Gynecomastia removal (complete or leave a little bit for nipple structural integrity)?

Question

Hi, I'm looking to get gyno done. One of the doctors I spoke with mentioned that he completely removes the gland and the other mentioned that he leaves some under the nipple to ensure it doesn't collapse. I have very mild gyno and I want to make sure it doesn't come back if I use Propeia or another medication that can stimulate growth. Not sure which doctor to go with? Any advice ??

Jed H. Horowitz, MD, FACS · Answer

Several common factors can cause gynecomastia including 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.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 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.The most important decision to be made before performing any surgical procedure is determining whether you are an ideal #candidate.

Stuart A. Linder, MD, FACS · Answer

It is important to leave a small cuff of tissue behind the areola to prevent depression contour deformity. Seek a specialist in your area

Tom J. Pousti, MD · Answer

Thank you for the question. It is important, in my opinion, to NOT  remove all of the glandular tissue;  a few millimeters of glandular tissue left intact below the nipples/areola complexes will help prevent contour depressions ( "saucer deformities").   Ultimately, careful selection of your plastic surgeon will be key. Best wishes.

Malcolm A. Lesavoy, MD, FACS · Answer

It is always better to leave a little tissue under the nipple areolar complex during gynecomastia surgery, so there is not a contour depression in this area.

Derby Sang Caputo, MD · Answer

Hello,  thank you for your question.   Correction of gynecomastia should leave some breast tissue under te nipple/areola complex in order the have natural outcome.  Removing all breast tissue under the nipple will only create distortion to the area and should avoided.  Have a great day.

Gynecomastia removal (complete or leave a little bit for nipple structural integrity)?

Answers (6)