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

I'm a guy with a hormonal problem (it's in the process of being corrected)looking to get chest surgery. My "man boobs" are a BIG problem and from what I've been told are approximately an F cup size. There is a lot of breast tissue and I do want surgery but not if there is a high risk of losing sensation (I can tolerate the compression vests). So, given that information, how high likely am I to lose or reduce nipple sensation, and about how long would it take to regain maximum sensation?

Doctor Answers 13

Loss of Sensation Depends on the Gynecomastia Surgery Technique Used

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!

Depends...

But, I would say you are very likely to loose nipple sensation. If you are really that large, you may require skin excision and a nipple graft -- so I doubt you would have nipple sensation.

William B. Rosenblatt, MD
New York Plastic Surgeon
4.1 out of 5 stars 11 reviews

Risks Associated with 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.

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 96 reviews

Nipple Contour After Gynecomastia Surgery

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

Babak Dadvand, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 39 reviews

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

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, FICS
Double Board Certified Plastic Surgeon

John Nguyen, MD, FACS
Houston Plastic Surgeon
4.7 out of 5 stars 71 reviews

Risk of Sensation Loss following Gynecomastia

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. 

Sesation loss after Gynecomastia Surgery

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.

Mordcai Blau, MD
New York Plastic Surgeon
4.6 out of 5 stars 54 reviews

Loss of sensation in male breast reduction (gynecomastia repair)

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.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 72 reviews

Gynecomastia excision

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.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 24 reviews

Sensation after large Gynecomastia removal

You will require a total mastectomy with nipple transplant. This entails removing the nipple/areola, doing a mastectomy (just like for cancer in women), and then replacing the nipple back on the chest as a skin graft in the proper position. The difference between this and a cancer operation is that not as much tissue is removed and the surface of the skin can be left smooth and even. The nipple complex usually grows back normally. The residual skin retains its normal sensation. The nipple, since it was cut totally free, will be insensate until the nerves from the underlying skin grow into it. This takes several months to a year. By then, however, sensation is usually back to near normal, particularly if you do some sensibility reeducation exercises.
 

Robert T. Buchanan, MD
Highlands Plastic Surgeon
5.0 out of 5 stars 5 reviews

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.