Gynecomastia before and after photo courtesy of Dr. Miguel Delgado, board-certified plastic surgeon in San Francisco, California. Results may vary.
Gynecomastia before and after photo courtesy of Dr. Miguel Delgado, board-certified plastic surgeon in San Francisco, California. Results may vary.
Gynecomastia before and after photo courtesy of Dr. Miguel Delgado, board-certified plastic surgeon in San Francisco, California. Results may vary.
Gynecomastia before and after photo courtesy of Dr. Miguel Delgado, board-certified plastic surgeon in San Francisco, California. Results may vary.
Gynecomastia before and after photo courtesy of Dr. Miguel Delgado, board-certified plastic surgeon in San Francisco, California. Results may vary.
Gynecomastia before and after photo courtesy of Dr. Miguel Delgado, board-certified plastic surgeon in San Francisco, California. Results may vary.
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, itâs the most effective way to get rid of man boobs.Â
Underlying causes of gynecomastia (the medical term for enlarged male breast tissue) include:Â
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."
Pros
Cons
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.
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:Â
To get the best results and maximize safety, itâs 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, andâbecause surgery will still improve gynecomastia when a man is severely overweightâpatients 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 isnât 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 itâs 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 hasnât resolved within 2 years beyond puberty, it typically doesnât, according to an article on the ethics of plastic surgery in adolescents.Â
Breast tissue can take a toll on a male teenâs 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.Â
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 reductionâas long as your skin has good enough elasticity that it wonât sag once the fat is removed.
If you have true gynecomastia, youâll 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 itâs worth having a detailed conversation during your consultation about your aesthetic goals, and how they plan to achieve them.
Before the surgery, youâll 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.Â
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 surgeonâs 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.Â
Once the excess fat is removed, the surgeon feels if thereâs a gland. Often that unwanted gland is underneath whatâs called the ânipple areolar complexâ (the medical term for the nipple and areola).Â
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 outâexcept 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 thereâs a trick for hiding it: âShould 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,â notes Dr. Schlesinger.
In some cases, Dr. Schlesinger fully detaches the nipple areolar complex, âsews 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.â This technique âgives the appearance of well-developed pectoral muscles and symmetrically positioned nipple areola complexes.â
Dr. Mathew Plant, a plastic surgeon in Toronto, Ontario, prefers a technique that he says makes the scars very well-hidden. âWhile 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.â
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 youâve recovered from the anesthesia, youâll 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 youâd like.Â
In this case, Dr. Michael Law, a Raleigh, North Carolina plastic surgeon says âan 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.âÂ
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, youâll need to take at least two weeks off, possibly even a month.
âThe good news is that in the majority of patients, recovery is extremely quick and virtually painless,â says Baltimore plastic surgeon Dr. Ronald Schuster. âPatients 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 âlow profileâ and chill out for a week.â
Hereâs what to expect during that time:
Youâll 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.Â
Your new look wonât 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.
Gynecomastia surgery results should be permanent, as long as you maintain a stable weight.Â
You'll also need to ensure that youâve addressed any underlying causes or medical conditions, such as a hormonal imbalance.Â
Eating right and exercising the pectoral muscles after gynecomastia surgery can help you achieve the best long-term results.Â
âIf itâs performed properly and if diet and exercise are maintained, the results of gynecomastia surgery should be dramatic and long-lasting,â says San Francisco plastic surgeon Dr. Miguel Delgado.Â
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 itâs important to stay in touch with your surgeon in case things change.Â
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 itâs performed by an experienced, board-certified plastic surgeon in an accredited surgery center or hospital. As with any surgery, however, complications can arise.Â
Common side effects include swelling, bruising, infection, fluid buildup, or hematoma (bleeding under the skin).Â
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.
Thereâs 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. âItâs normal to experience numbness around the areola and chest,â says Dr. Horowitz. âAs your body heals, you may notice random bursts of pain in your chest. This is usually a sign that the numbness is subsiding.â
Thereâs 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.Â
If you're not ready for surgery, you do have a few other options.Â
Nonsurgical body contouring procedures like CoolSculpting are not recommended for gynecomastia treatment. âTypically, the gland is intermingled with fat, and that kind of substructure doesnât respond well to something noninvasive,â says Dr. Sean Doherty, a plastic surgeon in Boston. âPlus, the safety of energy-based treatments around the gland hasnât yet been shown."
To treat true gynecomastia, surgery is the most effective, longest-lasting approach.
Updated May 12, 2023