Gynecomastia

MALE BREAST REDUCTION SURGERY

True gynecomastia (enlarged male breast) is a condition resulting from imbalance between testosterone and estrogen production. It can be the result of hormonal changes, heredity, obesity, or the use of certain drugs. Although not usually painful, gynecomastia can cause emotional discomfort and impair your self-confidence. Some men may even avoid certain physical activities and intimacy simply to hide their condition. Gynecomastia surgery is a procedure to remove the excess glandular breast tissue, reducing the size of the breasts, while flattening and enhancing the chest contours. Men who undergo gynecomastia surgery often report a significant increase in confidence and a dramatic boost in self-image.

UNDERSTANDING GYNECOMASTIA

Although many people think that estrogen is a female hormone, men also produce it (although in much smaller quantities). Since estrogen is a hormone controlling the growth of breasts (among other roles), its overproduction or imbalance with testosterone (male hormone) may result in enlarged breast glands in males.

BREAST TISSUE VS. FAT AND TREATMENT OPTIONS

This is different than male breast enlargement in obesity, where the enlarged breast is made largely of fatty tissue. Surgery is not typically recommend as the first option for patients who are significantly overweight or obese. With all surgeries, Dr. Majewski will recommend that patients lose as much weight as possible before pursuing surgical options, for the patient’s safety, and to ensure the best results.

Men who simply have excess fat on their chest, who have lost weight or are in the process of losing weight, might consider a non-surgical fat reduction option, such as CoolSculpting before looking into surgical options. CoolSculpting can be incredibly effective for treating chest fat in men.

However, for men with true gynecomastia, CoolSculpting will not effectively reduce the size of the breasts, because the breast is made of breast tissue, not fat.

SYMPTOMS oF GYNECOMASTIA

Although not life-threatening, gynecomastia can cause both physical and emotional pain. Some men pursue treatment for their gynecomastia because of pain or tenderness in their chest, which seems to develop over time.

More commonly, men do not experience physical pain, but emotional frustration caused by having enlarged breasts, which is enough to pursue surgical treatment. Although less often discussed, men’s bodies can be a source of insecurity and distress much like women’s. Men with gynecomastia have usually struggled with a poor self-image for years before pursuing treatment.

Different from having traditionally male pectoral muscles, gynecomastia usually leaves men with softer, rounder breasts, which can make them feel feminine. Patients might have endured teasing from friends and family about their chest throughout their lives, in addition to negative self-talk that can take a serious toll on a person’s happiness.

DO I HAVE GYNECOMASTIA?

Many men with enlarged breasts do not realize that their condition has a name, or that it can be treated with surgery. They are relieved to discover that they can eliminate this source of frustration with just a few weeks of recovery.

You may not know whether your enlarged breasts are true gynecomastia or simply excess fat - but regardless, if you are in reasonably good shape, and would like to do something to change the appearance of your chest, you should schedule a consultation with Dr. Majewski. He will be able to help you understand your condition, and talk you through all your treatment options so you can make a decision that is right for you.

AM I A GOOD CANDIDATE FOR GYNECOMASTIA SURGERY?

You are an ideal candidate for gynecomastia surgery if you:

struggle with excess localized fat, glandular tissue, and skin in one or both breasts
are an adult with close to ideal weight (within 30%)
have good quality elastic skin and good muscle tone
are in good health
don't smoke
have realistic expectations and a positive outlook
do not have a life-threatening illness or medical conditions that can impair healing

CONSULTATION

The purpose of your consultation with Dr. Majewski is to evaluate whether you are a candidate for gynecomastia surgery (or a different procedure) and to develop a treatment plan that will help you achieve your goals.

Dr. Majewski will ask you questions about:

Your surgical goals
Medical conditions, drug allergies and medical treatments
Current medications, vitamins, herbal supplements, alcohol, tobacco and drug use
Previous surgeries

He will also:

Evaluate your general health status and any pre-existing health conditions or risk factors
Take photographs
Discuss your surgical options and other non-surgical treatment options (such as CoolSculpting®)
Recommend a course of treatment
Discuss likely outcomes of surgery and any risks or potential complications

The consultation is the time to ask Dr. Majewski any questions you may have regarding the procedure, recovery, and expected results.

