Gynecomastia Surgery: The Ultimate Guide to Male Breast Reduction

Medically reviewed by S. Larry Schlesinger, MD, FACSBoard Certified Plastic SurgeonReviewed on May 26, 2023
Written byKaryn RepinskiUpdated on May 12, 2023
RealSelf ensures that an experienced doctor who is trained and certified to safely perform this procedure has reviewed this information for medical accuracy.You can trust RealSelf content to be unbiased and medically accurate. Learn more about our content standards.
Medically reviewed by S. Larry Schlesinger, MD, FACSBoard Certified Plastic SurgeonReviewed on May 26, 2023
Written byKaryn RepinskiUpdated on May 12, 2023
RealSelf ensures that an experienced doctor who is trained and certified to safely perform this procedure has reviewed this information for medical accuracy.You can trust RealSelf content to be unbiased and medically accurate. Learn more about our content standards.

Gynecomastia surgery (aka gyno surgery or male breast reduction surgery) is an outpatient plastic surgery procedure that removes excess breast tissue and creates a more traditionally masculine-looking chest. In other words, it’s the most effective way to get rid of man boobs. 

Underlying causes of gynecomastia (the medical term for enlarged male breast tissue) include: 

  • hormonal changes of puberty
  • using anabolic steroids
  • obesity

This outpatient surgical procedure removes excess glandular tissue, fat, and skin via a combination of surgical techniques and liposuction.

Some men (particularly those who have undergone significant weight loss) opt to combine male breast reduction surgery with a tummy tuck, liposculpture, and other cosmetic procedures for a full "daddy makeover."

Interested in gynecomastia surgery?

Find a Doctor Near You

Pros

  • Patient satisfaction is high. Reviewers on RealSelf give this procedure a 93% Worth It Rating. 
  • Gynecomastia surgery can significantly improve male chest contours by removing excess breast tissue.  
  • It’s an outpatient procedure with few reported risks.
  • Results will be permanent, as long as you stay active and avoid weight gain. 
  • Many gynecomastia patients report an increase in self-confidence after male breast reduction surgery. “Most of my gynecomastia patients feel they have had a life-changing event,” says Dr. Larry Schlesinger, a board-certified plastic surgeon in Honolulu. “Their self-esteem rises, and their personal interactions become more fulfilling.”

Cons

  • While it will get rid of man boobs, this surgery can’t create the look of developed pectoral muscles, if they’re not already there. Creating that kind of definition requires chest exercises or pec implants. 
  • You will have scars, though they shouldn’t be too noticeable and will fade with time. 
  • It isn't cheap, and insurance doesn't usually cover elective cosmetic surgery procedures like this one.

  • Average Cost:
  • $6,050
  • Range:
  • $4,500 - $15,000

The cost of male breast reduction surgery can vary widely, depending on whether insurance covers any of it, how much tissue is removed, and other details of your procedure.

Most surgeons offer payment plans or accept financing options, such as CareCredit.

See our complete guide to gynecomastia surgery costs

Interested in gynecomastia surgery?

Find a Doctor Near You

The gynecomastia surgery photos in our gallery have been shared by the provider who performed the procedure, with the patient's consent.

Ideal candidates for male breast reduction are: 

  • Adult men who feel self-conscious about excess breast tissue 
  • Physically healthy
  • At a stable weight (since gaining or losing weight can affect results)

To get the best results and maximize safety, it’s recommended that patients be at a body mass index (BMI) of between 19 and 25. However, doctors on RealSelf tend to agree that there is no ideal BMI for gynecomastia surgery, and—because surgery will still improve gynecomastia when a man is severely overweight—patients with BMIs up to 30 are often treated.

During your initial consultation, your surgeon should perform a thorough exam to rule out medical causes of gynecomastia, such as an overactive thyroid, certain medications, or breast cancer. If you can feel a hard mass that isn’t located underneath the nipple, or you have symptoms like nipple discharge or enlarged lymph nodes, your surgeon may need to refer you for a mammogram or MRI.

Doctors on RealSelf recommend waiting until after puberty to be evaluated as a candidate for gynecomastia surgery, but it’s not a hard and fast rule. Gynecomastia usually develops in adolescence, when boys may produce excess estrogen. According to a 2009 study published in Mayo Clinic Proceedings, gynecomastia is prevalent in 50% to 60% of adolescent males. If gynecomastia hasn’t resolved within 2 years beyond puberty, it typically doesn’t, according to an article on the ethics of plastic surgery in adolescents. 

Breast tissue can take a toll on a male teen’s emotional and mental health and undermine his self-confidence, which is why a significant number of teens opt to have male breast reduction. A recent study of young men who had surgical treatment of gynecomastia reported significant improvement in the quality of life. Just note that a secondary procedure may be needed in the future, if breast tissue development continues. 

Male breast reduction surgery takes one to three hours, depending on whether your treatment plan calls for just gynecomastia liposuction of excess fat, or a combination of lipo and surgical excision, to remove excess glandular tissue.

