Male Chest Contouring (Gynecomastia)

Male Chest Contouring (Gynecomastia)

Male gynecomastia, or excess fat and breast tissue of the male chest is a common condition affecting one or both breasts. While this condition can be caused by the use of some medications and indicative of hormone imbalance, it is commonly benign though extremely embarrassing and may even be painful. The specific cause of male gynecomastia is usually not known, but it may be a result of decreased male hormone levels, increase in body fat or as a effect of certain medications or medical conditions.

Many men choose not to discuss this issue, even with their doctor, out of embarrassment.  Attempts to cover the chest with heavy clothing, never going without a shirt, or even taping the chest are common practices of “dealing” with the issue. The good news for the male that struggles with this condition is that this condition can be corrected through a safe, effective and sometimes minimally invasive procedure performed by an experienced and compassionate plastic surgeon like Dr. Trussler.

What Are My Options?

Chest contouring can be performed through multiple different techniques, depending on each patient’s individual condition, specifically the amount of excess breast tissue and skin. For those men with gynecomastia which consist mostly of glandular tissue, excisional surgery is usually the best option, which removes the excess tissue and sometimes skin through incisions around the nipple areola or in the lower chest skin fold. Male gynecomastia caused primarily by excessive fatty tissue can often be treated through chest liposuction, which suctions out the excess fat through two tiny incisions around the chest. Excisional and liposuction techniques are commonly combined in most cases of male gynecomastia secondary to the common combination of firm breast tissue and fat. In extreme cases, Dr. Trussler will perform a male upper body lift, which removes significant amount of chest skin, breast tissue and fat, as well as repositioning the nipple on the male chest.  Dr. Trussler will listen to your goals and determine which type of procedure is best for your condition.

Considerations

Candidates for male chest contouring for male gynecomastia are those primarily without reversible causes of hormone imbalances and those within their ideal weight. It is not uncommon for a patients with gynecomastia to be evaluated by an endocrinologist prior to seeing a plastic surgeon. An endocrinologist can screen for any hormone imbalance which may be treated with hormones rather than surgery. Testicular tumors, adrenal tumors and brain tumors can all be a cause of male gynecomastia, so pre-screening is important. A high ratio of body fat can also contribute to the production of estrogen which can lead to gynecomastia. Dr. Trussler believes in diet and exercise prior to any male chest contouring procedure, especially in gynecomastia in the over weight patient.

Ideal candidates for male chest contouring are in good overall health, non-smokers, and at a normal weight, but are bothered by the appearance of their chest, breasts and/or nipple areola. The best results are achieved in patients with good skin quality that will recoil after removal of excess breast tissue. While this procedure is most often performed after puberty is finished, teenagers may be eligible as well if they have been suffering from gynecomastia for more than two years with a severe case that have been evaluated by an endocrinologist.

Expectations

Dr. Trussler can remove excess breast and chest tissue through multiple techniques. This is reassuring that there is a solution to any patient who suffers with this embarrassing condition. Successful and realistic chest contouring results for most male patients with enlarged breasts can be delivered with a one stage procedure.

Treatment

The surgical approach for male chest contouring depends on the type of breast tissue (firm or fatty), the location (under the nipple or around the whole chest), and any excess skin or sagging of the nipple. Small amounts of firm breast tissue under the nipple areola can be removed through an incision under the areola. More extensive tissue can be removed through this incision and then re-contouring with liposuction done on the outer chest. Liposuction only candidates can be treated through two small outer chest incisions which enable removal of the fatty tissue through a liposuction cannula. Dr. Trussler will use ultrasonic liposuction (UAL) to help break-up and melt the fatty tissue on some chest contouring patients. In cases of male gynecomastia with skin excess typically seen in patients who either have severe gynecomastia or have undergone significant weight-loss, an upper body lift is typically performed. In an upper body lift (UBL) excess skin and chest tissue are removed through an incision along the lower chest crease which can be extended along the outer chest and into the upper arm for complete correction and definition in this area. The nipple can be repositioned in the procedure if needed. Typically there is more healing with this procedure and 2 to 4 drains are placed to help collect any fluid that accumulates in the surgical area.

These procedures are all typically performed on an outpatient basis and usually take about an hour and a half, but may take upwards of 4 hours for an upper body lift. General anesthesia or local anesthesia with sedation may be used, depending on the extent of treatment required. Dr. Trussler will develop a customized treatment plan for each individual patient.

After Care & Recovery

After male chest contouring, patients will be able to return home the same day, but will likely experience mild discomfort for a few days. Dr. Trussler will provide patients with compression garments to promote proper healing, instructions on drain care if needed, and oral pain medication as needed to help with the recovery process. Patients will be encouraged to get up and walk around the same day as their procedure, which will help with the recovery process and reduce risks of venothromboembolism (VTE) or blood clots. Compression garments are left in place for the first week and drains are typically in place for about a week.

Stitches from excision surgery are commonly dissolvable, but residual stitches will be removed about a week or two after the procedure. Dr. Trussler will provide patients with specific post-operative instructions for their individual procedure, but patients can usually return to work after a week and return to exercise after three to four weeks.

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Whether you have a question or would like to setup a consultation, Dr. Trussler and his staff are here to help. Please fill out our contact form, or call our office at 512-450-1077 to schedule an appointment. Start your journey to not only looking, but feeling better today!

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Andrew Trussler, MD
5656 Bee Cave Road – Suite J200
Austin, TX 78746
Phone: 512-450-1077 | Fax: 512-450-1817
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