Should I be looking into liposuction for my (pseudo?) gynecomastia? (Photos)

Question

I had been overweight from ages 9 through 17 (now 18); around age 13 I started becoming very self-conscious about my man boobs, though no significant amount of glandular tissue ever really entered the picture. Around age 16 I went through with the weight loss (100 lbs), and the size decreased significantly, but not enough- it kills my self-confidence; I am extremely reluctant to take my shirt off around others, and always wear a tight undershirt tucked far enough into my pants to hide them.

Scott W. Vann, MD, FACS · Answer

Male breast enlargement always consists of some fat and some gland. I have found after doing many patients that about 70% of the time it is almost all fat and liposuction alone gives a great result. In the other 30% there is some remaining firm gland tissue after I lipo all the fat away which I remove through a small areola incision.  I always get all the fat out with liposuction and then decide if an incision is needed. Hard to always tell preop so the patient and I are prepared in advance. See a plastic surgeon who does a lot of this work. Good luck.

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

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. You should meet with a board certified plastic surgeon to be able to get a formal diagnosis and to be able to decide on a course of treatment if necessary.
#gynecomastia #malebreastreduction

Leila Kasrai, MD, FRCSC · Answer

First, I’d like to congratulate you on your weight loss. 100lbs is quite a lot!
You would need an in-person examination to see what is causing your gynecomastia. If it’s excess fat, then liposuction may be sufficient as long as your skin is elastic enough to retract after surgery. However, for people who have experienced dramatic weight loss, loose skin is a typical issue. For this reason, skin removal may be necessary. Your examining surgeon can also let you know if you have excess glandular tissue that can also be removed.

Miguel Delgado, MD · Answer

Liposuction is a good treatment for pseudogynecomastia, however it is rare that gynecomastia is caused by fat alone. If you have liposuction only and there is breast tissue, the breast tissue will even be more prominent if only fat is removed, and then to go back and remove breast tissue will be more complicated due to scar tissue that will form. Be sure to see a Board Certified Plastic Surgeon who specializes in gynecomastia! Good luck.

Mark Crispin, MD · Answer

You appear to be a good candidate for excision of the breast bud under the nipple and potentially some liposuction of the surrounding area although a physical exam would be essential before drawing that conclusion.

Michael Law, MD · Answer

Congratulations on your weight loss.  A physical examination can determine whether or not the unwanted fullness is fat or glandular tissue. Either way, this can be improved by surgery. Visit a plastic surgeon with a lot of experience with gynecomastia. The goal will be to minimize the unwanted fullness with as little visible scarring as possible
So many gynecomastia patients have shared with me the self-consciousness, embarrassment, frustration and psychological stress that they have endured because of breast enlargement. Most never feel comfortable taking off their shirt at the beach or at the pool or wearing a snug-fitting shirt. Many use compression vests in an attempt to reduce the unsightly appearance of gynecomastia. Every patient I see feels that it has adversely affected his comfort and confidence in social situations. And many describe a feeling of discomfort and embarrassment with regard to sexual intimacy. If you have experienced any or all of these issues personally, I want to assure you that (1) you are not alone and (2) essentially every case of gynecomastia can be significantly improved, and most can be corrected completely.
The most common form of gynecomastia (‘mixed glandular/adipose’) requires ultrasonic liposuction and, in some cases, direct breast tissue excision as well. 
My goal is to create the smallest incision with the smallest scar possible. My library of gynecomastia videos will help explain the different approaches I take to addressing different types of gynecomastia. 
Take your time researching your surgeon. Look at several websites, go on several consultations, speak to other patients and of course view many many before and after photographs. Find a plastic surgeon who performs gynecomastia surgery often and with whom you feel comfortable.

Tom J. Pousti, MD · Answer

Thank you for the question and pictures. Accurate diagnosis would necessitate physical examination. It IS important to differentiate  as uncomfortable as gynecomastia ( excess breast tissue) from lipomastia ( otherwise known as pseudo-gynecomastia or excess adipose tissue of chest wall). Treatment will differ depending on diagnosis. 
Generally speaking, liposuction surgery alone is useful to treat lipomastia (an enlarged chest secondary to adipose tissue); rarely does it suffices as the only modality of treatment when it comes to treating true gynecomastia. Most patients with gynecomastia benefit from direct excision of glandular tissue plus/minus peripheral liposuction surgery (more effective and predictable outcomes compared to nonsurgical treatment)
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.  Best wishes.

Parham Ganchi, PhD, MD · Answer

Hi pulpgrand1,Hope you're doing well.  Great job on the weight loss!  If the remaining fullness in your chest bothers you, then I would definitely recommend addressing it.  We see many patients with varying degrees of gynecomastia and they are some of our happiest patients!  It is like a burden has been lifted off their shoulders.  In your case, you may have some gland tissue and some fat.  This can only be determined by an experienced plastic surgeon who can examine you in person.  In either case, surgery can treat this very nicely.  Good luck!Dr. Parham Ganchi - Wayne, NJ Plastic SurgeonPrinceton ~ Harvard ~ Duke

Daniel Brown, MD, FACS · Answer

Hi Pulpgrand1,Congratulations on your weight loss!  Short answer is that if the appearance of your chest bothers you, I would encourage you to schedule a consultation with a board certified plastic surgeon in your area who has expertise in treating gynecomastia.  Make sure that they have before and after photos of results that you like.  Call, make an appointment and go discuss your options.Best wishes!Dr. Brown

Sean Doherty, MD, FACS · Answer

It is impossible to tell without examining you in person whether or not liposuction alone will address your issue so schedule a consultation with a board certified plastic surgeon to be assessed in person. There is no reason for you to feel self conscious about your chest when it can easily be treated. And congrats on the weight loss and taking control of your health. Best of luck.

Should I be looking into liposuction for my (pseudo?) gynecomastia? (Photos)

Answers (17)

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