What Is Gynecomastia? Everything to Know about Male Breast Reduction

If you’re a male who’s struggling with gynecomastia, you’re not alone. In fact, a lot of patients come to us with similar concerns: stubborn excess breast tissue that neither diet nor exercise seem to eliminate. In these cases, gynecomastia surgery – which typically involves liposuction and surgery – might prove to be the only route to a contoured, lean and flat chest area.

But surgery is always a big decision. You might be wondering: How is it performed? Is it painful? What are the complications? Are you even sure surgery is necessary? These are all valid concerns, and asking the right questions will go a long way in helping you prepare for your procedure. Here, we sit down with Dr. Anthony Wilson for all the insight you might need about male breast reduction surgery. 

Who is a good candidate for gynecomastia surgery?

You might be surprised to know that approximately 50 to 65 percent of males across the world struggle with enlarged breast tissue. Oftentimes, this doesn’t go away with time or treatment. “Male patients who are bothered by excess fat and breast tissue of the chest are good candidates for breast-reduction surgery,” Dr. Wilson says. So, if your breast size has been affecting your self-esteem, surgery might be the way to go. 

What commonly causes gynecomastia?

Gynecomastia affects males of all ages, starting puberty when estrogen – the hormone responsible for breast growth – levels begin to fluctuate. While that typically goes away after puberty, for a lot of older males, an imbalance between estrogen and androgen hormones can still result in enlarged breasts. However, that’s not the only cause. “There can be many causes of gynecomastia including hormone imbalance, heavy marijuana use, and prior anabolic steroid use,” Dr. Wilson says.

How is the surgery performed? 

“The procedure is generally a combination of direct surgical excision of the glandular tissue through a small crescent incision on the lower border of the areola on each side as well as liposuction of the lateral and superior chest,” Dr. Wilson says. Whether it’s performed under local or general anesthesia, however, depends on the patient as well as the amount of glandular tissue the surgeon will be removing and the need for additional liposuction.

Is gynecomastia surgery painful?

It depends, says Dr. Wilson. If the procedure is performed under local anesthesia, chances are, you’ll experience discomfort caused by injections that numb that area of your body. After surgery, most patients tend to do well on minimal pain medication. One important thing to note: On each side of the chest, your surgeon will place a drain to help remove any built-up fluids. “Patients do have a postoperative drain in place for one week,” Dr. Wilson says. “This can cause discomfort at the drain exit site.” 

What is the recovery process like?

After your surgeon removes the postoperative drain, it’ll take about an additional week for you to be able to get back to work. “Patients should ensure they have set aside the initial one to two weeks to recover,” Dr. Wilson says. “The biggest hindrance to a smooth recovery is attempting to return to activities too soon.” If your job is physically demanding, you might want to consider taking some extra time off or asking for a period of light duty for one to two weeks. Dr. Wilson also recommends avoiding heavy exercise and wearing post-operative compression garments for two weeks.

Are there any complications patients should know about?

The most common complication is hematoma. This happens when blood pools under the skin at the incision site, and if left unaddressed, it can quickly become a serious concern. “Patients will notice sudden swelling of the chest, typically one side,” Dr. Wilson says. “Patients also notice an increase in pain and tenderness as well as a tight feeling. This can be treated either by aspiration of the blood or reopening of the surgical incision to find bleeding vessels, depending on the severity. Hematoma can be brought on by an increase in blood pressure post-operatively.”

What are some of the most common concerns patients have before moving forward with the surgery? 

When it comes to gynecomastia surgery, some patients worry about being left with excess skin where the breast tissue is removed. However, that’s typically not an issue – unless the amount of breast tissue removed is significant, Dr. Wilson confirms. “Most patients go on to build up their pectoralis muscle through working out and are able to fill any post-operative skin laxity.”

What is a big misconception around gynecomastia surgery? 

Other patients might incorrectly think that the procedure can be done with liposuction alone. That doesn’t necessarily apply to all cases. Every patient is different, and depending on the size and shape of breast tissue, your surgeon may recommend excision, which typically involves removing the tissue through a larger incision. “There are some cases that may be amenable to liposuction alone,” Dr. Wilson explains, “particularly if patients are scar-averse to even the small scar for the excision.”

If you’re struggling with the appearance of excess breast tissue, let us guide you through your options at AW Plastic Surgery. Reach out to us for a consultation on how gynecomastia surgery can enhance your chest shape and whether or not it’s right for you. We’re ready to help you look and feel your absolute best.