Is Laser Surgery the Most Effective Form of Male Breast Reduction?

Question

What natural, non-surgical methods that will produce the same results as surgery for male breast reduction?

Jeffrey D. Wagner, MD · Answer

The answer is not really.  Gynecomastia does not respond well to medical therapies, and there is no FDA approved medical therapy.  Sometimes the appearance of gynecomastia can be more or less apparent; that is, "camouflaged" by surrounding chest fat or muscle tissue.  Some patients will be more satisfied with their chest shape when they lose or gain weight, develop their pectorals, etc.  This does not really treat their gynecomastia, but may make it less visible.  In most patients with gynecomastia there are both glandular and fat components, and effective treatment addresses both. Dense, firm glandular tissue does not respond well to liposuction alone, whereas fat can be treated nicely with liposuction. If the glandular component is fairly small and the fatty component is larger, liposuction alone can make a worthwhile impact in selected cases. In most patients, both components need to be addressed. Typically this means partial resection of the glandular component combined with liposuction for the fatty component, as well as to feather out the edges of the resection cavity.

Jed H. Horowitz, MD, FACS · Answer

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. The excision technique is used on cases of #gynecomastia where excess skin and glandular breast tissue must be removed and the areola or nipple needs reduction and repositioning to create a natural looking appearance. The incision patterns are determined by the specific condition of the patient. The doctor will recommend this procedure which combines the liposuction technique and excision technique to create a natural look. Patients are given specific instructions for the recovery period. Men who suffer from large #areolas may notice that after breast surgery, the skin of the chest muscles will tighten, causing the areolas to tighten and diminish in size. This is a result of the removal of glandular and/or adipose tissue.

Larry S. Nichter, MD, MS, FACS · Answer

I know of no FDA approved non surgical/non invasive treatment for gynecomastia. If you are seeking non surgical options  for mild gynecomastia, I think that Vanquish which uses RF energy, or UltraShape that uses ultrasound rather than Cool Sculpt would be the best option though all are off FDA usage. Surgery is the best option for the vast majority of patients with gynecomastia.#gynecomastia#malebreastreduction

Michael Constantin Gartner, DO · Answer

Exercising and dieting can firm up the area by reducing the amount of fat, however if the problem is excess glandular tissue or loose skin, then surgery is your best option.

John Nguyen, MD, FACS · Answer

There are no effective non-surgical treatments for gynecomastia.  Best that you consult with a board certified plastic surgeon for your evaluation.  Good luck and be safe.John T.
Nguyen, MD, FACS, FICSDouble Board
Certified Plastic Surgeon

Michael Law, MD · Answer

There is currently no recommended, FDA-approved medical (i.e. non-surgical) treatment for gynecomastia. While gynecomastia may spontaneously regress in some instances, in most adolescent and adult males the breast tissue development is a permanent change that must be treated surgically. In the few cases where a definite cause can be identified, such as low testosterone levels or exposure to a particular medication, the gynecomastia almost always persists after the causative factor is corrected or eliminated. Because gynecomastia is so different from person to person, it is absolutely critical that the surgical approach to this problem is carefully individualized.

	'Pure glandular' gynecomastia ('puffy nipples') in most cases can be treated by direct tissue excision alone. There is no fatty tissue excess and no significant skin excess. The glandular breast tissue enlargement is located immediately behind the nipple and areola, and is removed through an incision placed at the inferior border of the areola. The incision can be limited, in most cases, from about the 4 o'clock to the 8 o'clock position of the areola. The color difference between areolar skin and chest skin serves to conceal this incision quite nicely for most patients. In many cases the scar is completely invisible after just a few weeks or months of healing.

	The most common form of gynecomastia ('mixed glandular / adipose') requires ultrasonic liposuction and in some cases direct breast tissue excision as well. Ultrasonic liposuction involves the use of ultrasonic energy to emulsify fat (turn it from solid to liquid) after the infiltration of tumescent solution and before the aspiration of fat. The ultrasonic energy is delivered using a solid probe that is extremely effective at breaking up the dense, fibrous breast tissue behind the nipple-areola complex. In some cases it is effective enough to eliminate the need to make an incision at the areolar border to directly remove breast tissue following ultrasonic liposuction. This practice employs the VASER&reg; ultrasonic liposuction system developed by Sound Surgical Technologies, Inc. A specialized VASER&reg; probe designed specifically for gynecomastia has made the device even more effective for this particular procedure.

	 

	Whenever possible, it is preferable to avoid skin excision and the scars that result from it. If the surgery leaves obvious scars and the patient is very self-conscious about them, then the patient has merely traded one reason to never take off their shirt ("man-boobs") for another (scars that show you had surgery for your "man boobs'). In some cases this requires a staged surgical approach. In the first procedure, breast tissue is removed by ultrasonic liposuction with or without direct tissue removal - but only up to the point where a deflated or 'saggier' breast appearance is not produced. Several months are allowed to pass so that the final liposuction result can be evaluated. During this time, the skin tends to retract for two reasons: a significant portion of the distending breast and adipose tissue has been removed, and the energy produced by the ultrasonic liposuction device has stimulated further tissue and skin retraction.

Miguel Delgado, MD · Answer

I am ask this question frequently. If you have true gynecomastia it will not resolve after its development unless you are in the teenage years. Diet and exercise will reduced the fat tissue but the breast gland will not resolve.

William Bruno, MD · Answer

There is no treatment (non-surgical) that can give the results that surgery can for male breast reduction. Gynecomastia (excess male breast tissue) is typically treated with a combination of liposuction to removes excess fat plus direct excision of breast tissue through a small areolar incision. Non-surgical treatments can not remove the breast tissue, which is quite firm. I recommend consulting with a board certified plastic surgeon for an evaluation to see which approach is best for you.

	Best wishes,

	Dr.Bruno

David F. Pratt, MD · Answer

Traditional tumescent power assisted liposuction (PAL) has beenvery effective in my hands in the treatment of gynecomastia, especially whencombined with a “Stealth” excision.  Additionof a laser to the liposuction protocol certainly makes it more "high tech", but also adds extra expense and increased therisk of complications such as inadvertent burns.  In surgery, as in most other aspects of life,”keep it simple” is a good rule of thumb.

Babak Dadvand, MD · Answer

Hi,Unfortunately there is no non-surgical treatment for gynecomastia.  Gynecomastia is due to excess breast tissue and only surgery can effectively and predictably remove it. Excess fatty tissue that can give the chest a more feminine look can be treat non-surgically with diet and exercise. However, breast tissue excess needs to be surgically removed.Sincerely,Dr. Dadvand

Is Laser Surgery the Most Effective Form of Male Breast Reduction?

Answers (13)

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