Gynecomastia Surgery, I had this problem from my early 20’s, need recommendations for doctors.

Usually the reduction of excess male breast tissue ( gynecomastia) can be done by liposuction (there are several types of liposuction technologies that can be used such as the MicroAire and Vaser)  and breast tissue excision thru a small peri-areolar incision. The surgery is done as an outpatient and a special garment made specifically for gynecomastia surgery is used post op to limit swelling and to encourage skin tightening. The garment is not visible under clothing and since the recovery is not bad , patients can return to work pretty quickly in 4-7 days... Good Luck!

                  The
surgical management of gynecomastia varies from patient to patient. This
variation depends on the severity of the problem and the type of gynecomastia
present.

                  When
glandular tissue is present surgical excision is usually necessary. This is
usually accomplished through a peri-areolar incision. The breast tissue is
first separated from the skin and subcutaneous tissue. Once this is
accomplished the breast tissue is separated from the underlying muscles and
removed as a single unit.

                  When
the breast tissue is predominately made of fat, liposuction can be utilized.
This technique involves passing a canula through the breast tissue repeatedly
while suction is applied to the canula. Cores of fat are removed and the area
is effectively sculpted.

                  In
some cases glandular and fatty components are present, and
combination procedures are necessary. Following surgery patients wear a
compression garment for four to six weeks. This helps remodel the tissue and
minimize complications.

                  It’s
important to realize that no two patients are alike and treatment should be
individualized. If you’re concerned about gynecomastia, consultation with a
board certified plastic surgeon would be appropriate. 

Gynecomastia procedures vary patient to patient.  Gynecomastia can range from liposuction only techniques to treat a mostly fatty chest area, to a combined procedure with limited subareolar incision to directly resect glandular tissue not removed by liposuction (this includes laser and vaser assisted), to full breast reduction/amputation with free nipple grafting for men who have breasts that would qualify for a female breast reduction!

The goal of gynecomastia surgery is to flatten the chest mound into a more normal contour, which for men is nipple flush with the skin above the inframammary fold.  Liposuction can contour the chest about the nipple areolar complex, however, if there is a lot of glandular tissue, you need to either resect it or bring it out piecemeal as described by Dr Rohrich and his colleagues at UT Southwestern.  In chests where you can perform liposuction +/- direct excision, you can achieve more normal results.  Unfortunately if someone has gynecomastia that is so severe that a breast reduction technique has to be employed, there will be tell tale long scars about the chest, and depending on the technique, there can be loss of normal anatomic boundaries such as the inframammary fold.

At the end of the day, the key is not to overresect this tissue which can lead to a more difficult problem to fix and to go over with the patient that as with any bilateral procedures, there will be some minor asymmetries.

 

In terms of picking a surgeon, do your basic research ie. board certification, and then take the next step and go for a consult.  You should ask your surgeon what his or her experience is with this procedure and what techniques he or she uses.  As with any procedure, I would like whomever I would choose to be well versed in a variety of ways to treat you as an individual case rather than as  a peg for a square hole (you could be round, oval, octagonal, etc.)