What sort of options are available for my gyno & how to find a doctor that can perform the surgery well? (Photos)

Gynecomastia is a common problem in males. There are certain times when this is normal in males life due to the body's response to changes in hormones. It is first wise to be evaluated by a primary care provider for any medical causes for gynecomastia (Prescription or recreational drugs, alcohol, testicular masses, etcetera). Options for surgical gynecomastia treatment include liposuction, liposuction in combination with minimal incision techniques, and finally direct excision. Most all of these can be done with local anesthesia or moderate sedation. Your candidacy for one of these procedures would depend on a formal evaluation from a plastic surgeon who is experienced with the topic.
The downtime for this procedure depends on which technique is used and the patient's own postoperative course. Typically after surgery like this, a surgeon will have the patient wait at least 4 weeks, if not more, to resume full exercise capacity. At this time can be shortened if liposuction only is used.
When looking for surgeon make sure that they are a Plastic Surgeon who is board certified or board eligible by the American Board of Plastic Surgery, which is the only board recognized by the American Board of medical specialties to do this type of surgery. This is a common procedure that we do in our office. Please see the attached link for more information

it looks like your gyno is rather mild and a little asymmetric. In general nearly all patients with gyno need liposuction to get a smooth result and removal of the gland in order to get a complete result. Look for experienced gyno surgeons who do this on a regular basis in order to get the best results. Good luck.

Hello! I would recommend you Gynecomastia with Vaser Liposuction, and incisions could be made only if you still have some breast tissue left during the surgery. But besides, the skin would be tighter and the recovery would be better with vaser liposuction.
You would be able to do some light exercises after a month whereas the heavier ones are recommended after three months.

You seem to have mild gynecomastia, based on these photos. Treatment consists of removal of redundant breast tissue and fat with combination of liposuction and direct excision of the gland. Only on the basis of in person consultation with a board certified plastic surgeon, with experience in gynecomastia reduction, can be decided how extensive surgery you may need. Good luck.

Dear Loving650837,
it is hard to tell for sure without an examination. If you are considering surgery, I would suggest you consult a board-certified plastic surgeon. Only after a thorough examination, you will get more information and recommendations.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Thank you for your question and for sharing your photos. It is hard to say without performing a thorough exam. Gynecomastia is characterized by excess breast tissue. While gynecomastia varies in severity, it is quite common and affects up to 60% of men. Fortunately, gynecomastia can typically be treated with liposuction. I use a combination of liposuction technique using a small incision hidden in your areola to treat gynecomastia. The postoperative care will vary by surgeon, but I typically have patients where a compression vest after surgery. While light activity can be resumed earlier on in the recovery process, I advise patients to refrain from vigorous activity or weight-lifting for a few weeks while they are healing. I recommend speaking with a fully trained plastic surgeon to discuss your goals and treatment options.

There are three tissue variables that need to be differentiated to make a quality assessment. These are subcutaneous fat on the chest, actual glandular breast tissue and an older individuals or anybody who’s had weight fluctuations skin laxity needs to be taken into consideration.
All three can cause fullness of the chest and understanding which is the primary, secondary and tertiary problem helps dictate what the right procedure is and what kind of outcomes you can expect.
One way to accurately determine the amount of glandular tissue is to order a preoperative mammogram.
With that the radiologist can actually tell you the specific size and degree of breast tissue and that can help surgeons determine who needs open glandular excision or if just Liposuction is sufficient.
Glandular tissue cannot be removed with Liposuction and requires an incision and direct surgical excision.
Not all the glandular tissue can be removed or patients will be left looking at disfigured with an indentation on the central part of their chest,
The key is to find the most talented and experienced surgeon both in regards to making the assessments and doing the surgery well and consistently.
Do that by having multiple in person consultations starting locally with board-certified plastic surgeons in your community.
A good consultation should discuss the various tissue types and which one is the primary problem for you and recommending an appropriate treatment option. during the consultation you should ask each provider to show their entire collection of before and after pictures. being shown a handful of preselected pictures which most likely represent the best results of each providers career is insufficient to get a clear understanding of an average results look like in the hands of each provider. instead you should ask the provider does open up their portfolio and show all pictures including excellent outcomes, average outcomes and less than outcomes. In particular they should show as many pictures as possible of patients who are very similar chest characteristics to your own.
An experience provider should have no difficulty showing you at least 50 sets before and after pictures.
Individuals with any degree of skin laxity from history of weight fluctuations for men over the age of 35 I’m going to get limited outcomes because skin laxity contributes significantly to chest fullness. One way to assess the outcome is to put the skin and pectoralis muscle under tension by stretching one arm at a time behind your head while looking in the mirror or having someone else take a picture. With the skin and pectoralis muscle under tension you can very clearly see the contour of the glandular tissue.
In the end the key is to find the most talented an experience provider and that requires shopping around and consulting with quite a few providers.
Simply being board-certified in plastic surgery with an overall good reputation is insufficient to confirm someone has mastered this procedure.
Find the right provider and everything falls into place.
Best,
Mats Hagstrom MD

Thank you for your question and photos. Gynecomastia is characterized by enlargement of the male breast area. Often, the areolae are widened and puffy. One can often feel a firm "knot" of tissue directly behind the nipple. It is important to remove this tissue behind the areolae in order for the areolae to shrink. Older techniques typically led to scarring on the underside of the areola. A minimally invasive approach from the axilla hides the scar and addresses the core of the issue: fat and gland materialConsult with a Board Certified plastic surgeon near you to see if they offer this technique.
Best wishes, Dr. Morrissey

this is really a subset of gynecomastia. however, the traditional removing of tissue in the breast area is very unlikely to solve your problem. The puffiness of the nipple-areolar complex (NAC) requires a different surgery which i do in my office under local anesthetic with just oral sedation. you can return to work the next day and drains are rarely placed. I place an incision at the lower half of NAC and then elevate it and remove the necessary tissue below this. I use only internal sutures and the scar with time, will be very hard to see. Unfortunately you cannot solve this situation by exercising or dieting. you need surgery for this problem. I have treated a very large number of men with this problem.

David Berman MD, FRCSC