Male Breast Reduction (Gynecomastia)
Male “breast” development or fullness is also known as gynecomastia. This is a condition that affects many men and can be quite bothersome. Male breast development can be due to hormonal imbalance, weight gain, or genetics. About 30-40% of teenage boys develop some breast development around the time of puberty—called “pubertal gynecomastia”—which usually resolves after one to two years. When it has been there more than two years after puberty, it is medically referred to as gynecomastia. Male athletes that may have used anabolic steroids are also more predisposed to developing gynecomastia.
Male gynecomastia patients typically feel very self conscience about wearing certain shirts, such as golf shirts. Even extreme working out will not eradicate this condition. Some men do not really notice this condition until their mid to late 20s and 30s—especially muscular-framed, athletic men who put on some weight with metabolic slowdown and lifestyle changes.
Male Breast Reduction
Board-certified plastic surgeon James F. Boynton, MD utilizes a specialized “minimally” invasive technique to remove the tissue causing gynecomastia and also reshape the chest area, restoring its masculine form. This “minimally” invasive treatment for gynecomastia involves two 2 mm “puncture” incisions. The chest wall and “armpit” area are liposuctioned and sculpted using special cannulas designed for more “fibrous” tissue, as is typical in the male chest. After liposuction is completed throughout the chest and armpit area, a “pull-through” excisional component of the procedure is performed to actually remove the “fibrous” breast tissue from underneath the “areola” and nipple complex.
Sometimes male patients feel they have “puffy” nipples, and the male breast reduction procedure eradicates and flattens the chest in essentially a “scar-free” way. The surgery is outpatient and avoids the large, open incisions and scars—including free nipple grafting scars—that are typical of the traditional techniques. Most patients notice significant flattening of the chest as well as a “shrinkage” of the often-dilated size of the areola. Special compression vests are utilized along with post lymphatic massage therapy. Patients generally need only a day off of work and can resume full working out and exercise in two weeks. Final results usually take up to six months to see. Teenagers up to middle-aged men enjoy the improvements they get, as well as their improved appearance in clothing.
How long until I see the results in the chest area?
About 60 percent of the results are seen after the first month, 80 percent after three months, and final results are typically seen at six months.
How do you remove the tissue through such a small incision?
Historically, liposuction alone does not achieve flat results in the male chest, and some component of excision needs to be performed to remove the fibrous gynecomastia tissue (typically located behind the areola/nipple complex) that causes many male patients to have “puffy” nipples. The tissue is removed in “strips” using specialized surgical instruments that enable it to be removed without having to utilize a traditional “crescent” or “half moon” shaped incision that goes around the bottom half of the areola.
How much swelling and bruising will there be?
Pain is typically mild to moderate. The procedure is done as an outpatient treatment, and most patients are able to resume their activities of daily living (such as showering, going out to dinner, getting around, etc.) the following day. Most patients will take one or two days off of work at most. A small minority of patients will take a week off of work, but that is rarely necessary. Men bruise more substantially than women do in general, so the bruising is to be expected. Men often want to get back in the gym and work out, but that is something that needs to wait at least two weeks.
Will I need to do any massaging?
Massaging is an important adjunct to chest wall sculpting and gynecomastia treatment. All patients get variable degrees of scar tissue formation after the procedure, and formal post-lymphatic treatments and massages are very important. With some patients, we start this process one week after the procedure; with others, we wait until two weeks following treatment.
What are the dressings/garments like?
Men wear a “compression vest” that fits easily and inconspicuously under their clothes. The material is breathable and comfortable, and patients are able to do this in all seasons. Sometimes, we add a special foam inside of the garments to achieve targeting compression in specific areas. Many male patients decide to do their abdomen and “love handles” at the same time as the chest, and the garment is the same regardless, so that is something they enjoy.
Will the incisions drain?
Chest liposuction areas typically do not drain as much as the abdomen and love handle areas, but there is a possibility of some mild drainage in the first two days. The specialized garment is designed to wick away fluid and helps in this regard.
When can I resume exercise and lifting weights?
Typically two weeks after the surgery.
Schedule a Consultation
If you are considering treatment for gynecomastia, Dr. Boynton can help. Please contact our practice to schedule a confidential consultation with Dr. Boynton, and he will be happy to answer your questions and discuss all aspects of the procedure with you.