What is Gynecomastia?
Male gynecomastia, or excess fat and breast tissue of the male chest, is a common condition affecting one or both breasts. 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. Andrew Trussler.
The Causes of Gynecomastia
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 an effect of certain medications or medical conditions.
Who are the Ideal Candidates for Gynecomastia Surgery?
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 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. Austin Plastic Surgeon Dr. Andrew Trussler believes in diet and exercise prior to any male chest contouring procedure, especially in gynecomastia in the overweight 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 has been evaluated by an endocrinologist.
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 can 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.
Results to expect from Male Breast Reduction Surgery
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 from this embarrassing condition. Successful and realistic chest contouring results for most male patients with enlarged breasts can be delivered with a one stage procedure.
What is the Recovery Time from Gynecomastia Surgery?
- 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.
*Disclaimer: Results and individual patient experience may vary.