It's very important to understand all aspects of your procedure. It's natural to feel some anxiety, whether it's excitement for your anticipated new look or a bit of preoperative stress - or both. Don't be shy about discussing these feelings with Dr. Majewski.

COst

The cost of the gynecomastia procedure varies depending on the extent of your surgery, and whether you decide to undergo other procedures at the same time. The cost of your procedure will include anesthesia fees, surgical facility costs, medical tests, post-surgery garments, prescriptions for medications, and the surgeon’s fee.

When choosing a board certified plastic surgeon for your procedure, remember that the surgeon’s experience and your comfort with him or her are just as important as the final cost of the surgery.

Health insurance typically covers part or all of the cost of gynecomastia surgery. For any expenses not covered, we offer CareCredit.

You might also consider the cost of childcare or other assistance you might need during your recovery period - such as meal delivery, a cleaning service, etc. Although usually not necessary, some patients prefer to delegate some of their household responsibilities during the first few weeks of recovery so they can focus on healing fully.

PREPARATION

In preparing for your surgery, you may be asked to:

Get lab testing or a medical evaluation
Take certain medications or adjust your current medications
Stop smoking
Avoid taking aspirin, anti-inflammatory drugs and herbal supplements as they can increase bleeding

Many of Dr. Majewski’s liposuction cases will take place at our state-of-the-art Surgery Center at the Reserve, located conveniently right next door to our clinic.

PROCEDURE

Surgical approaches to the treatment of gynecomastia include subcutaneous mastectomy, liposuction-assisted mastectomy, laser-assisted liposuction, and laser-lipolysis without liposuction. In some cases, liposuction alone might be used.

Regardless of the approach used, medications will be administered for your comfort during the surgical procedure. Dr. Majewski will recommend the best choice of anesthesia for you and will explain what to expect from anesthesia.

In cases where gynecomastia is primarily the result of excess fatty tissue, liposuction techniques alone may be used. This requires insertion of a cannula, a thin hollow tube, through several small incisions.

The cannula is moved back and forth in a controlled motion to loosen the excess fat, which is then removed from the body by vacuum suction.

There are various liposuction techniques that may be used; the technique most appropriate in your case will be defined prior to your procedure.

EXCISION TECHNIQUE

Excision techniques are recommended where glandular breast tissue or excess skin must be removed to correct gynecomastia. Excision is also necessary if the areola will be reduced or the nipple will be repositioned to a more natural male contour. Incision patterns vary depending on the specific conditions and surgical preference.

COMBINATION OF LIPOSUCTION AND EXCISION TECHNIQUES

Sometimes gynecomastia is treated with both liposuction and excision.

RECOVERY

During your gynecomastia surgery recovery period, dressings or bandages will be applied to your incisions and an elastic bandage or support garment may be used to minimize swelling, and support your new chest contour as it heals after surgery.

A small, thin tube may be temporarily placed under the skin to drain any excess blood or fluid that may collect.

You will be given specific instructions that may include how to care for the surgical site and drains, medications to apply or take orally to aid healing and reduce the potential for infection, specific concerns to look for at the surgical site or in your general health, and when to follow up with your plastic surgeon.

Be sure to ask Dr. Majewski specific questions about what you can expect during your individual recovery period.

Where will I be taken after my surgery is complete?
What medication will I be given or prescribed after surgery?
Will I have dressings/bandages after surgery? When will they be removed?
Are stitches removed? When?
When can I resume normal activity and exercise?
When do I return for follow-up care?

It's very important to follow your plastic surgeon's instructions and attend follow-up visits as scheduled.

RESULTS

The final results of gynecomastia surgery are permanent in many cases. However, if gynecomastia resulted from the use of certain prescription medications, drugs (including steroids) or weight gain, you must be fully free from these substances and remain at a stable weight in order to maintain your results. Please discuss this with your physician before making changes to your prescription medications.