Top New York plastic surgeon Dr. Darrick Antell
is board certified in plastic surgery, emphasizing
aesthetic / cosmetic surgery. One of the cosmetic
surgery procedures he performs is male breast
reduction, also known as gynecomastia.
If you are considering gynecomastia, this section
will give you a basic understanding of the procedure.
To view more information about gynecomastia, please
click on one of the links below.
A word about
breast reduction in men...
Gynecomastia is a medical term that comes from
the Greek words for "women-like breasts." Though
this oddly named condition is rarely talked about,
it's actually quite common. Gynecomastia affects
an estimated 40 to 60 percent of men. It may affect
only one breast or both. Though certain drugs and
medical problems have been linked with male breast
overdevelopment, there is no known cause in the
vast majority of cases.
For men who feel self-conscious about their appearance,
breast-reduction surgery can help. The procedure
removes fat and or glandular tissue from the breasts,
and in extreme cases removes excess skin, resulting
in a chest that is flatter, firmer, and better contoured.
If you're considering surgery to correct gynecomastia,
this brochure will give you a basic understanding
of the procedure — when it can help, how it's
performed, and what results you can expect. It can't
answer all of your questions, since a lot depends
on your individual circumstances. Please be sure
to ask your doctor if there is anything about the
procedure you don't understand.
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surgery list]
The best candidates
for male breast reduction surgery
Surgery to correct gynecomastia can be performed
on healthy, emotionally stable men of any age. The
best candidates for surgery have firm, elastic skin
that will reshape to the body's new contours.
Surgery may be discouraged for obese men, or for
overweight men who have not first attempted to correct
the problem with exercise or weight loss. Also,
individuals who drink alcohol beverages in excess
or smoke marijuana are usually not considered good
candidates for surgery. These drugs, along with
anabolic steroids, may cause gynecomastia. Therefore,
patients are first directed to stop the use of these
drugs to see if the breast fullness will diminish
before surgery is considered an option.
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All plastic
surgery carries some uncertainty and risk
When male breast-reduction surgery is performed
by a qualified plastic surgeon, complications are
infrequent and usually minor. Nevertheless, as with
any surgery, there are risks. These include infection,
skin injury, excessive bleeding, adverse reaction
to anesthesia, and excessive fluid loss or accumulation.
The procedure may also result in noticeable scars,
permanent pigment changes in the breast area, or
slightly mismatched breasts or nipples. If asymmetry
is significant, a second procedure may be performed
to remove additional tissue.
The temporary effects of breast reduction include
loss of breast sensation or numbness, which may
last up to a year.
Many men have gynecomastia —
enlarged, female-like breasts — causes
by excess glandular tissue or fat
(or both).
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Planning your
male breast reduction surgery
The initial consultation with your surgeon is
very important. Your surgeon will need a complete
medical history, so check your own records ahead
of time and be ready to provide this information.
First, your surgeon will examine your breasts and
check for causes of the gynecomastia, such as impaired
liver function, use of estrogen-containing medications,
or anabolic steroids. If a medical problem is the
suspected cause, you'll be referred to an appropriate
specialist
Your plastic surgeon may, in extreme cases, also
recommend a mammogram, or breast x-ray. This will
not only rule out the very small possibility of
breast cancer, but will reveal the breast's composition.
Once your surgeon knows how much fat and glandular
tissue is contained within the breasts, he or she
can choose a surgical approach to best suit your
needs.
Don't hesitate to ask your surgeon any questions
you may have during the initial consultation - including
your concerns about the recommended treatment or
the costs involved. Treatment of gynecomastia may
be covered by medical insurance — but policies
vary greatly. Check your policy or call your carrier
to be sure. If you are covered, make certain you
get written pre-authorization for the treatment
recommended by your surgeon.
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Preparing for
your breast reduction surgery
Your surgeon will give you specific instructions
on how to prepare for surgery, including guidelines
on eating, drinking, and taking certain vitamins
and medications.
Smokers should plan to stop smoking for a minimum
of one or two weeks before surgery and during recovery.
Smoking decreases circulation and interferes with
proper healing. Therefore, it is essential to follow
all your surgeon's instructions.
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Where your
surgery will be performed
Surgery for gynecomastia is most often performed
as an outpatient procedure, but in extreme cases,
or those where other medical conditions present
cause for concern, an overnight hospital stay may
be recommended. The surgery itself usually takes
about an hour and a half to complete. However, more
extensive procedures may take longer.
