Breast Reduction – Men

What is Gynecomastia?

Gynecomastia comes from the Greek term meaning woman-like breasts.
It is very common and thought to affect 65% of boys in the 14-to 15 year age group and up to 30% of older men.
Generally, it develops during early puberty. In many cases, it resolves after the puberty growth spurt.
The majority of the time, gynecomastia occurs without a known cause and is a normal finding. However, it can be associated with an underlying disease at any age and warrants evaluation by a qualified physician.

If the gynecomastia is due to marijuana or prescription drugs, discontinuing these may help the condition.
If gynecomastia developed during early puberty, it is best to allow the young man to complete puberty prior to any type of surgical intervention as the condition may resolve on its own.
If the gynecomastia persists after the growth spurt and is not due to any type of drugs or medical conditions, then it is treated with a breast reduction procedure.

The procedure removes the fat and breast (glandular) tissue from the breast.
In extreme cases, the skin may also need to be removed. This was quite common in the past. Since the introduction of ultrasonic liposuction for treatment of gynecomastia, the need for skin removal is less common.
Surgery results in flatter firmer and better-contoured breasts.

Since its introduction in the 1990’s, ultrasonic liposuction has become a preferred approach to treatment of gynecomastia by many plastic surgeons.
It allows removal of the excess fat and breast tissue through two very small incisions (3-4 mm each) placed within the circumference of the areola. The entire procedure is carried out through these incisions.
The ultrasound energy helps the skin of the breast shrink back thereby significantly decreasing the potential need for skin removal. Excellent contouring of the fatty tissue often found in the underarm area is also possible with this technique.

This technique allows removal of the breast gland tissue and fatty tissue through an incision made within the lower one-half of the areola.
It works well in situations where the majority of the breast tissue is localized within a well-defined breast mound. However, it does not always provide adequate contouring if there is excess tissue in the underarm area.
If there is a significant amount of breast tissue that is directly removed, there may be excess skin that does not shrink back. This often necessitates direct excision of the skin through a separate incision.

Some surgeons will use a combination of direct surgical removal of the breast tissue and liposuction of the fatty tissue from the surrounding chest and underarm region.
Breast reduction with removal of breast tissue and removal of skin
This technique is reserved for cases of extreme Gynecomastia.
Unfortunately, it leaves extensive scars which are difficult to hide when undressed.
Fortunately, this degree of Gynecomastia is not very common.