If you have a condition called pseudogynecomastia, with excess fatty tissue in the chest area, lipo alone may provide enough reduction—as long as your skin has good enough elasticity that it won’t sag once the fat is removed.

If you have true gynecomastia, you’ll likely need a combination of lipo and the surgical removal of glandular breast tissue, along with any excess skin. Your surgeon may also reposition your nipple and areola. Every surgeon has their own preferred techniques, so it’s worth having a detailed conversation during your consultation about your aesthetic goals, and how they plan to achieve them.

Before the surgery, you’ll be given either general anesthesia, which puts you under for the entire procedure, or local anesthesia to numb your chest, combined with an oral or IV sedative (a combo known as twilight sedation).

Once the anesthesia takes effect, your procedure will begin. 

First, your surgeon will make a few small incisions. They may be under your arms, around your areolas, or to the side of your chest, depending on your anatomy and your surgeon’s technique.

If your treatment plan involves liposuction, your doctor will inject tumescent fluid (to help anesthetize the tissue and reduce bleeding) and use a tool called a cannula (a thin tube) to remove the extra fat and liposculpt a more masculine-looking chest. Dr. Schlesinger always starts with tumescent fluid, to make the fat and gland tissue rigid, and then performs liposuction for patients with either pseudogynecomastia or true gynecomastia. 

Once the excess fat is removed, the surgeon feels if there’s a gland. Often that unwanted gland is underneath what’s called the “nipple areolar complex” (the medical term for the nipple and areola). 

To access that gland, Dr. Schlesinger makes an incision along the bottom of the areola, down to the level of the glandular tissue. He removes almost all of the gland, as well as some areolar tissue, to allow the puffy, 3D areolar complex to flatten out—except for the area immediately around the nipple. Any excess skin is removed and the incisions are closed with tiny sutures. This can leave a small scar, but there’s a trick for hiding it: “Should any scar around the areola persist for more than 6 months, we have an excellent local tattoo artist who tattoos areolar pigment over the periareolar scar, leading to a complete obliteration of any persistent scarring,” notes Dr. Schlesinger.

In some cases, Dr. Schlesinger fully detaches the nipple areolar complex, “sews the bottom of the chest in such a way to give the appearance of large, well-placed pec muscles, and then replants the free nipple graft on newly created recipient beds.” This technique “gives the appearance of well-developed pectoral muscles and symmetrically positioned nipple areola complexes.”

Dr. Mathew Plant, a plastic surgeon in Toronto, Ontario, prefers a technique that he says makes the scars very well-hidden. “While in some more severe cases it may still be necessary to make these periareolar incisions, in most cases a smaller (1cm) incision can be made away from the areola, towards the armpit, and the gland can be removed this way without creating the telltale scar on the areola.”

Some surgeons place thin surgical drain tubes near the incisions, to prevent fluid build-up as you heal. These should be removed 24 to 48 hours post-procedure.

Once you’ve recovered from the anesthesia, you’ll be ready to head home. You will still be groggy, so plan to have someone escort you home safely and stay with you for at least the first night of your recovery.

Enlarged or puffy nipples and areola will often shrink during the healing process, after the glandular tissue has been removed. However, they may still be larger than you’d like. 

In this case, Dr. Michael Law, a Raleigh, North Carolina plastic surgeon says “an areola reduction can be performed in addition to direct excision of breast tissue and liposuction. This requires an incision, and thus a scar, that encompasses the entire circumference of the areola.” 

Be sure to address any nipple concerns during your initial consultation.

Most people take a few days to a week off work after gyno surgery. If your job requires strenuous activity or heavy lifting, you’ll need to take at least two weeks off, possibly even a month.

“The good news is that in the majority of patients, recovery is extremely quick and virtually painless,” says Baltimore plastic surgeon Dr. Ronald Schuster. “Patients who have a quiet, desk-type job can easily have their surgery done on Friday and return to work on Monday. They must, however, keep a ‘low profile’ and chill out for a week.”

Here’s what to expect during that time:

  • Your doctor may prescribe pain medication for the first 3 days after surgery, but most patients find that over-the-counter options are sufficient. 
  • As part of his recovery protocol, Dr. Schlesinger prescribes a 70% dimethylsulfoxide (DMSO) spray for his patients to use every 2 hours for the first 2 days. “DMSO decreases swelling and bruising,” he explains. “It can be done at home by one’s self, a friend, or a significant other. After the second day, it is used anywhere between 2-4 times per day.”
  • For some of his patients, he administers PRP injections on the 2nd day of recovery to help speed the healing process. 
  • He also recommends 10-minute sessions of therapeutic ultrasound (the kind used by physical therapists to treat sore muscles) 2-3 times per week, with up to 8 treatment sessions per side. “This will even out the subcutaneous tissue and speed recovery.”
  • Your doctor will probably suggest holding off on too much physical activity for at least the first week of recovery. Most providers encourage taking brief walks a few times a day, starting on the day of surgery, but vigorous exercise at this point will sap the strength you need to heal and increase swelling.
  • Recommendations for when to start light cardio workouts range from 2 to 4 weeks after your procedure. Follow your surgeon’s recommendations and pay attention to how your body feels.
  • Within 6 weeks of gyno surgery, you can start working out with light weights, gradually ramping up your routine as you regain your strength. Chest exercises will help enhance your results.
  • You’ll wear a compression vest to wear for 3 to 6 weeks, which will help your chest conform to its new shape as it heals. “The compression garment helps reduce swelling, and the longer it is worn, the more quickly you will heal,” says Orange County, California, plastic surgeon Dr. Jed Horowitz.
  • If your stitches are dissolvable, they’ll gradually disappear. Otherwise, you’ll return to your doctor’s office to have stitches and surgical drains removed at a follow-up visit about a week after surgery.
  • Once the incisions are healed, you can start using a silicone scar gel to keep the scar thin and flat, while reducing the time it takes to fade. If your scars still bother you, other scar treatment options like lasers can help them fade further.

