18 year old for male breast reduction surgery? (Photo)

Question

I am an 18 year old who suspects they have gynecomastia. I heard that the age for surgery is 20+ so I was wondering whether I would be permitted to have surgery at my age. Ive been 5'11, weighing 200ibs with facial since I was 14. I dont smoke, drink etc. and i try to work out at least twice a week. Could get a rough estimate based on the attached pictures? I heard that removing the breast gland is covered by OHIP.

Jed H. Horowitz, MD, FACS · Answer

Gynecomastia is a common occurrence in boys going through puberty.There are different types of #gynecomastia.  Categorized as #physiologic gynecomastia, up to 2/3 of boys going through puberty develop some form of gynecomastia. This form of gynecomastia is due to the surges in testosterone and estrogen which often lead to an imbalance of the testosterone:estrogen ratio. Puberty is a difficult time for most boys, with many changes occurring not just physically but also emotionally. Developing gynecomastia during this age can affect the self-image and confidence of a teenager. The peak incidence occurs around 14 years of age.In up to 75% of boys who develop pubertal gynecomastia, it will disappear without treatment within 2 years. In 90% of boys with pubertal gynecomastia, it will disappear without treatment within 3 years. So deciding who needs surgery is very important in this age group because a majority of these boys will not need any intervention.

#Normal Gynecomastia is usually apparent in males between the ages of 12 to 15 years old. It is also common for older men 65 years old or more who experience a drop in their testosterone levels. #Normal Gynecomastia takes approximately one to two years to naturally regress on its own.

Meanwhile, #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 with #Adolescent 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.

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

Who is a candidate for Male Breast Reduction?Healthy male patients with excess breast tissue or unwanted breast development who have no underlying breast disease.Men who desire improved physical and aesthetic appearance should have realistic expectations based on their condition and the procedure performed.Intended ResultPermanent reduction of unwanted volume and improvement in the contour and appearance of the male chest.Procedure descriptionThere are varying degrees of gynecomastia ranging from puffy nipple to severe breast enlargement and/or breast sag. The severity of the gynecomastia will determine which treatment option is necessary. In most cases, men suffer from standard gynecomastia, which can be surgically treated as an in-office procedure under local anesthesia. For more severe cases, it may be recommended that you have your procedure under general anesthesia at an outpatient surgery center. Your consultation will determine which option is best suited for treating your gynecomastia.You should consult with a Board Certified Plastic Surgeon and decide on course of treatment if necessary. I have attached a link to help you choose the best one for you!#gynecomastiaremoval#findingthebestplasticsurgeon

Ronald Schuster, MD · Answer

Yes it looks like you have gynecomastia. If you have had it more than 2-3 years I doubt it will go away. Your skin looks like it is in great shape and should shrink nicely. Go get some consults.

Ramiro Morales, Jr., MD · Answer

At the age of 18, you seem to have fully developed by now and I certainly think that you can have the gynecomastia surgery.  I don't know about the OHIP, but here in my state gynecomastia surgery is never a covered procedure.  Males that develop a one sided new breast mass later in life would be covered as a breast biopsy for a new mass or growth in the breast.  But as gynecomastia is a common occurence, it is not usually covered.

Vincent N. Zubowicz, MD · Answer

Gynecomastia evolving in puberty generally is gone within a couple of years. By 18 years of age this is probably a permanent condition. Excision is fairly simple. Depending on the anesthetic you can probably have this done for $2-$3000.

Mathew A. Plant, MD, FRCSC · Answer

Without examining you I cant be entirely sure how much of the problem is glandular and how much is fatty tissue. In either case it is a relatively straightforward operation that can be done with minimal access incisions near the armpit. Unfortunately OHIP will only pay for treatment of gynecomastia in adolescents and in adults who have it as a result of a medical problem. Unfortunately at 18 years old if you dont have a medical condition that is causing this (hormone imbalance, side effect of treatment for another condition etc..) then OHIP wont cover the cost of surgery. The only way to know for sure is to book a consultation with a Royal College certified plastic surgeon near you. Best of luck!

William T. Stoeckel, MD · Answer

Many surgeons will want to wait on operating on gynecomastia until they are relatively convinced that the condition will not regress on its own without surgery. If your condition has been relatively unchanged for a year or so, I am not certain there is any reason to delay surgery until you are 20. Being a good surgical candidate is not only about age though and a thorough history and physical exam would be needed to accurately determine when and what the best treatment might be for you. There are not many insurance plans that will cover the cost of the procedure as they almost all consider the procedure to be an elective cosmetic surgery.

Tom J. Pousti, MD · Answer

Thank you for your question and photos. In my opinion, you can proceed with gynecomastia surgery (at the age of 18 years old)Correction of gynecomastia or breast reduction surgery will certainly help you; the trade-off associated with the surgery in your case will be the presence of scars on the chest. The trade-off for improved contour is one that you will have to accept prior to proceeding.

My best suggestion: when the time is right, seek consultation with board-certified plastic surgeons who can demonstrate significant experience achieving the types of outcomes you will be pleased with.

Then, communicate your goals, concerns, and questions. Learn about the pros/cons/risks/complications associated with surgery. Going through this process, you will be able to make an informed  decision whether or not to proceed.

You may find the attached link, helpful to you as you learn more. Best wishes.

Mordcai Blau, MD · Answer

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.

R. Stephen Mulholland, MD (retired) · Answer

Dear icecreem,

Thank you for your clinical post and photograph.  It does appear from the photograph that you
do have some degree of gynecomastia, which can be partially glandular or
adipose (fatty tissue).Treatments for gynecomastia vary depending upon the surgeon
and the degree of breast enlargement.  It
does appear you’d be a good candidate for non-excisional, non-minimal scarring
technique called BodyTite or SmartLipo.  During this technique energy assisted device
emits radio frequency energy internally, coagulates both gland and fat for
aspiration.  The advantage of this
technique is you get excellent contraction upwards of 35% without the large
around the areola or even lollipop scar that reduction surgery may ensue.

OHIP does not cover this kind of surgery, however, you want
to make sure that you’re at the age of skeletal maturity and have stopped
growing.  You want to make sure that you
have a normal libido and normal erections with no erectile dysfunction so that
you may rule out any underlying endocrinological abnormalities.

If this is purely hereditary glandular hypertrophy and
gynecomastia than BodyTite or SmartLipo would likely be your best option.

I have been performing liposuction for over 20 years and the
energy-assisted techniques for over 10. 
These energy-assisted techniques often avoid larger scarfication
procedures, which may heal adversely.

I hope this information has been of some assistance and best
of luck.

For more information, please review the link below. Pay close
attention to BodyTite, SmartLipo and Vaser Lipo.

R. Stephen Mulholland, M.D.

Certified Plastic Surgeon

Yorkville, Toronto

18 year old for male breast reduction surgery? (Photo)

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