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Type of anesthesia
for male breast reduction surgery
Correction of enlarged male breasts may be performed
under general, or in some cases, under local anesthesia
plus sedation. You'll be awake, but very relaxed
and insensitive to pain. More extensive correction
may be performed under general anesthesia, which
allows the patient to sleep through the entire operation.
Your surgeon will discuss which option is recommended
for you, and why this is the option of choice
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list]
The surgery
If excess glandular tissue is the primary cause
of the breast enlargement, it will be excised, or
cut out, with a scalpel. The excision may be performed
alone or in conjunction with liposuction. In a typical
procedure, an incision is made in an inconspicuous
location — either on the edge of the areola
or in the under arm area. Working through the incision,
the surgeon cuts away the excess glandular tissue,
fat and skin from around the areola and from the
sides and bottom of the breast. Major reductions
that involve the removal of a significant amount
of tissue and skin may require larger incisions
that result in more conspicuous scars. If liposuction
is used to remove excess fat, the cannula is usually
inserted through the existing incisions.
Glandular tissue must be cut out,
usually through a small incision
near the edge of the areola.
If your gynecomastia consists primarily of excessive
fatty tissue, your surgeon will likely use liposuction
to remove the excess fat. A small incision, less
than a half-inch in length, is made around the edge
of the areola — the dark skin that surrounds
the nipple. Or, the incision may be placed in the
underarm area. A slim hollow tube called a cannula
which is attached to a vacuum pump, is then inserted
into the incision. Using strong, deliberate strokes,
the surgeon moves the cannula through the layers
beneath the skin, breaking up the fat and suctioning
it out. Patients may feel a vibration or some friction
during the procedure, but generally no pain.
In extreme cases where large amounts of fat or
glandular tissue have been removed, skin may not
adjust well to the new smaller breast contour. In
these cases, excess skin may have to be removed
to allow the removing skin to firmly re-adjust to
the new breast contour.
Sometimes, a small drain is inserted through a
separate incision to draw off excess fluids. Once
closed, the incisions are usually covered with a
dressing. The chest may be wrapped to keep the skin
firmly in place.
Fatty tissue can be removed by
liposuction. A small, hollow tube
is inserted through a tiny incision,
leaving a nearly imperceptible scar.
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After your
male breast reduction surgery
Whether you've had excision with a scalpel or liposuction,
you will feel some discomfort for a few days after
surgery. However, discomfort can be controlled with
medications prescribed by your surgeon. In any case,
you should arrange to have someone drive you home
after surgery and to help you out for a day or two
if needed.
You'll be swollen and bruised for awhile —
in fact, you may wonder if there's been any improvement
at all. To help reduce swelling, you'll probably
be instructed to wear an elastic pressure garment
continuously for a week or two, and for a few weeks
longer at night. Although the worst of your swelling
will dissipate in the first few weeks, it may be
three months or more before the final results of
your surgery are apparent.
In the meantime, it is important to begin getting
back to normal. You'll be encouraged to begin walking
around on the day of surgery, and can return to
work when you feel well enough — which could
be as early as a day or two after surgery. Any stitches
will generally be removed about 1 to 2 weeks following
the procedure.
Your surgeon may advise you to avoid sexual activity
for a week or two, and heavy exercise for about
three weeks. You'll be told to stay away from any
sport or job that risks a blow to the chest area
for at least four weeks. In general, it will take
about a month before you're back to all of your
normal activities.
You should also avoid exposing the resulting scars
to the sun for at least six months. Sunlight can
permanently affect the skin's pigmentation, causing
the scar to turn dark. If sun exposure is unavoidable,
use a strong sunblock.
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Your new look
after male breast reduction
Gynecomastia surgery can enhance your appearance
and self-confidence, but it won't necessarily change
your looks to match your ideal. Before you decide
to have surgery, think carefully about your expectations
and discuss them frankly with your plastic surgeon.
The results of the procedure are significant and
permanent. If your expectations are realistic, chances
are good that you'll be very satisfied with your
new look.
Following surgery for gynecomastia,
the patient has a more masculine
chest contour.
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surgery list]
© Copyright American Society of Plastic Surgeons
If you would like to contact New York plastic surgeon
Darrick Antell, or if have any further questions
about male breast reduction surgery (gynecomastia)
or any of our plastic surgery procedures, please
use our contact form.
Phone: (212) 988-4040