You’ll see a difference in your pecs right away, but it will take a few days after your surgery for the initial swelling to go down. 

Your new look won’t be fully apparent for four to six weeks. At that point, most of the swelling will have gone down and you'll be able to assess your new chest contour.

See gynecomastia surgery before and after photos

Gynecomastia surgery results should be permanent, as long as you maintain a stable weight. 

You'll also need to ensure that you’ve addressed any underlying causes or medical conditions, such as a hormonal imbalance. 

Eating right and exercising the pectoral muscles after gynecomastia surgery can help you achieve the best long-term results. 

“If it’s performed properly and if diet and exercise are maintained, the results of gynecomastia surgery should be dramatic and long-lasting,” says San Francisco plastic surgeon Dr. Miguel Delgado. 

Our skin does lose some elasticity as we get older, so you may find that your pecs are less taut over time, due to the natural aging process.

Gaining a lot of weight or using performance-enhancing drugs could also change the look of your upper body. Some health conditions or medications that affect hormone levels might cause gynecomastia to return, so it’s important to stay in touch with your surgeon in case things change. 

Most patients seem pleased with their results. In a study published in the World Journal of Plastic Surgery, 27 patients ranging in age from 17 to 36 were asked to rate their satisfaction with gynecomastia surgery. On a scale of 1 to 10, most patients rated their satisfaction as a 9.

Male breast reduction surgery is considered safe, especially when it’s performed by an experienced, board-certified plastic surgeon in an accredited surgery center or hospital. As with any surgery, however, complications can arise. 

Common side effects include swelling, bruising, infection, fluid buildup, or hematoma (bleeding under the skin). 

In one meta-analysis, hematoma was the most frequently cited major complication, occurring in 6% of cases. Wearing a compression garment during recovery can help prevent this buildup of blood under the skin. If it does occur, it may resolve on its own or need to be surgically drained.

Other risks include incision separation, nerve damage, deep vein thrombosis, and visible scarring.

There’s also a risk of asymmetry or irregularities with the shape and contour of your pecs, which could require revision surgery to correct.

Some RealSelf members say their chest or nipples felt numb in the days following breast reduction surgery. This usually goes away with time. “It’s normal to experience numbness around the areola and chest,” says Dr. Horowitz. “As your body heals, you may notice random bursts of pain in your chest. This is usually a sign that the numbness is subsiding.”

There’s also a slight chance that you could develop a temporary condition called breast fat necrosis, where dead fat cells form scar tissue or a cyst, rather than being absorbed by your body. This is not permanent and should resolve with massage or an ultrasound treatment.

You can mitigate all of these potential risks by finding a board-certified plastic surgeon who has years of experience with the procedure and following their recovery instructions carefully. 

If you're not ready for surgery, you do have a few other options. 

  • Compression shirts offer a less expensive way to camouflage male breasts, but they are obviously a temporary solution. 
  • If you have pseudogynecomastia due to excess fat, you also might see an improvement from weight loss.
  • Some men see a reduction in excess breast tissue from hormone therapy, to treat an underlying imbalance of testosterone and estrogen. However, doctors on RealSelf say to avoid supplements that promise to reduce breast tissue, since this approach is not approved by the U.S. Food & Drug Administration. “There is no magic pill,” says Beverly Hills, California, plastic surgeon Dr. Tim Neavin. 

Nonsurgical body contouring procedures like CoolSculpting are not recommended for gynecomastia treatment. “Typically, the gland is intermingled with fat, and that kind of substructure doesn’t respond well to something noninvasive,” says Dr. Sean Doherty, a plastic surgeon in Boston. “Plus, the safety of energy-based treatments around the gland hasn’t yet been shown."

To treat true gynecomastia, surgery is the most effective, longest-lasting approach.

Interested in gynecomastia surgery?

Find a Doctor Near You

Updated May 12, 2023

0

0

Related stories from RealSelf News

4 Surprising Truths About the Male Facelift
4 Reasons Men Are More Open Than Ever About Getting Plastic Surgery
Here’s How Nonsurgical Penis Enlargement Works