visit the beach or a public swimming pool and you will see many men bearing their breasts without concern. However if you find that you are very uncomfortable removing your shirt in public, it may be time to consider surgery. See the attached video of three of my patients who share their story.
Male breast reduction (gynecomastia reduction) surgery
Gynecomastia reduction surgery is usually an elective procedure. There is a large range of "ideal" male breast sizes, so often, a conversation with your plastic surgeon before surgery helps to determine the optimal goal. The goal is reduce the size of the chest, so that it is proportionate with the rest of the body.
It is important that some fat be left on the breast, or else the skin would be firm, immobile and attached directly to the muscle. This could lead to contour deformities and a loss of aesthetic balance. Over resection can lead to indentations, and this can be difficult to repair.
The goal is to reduce the size of the breast, and smooth contour the chest, so that the nipple is not puffy. When the skin is firm, then liposuction or a small incision around the nipple is sufficient. When the skin is loose, additional techniques may be necessary to address the skin laxity.
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.