18 year old with gynecomastia. Is liposuction absolutely necessary along with the gland excision? (Photo)

I workout a relatively decent amount so I do not believe there is an abundance of fat on my chest area. I’m almost positive that glandular tissue is behind my condition. i’m a relatively stocky guy and am happy with the way my body looks other than my gynecomastia, so I was wondering if Liposuction is absolutely necessary along with the gland excision? I would like to maintain my stocky physique, just without the puffiness/fullness in my chest area. Thank you very much in advance.

Doctor Answers 9

Types of Possible Gynecomastia at Age 18

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.

Orange County Plastic Surgeon
5.0 out of 5 stars 109 reviews

Excision and/or liposuction for gynecomastia

For patients with your body type, I would typically use both liposuction and direct excision as part of my treatment plan for gynecomastia. Typically, there is some firm glandular tissue behind the areola which is most effectively treated by direct excision through a small incision around the lower border of the nipple/areola. In addition, I would perform some limited liposuction which would help to:  isolate the glandular tissue from the surrounding fat, and contour the chest in an effort to highlight the lateral border of the pec. muscle.

Owen Reid, MD
Richmond Plastic Surgeon
5.0 out of 5 stars 9 reviews

For mild gynecomastia like the pictures seem to show, ultrasonic lipo is usually my go to first procedure

Lipo alone often get the job done for gynecomastia like we see in your pix. you can always go back and do more invasive "cut and sew" type procedures later on if not enough improvement results. Less risk and less scarring with the more conservative approach with lipo alone, at least for the first (and hopefully last) procedure.

Bruce K. Barach, MD
Schenectady Plastic Surgeon
4.6 out of 5 stars 13 reviews

Treatment of mild gynecomastia

Based on limited information most likely that gynecomastia reduction by means of liposuction would be the first option of treatment. Without detailed clinical exam it would not be possible to say whether direct excision will be needed as well.

You should consult a plastic surgeon in your area for clinical evaluation and to discuss option of treatment. Good luck.

Zoran Potparic, MD
Fort Lauderdale Plastic Surgeon
5.0 out of 5 stars 17 reviews

Gynecomastia w/or w/o liposuction

I appreciate your concern, but understand that your condition is fairly mild and quite common. Liposuction is the least invasive option to treat your condition, and it may be combined with direct excision of breast tissue, if necessary. Often times, ultrasonic liposuction alone is effective in removing fat and breast tissue. Check out the link below to an article I wrote about Gynecomastia to better understand your options. Seek out a board certified plastic surgeon and good luck!

Robert M. Tornambe, MD
New York Plastic Surgeon
5.0 out of 5 stars 28 reviews


Gynecomastia surgery would be customized based on the physical examination . If there is a disc of breast tissue then it will require some removal to flatten the nipple areola. The liposuction is needed to feather the edges for smooth transition and removal of fat at the tail of the breast in the lateral chest for more definition of the chest/ breast.

Samir Shureih, MD
Baltimore Plastic Surgeon
4.2 out of 5 stars 7 reviews


Gynecomastia surgery can employ liposuction or excision or both in some instances. Many times I start out with only liposuction to see how a patient does and with limiting incisions.  Some go on to have the excision if necessary as well.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

Gynecomastia West Chester PA

No  liposuction is done by me only occasionally.

How should I choose a surgeon?
Selecting a surgeon is as important a choice as the decision to undergo surgery. Choose carefully only a board certified PLASTIC SURGEON. The decision is yours. What follows is some advice to assist in making your selection.
1. Experience matters. Choosing a surgeon who has performed over one thousand gynecomastia cases 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 a surgeon displays, the better. Pay attention not just to the number of pictures, but whether the surgeon is confident enough to show multiple angles of the same patient.
3. Gynecomastia surgery Reviews matter. Have patients reviewed your surgeon? Did those patients undergo the surgery you are considering?
4. Expertise matters. Is your surgeon recognized by the profession as an authority in the field? Are they certified by the American Board of Plastic Surgery? Have they authored books or medical journal articles regarding your surgery?
We hope these guidelines are of assistance when you are selecting your surgeon. When undergoing surgery, it is very important to be realistic about your expectations. Past results are not a guarantee of future results. Also, revision surgery tends to be significantly more difficult than initial surgery.

Mordcai Blau, MD
New York Plastic Surgeon
4.6 out of 5 stars 74 reviews


This type of procedure is never "necessary". If you do want to correct it, it is usually a combination of liposuction and gland removal. This can all be done through a tiny hidden incision inside the armpit. There is also a small chance this will improve as you age and grow a little so it's not an emergency. Good luck with it either way.

Sherwood Baxt, MD
Paramus Plastic Surgeon
3.8 out of 5 stars 25 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.