Treatment of Gynecomastia? (photos)

Hi, I am 23 years old man suffering from gynecomastia, it started when I was 17 and started exercising. I have puffy nipples, they are absolutely normal when there is a temperature change or while exercising, once my body gets used to the temperature or when I am taking rest after exercise, my nipples become puffy again. I am thinking of getting a surgery done and would like to know, what would be the best procedure to treat my gynecomastia and what is the minimum rest period after this surgery?

Doctor Answers 9

Puffy nipples

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Puffy nipples are one form of gynecomastia. It is caused by two things. First, there is extra breast tissue that sits right beneath the nipple and areola. Second, the areola relaxes and then allows the extra tissue to protrude forward and push the nipple outward. there is actiually a little bit of muscle with in the areola. When this muscle tightens, like when you are cold, or when you stimulate the nipple, the nipple flattens and does not allow the tissue to come forward.


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In the vast majority of gynecomastia patients, liposuction is used as well as tissue excision.  Based on the photos you shared, I would recommend this approach.  It is best to limit activities for a week or two depending on your healing.

Robert E. Zaworski, MD
Atlanta Plastic Surgeon
4.9 out of 5 stars 61 reviews


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Ideal case for using the "Scarless" approach with only a little spot inside the armpit. I allow people to do normal activity within the first few days but heavy sports and lifting is a month or more

Sherwood Baxt, MD
Paramus Plastic Surgeon

About the Types of Gynecomastia

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There are several common factors which contribute to gynecomastia. These include excessive levels of #estrogen, natural #hormone changes, use of recreational drugs or alcohol, medications and their associated side effects, and, various health conditions. Also, there are different types of #gynecomastia.

Normal Gynecomastia is usually apparent in boy between the ages of 12 to 15 years old and older men 65 years old or more who experience a drop in their testosterone levels. This type of Gynecomastia takes about one to two years to regress on its own.
Pure Glandular Gynecomastia is seen more commonly in body builders and is caused by steroid use. Surgical removal of the gland is required for treatment.
Adult Gynecomastia – Fat deposits are apparent in the glandular tissue. This type of gynecomastia is the most common. Doctors may recommend surgery for treatment of the condition.
Adolescent Gynecomastia is hereditary and usually appears in 30% to 60% of boys between the ages of nine to fourteen. Many cases of adolescent gynecomastia resolve on its own as the boy grows into adulthood. Some may choose to undergo surgery to correct the situation, this usually happens at the age of 18 or above. In severe cases in young boys, the physician and child development specialists will need to speak to the parents regarding the severity of the gynecomastia and if surgery is an option before the age of 18.
Assymetric or Unilateral Gynecomastia appears in either one or both breasts at different degrees. In many cases one breast appears larger than the other. Surgery is a common treatment for this type of gynecomastia.
Pseudo-Gynecomastia is composed of adipose tissue instead of glandular tissue. This type of gynecomastia can be treated with diet, liposuction or surgery
Severe Gynecomastia commonly affects those who have lost skin elasticity at an older age and those who have been obese or overweight at one point in their life and lost weight may have saggy skin and breasts that are severely enlarged. Surgery is the recommended treatment for severe gynecomastia.
There are three types of surgical treatment options available that treat gynecomastia. The doctor will recommend the one that is best suited to each individual case.

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 116 reviews

Treatment of Gynecomastia?

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Thank you for the question and pictures. Accurate diagnosis would necessitate physical examination. It IS important to differentiate gynecomastia ( excess breast tissue) from lipomastia ( otherwise known as pseudo-gynecomastia or excess adipose tissue of chest wall). Treatment will differ depending on diagnosis.

***In most cases, persistent gynecomastia (of greater than 1 to 2 year duration) does not resolve without surgical intervention. In most cases, gynecomastia is treated with resection of the excess breast tissue; peripheral chest liposuction surgery may also be helpful.
My best suggestion: seek consultation with board-certified plastic surgeons who can demonstrate significant experience achieving the types of outcomes you will be pleased with. You may find the attached link helpful to you as you learn more. Best wishes.

Periareolar Male Breast Reduction

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Hello, You are an excellent candidate for Periareolar male Breast Reduction. Through that incision, all extra fat and gland is removed. Liposuction is also usually performed on the surrounding area in order to provide an even contour. This will surely take care of the puffy nipple area as well. 

Jaime Caloca, Jr., MD
Mexico Plastic Surgeon
4.5 out of 5 stars 10 reviews

Gynecomastia.How to choose a surgeon

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How should I choose a surgeon? Choose carefully.
The decision is yours. Advice to assist in making your selection.Only a board certified plastic surgeon 1. Experience matters. Choosing a surgeon increases the likelihood that they have seen a case similar to yours in the past. Selecting a surgeon whose practice is focused on gynecomastia exclusively is also an indicator of experience. 2. Results matter. The more before-and-after pictures, the better. Pay attention whether the surgeon is confident enough to show multiple angles of the same patient. 3.Only gynecomastia Reviews matter. 4. Expertise matters. Is your surgeon recognized by the profession as an authority in the field? Have they authored books or medical journal articles regarding your surgery? Be realistic about your expectations. Also, revision surgery tends to be significantly more difficult than initial surgery.

Mordcai Blau, MD
New York Plastic Surgeon
4.6 out of 5 stars 89 reviews

Treatment of Gynecomastia?

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Hi Rahul,
The best procedure is a combination of liposuction and gland removal to get the best shape.
you can get back to your daily activities by a few days
exercising the chest muscles , swimming and sports activities might have to wait for a month
best of luck

Treatment of Gynecomastia

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You're not alone, gynecomastia, a condition of over-developed or enlarged breasts in men, is common in men of any age and affects as many as 30% of men. It can be the result of hormonal changes, heredity conditions, disease or the use of certain drugs. Depending on your condition, we may recommend liposuction combined with breast tissue removal, or breast tissue removal alone. In extreme cases, such as following massive weight loss, skin removal may be necessary as well. Given all the options, it’s important to choose a surgeon who has performed many of these procedures and takes the time to examine you, understand your goals and explain your options. Don't settle for less than a board certified plastic surgeon. If you have more questions about the procedure please feel free to ask. 

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.