Gynecomastia and Male Breast Reduction

What causes gynecomastia?

The excess buildup of fatty breast tissue and glandular tissue on men, forming male “breasts,” afflicts hundreds of thousands across the United States. Several different underlying causes can be the culprit behind gynecomastia, and only a doctor can diagnose the cause and draw up a proper treatment plan. Genetics may be the source, a family trait that is passed on from one generation to the next. Side effects of certain medications can cause the formation of male breasts. Sometimes, the cause is unknown. Although carrying extra weight can increase the appearance of gynecomastia, losing the extra weight will not cause the breasts to go away.

Can gynecomastia be treated?

Just because you suffer from gynecomastia doesn’t mean you are forever destined to avoid the beach and keep your shirt on. Male breast reduction is a viable option that provides permanent results to your problem. Two different treatment options are available.

• If the gynecomastia is caused by excess fatty tissue, then liposuction can be performed to remove the excess tissue and sculpt the chest. Either local anesthesia with intravenous sedation or general anesthesia will be used. Liposuction requires incisions on each side of the chest along the bottom of each areola or in the armpits in hard-to-see areas. The extra fatty tissue is removed, and the remaining tissue and skin, sculpted to create the desired look. You will need to wear a compression garment to aid in healing and the skin shrinkage process.
• Glandular excision removes both fatty tissue and glandular breast tissue. If the cause of the gynecomastia is the glands, then liposuction alone will not get the job done. Excision is used on the more severe cases of gynecomastia. Either local anesthesia with intravenous sedation or general anesthesia is used. Dr. Tolson will decide what’s best for you. Incisions are placed around the bottom edges of the areola or within the chest creases. Because more tissue and glandular tissue is removed, patients are often sorer with excision than with liposuction. You will need to wear a compression garment to aid in healing and shrinkage of the skin as well.
• Depending on what needs to be done, Dr. Tolson may choose to use a combination of both liposuction and excision, giving you the best of both worlds.

Who should consider having male breast reduction surgery?

Although fifty percent of the male population may suffer from gynecomastia to some degree, not every man should have male breast reduction performed. Those who should consider reduction surgery

• Are embarrassed to be without a shirt, play sports, or exercise in a gym.
• Feel like their body shape is out of proportion and desire to fix that.
• Have tried other treatments which have not worked to reduce the gynecomastia.
• Are maintaining a normal weight.
• Have fully developed and are no longer growing and changing. Although adolescents may benefit from male breast reduction, if the procedure is performed while they are still developing, they may need to have a second procedure later in life after they have finished growing.
• Are suffering psychological discomfort from their shape.

What goes into male breast reduction?

Consultation

If you are considering having male breast reduction performed, you need to schedule a consultation with a board-certified plastic surgeon. Dr. Tolson is certified by the American Board of Plastic Surgeons and is a member of the American Society for Plastic Surgeons and the American Society for Aesthetic Plastic Surgery. He has thirty years of experience in the cosmetic surgery field and stays on top of the best techniques for each procedure.

At your consultation, Dr. Tolson will discuss the following:

• Your overall cosmetic goals.
• Your medical history, including medicines, herbs, allergies, tobacco and drug use, and alcohol intake.
• Any previous cosmetic procedures.
• Your expectations.

He will also evaluate your skin’s elasticity and take photos to do computer imaging so that you can see the predicted outcome. Dr. Tolson may also request some tests to determine the cause of the gynecomastia.

Preparation

As the date for your scheduled procedure gets closer, you will need to start getting ready for the surgery.

• If you smoke, stop using, if you can, prior to your surgery date as the nicotine inhibits the healing process.
• Stop taking aspirin, anti-inflammatories, and any herbs that can thin the blood two weeks in advance.
• If you have chest hair removed regularly, stop two weeks before the procedure.
• Purchase any compression garments you will need to wear and bring them with you to the surgery.
• Arrange things at home so you don’t have to reach above your head to get them.
• Arrange for someone to drive you home after the procedure and stay with you the first twenty-four hours.
• If you develop a cold or chest infection, let Dr. Tolson know.

Procedure

Whether you are having liposuction or excision or a combination of the two, the procedure is an outpatient procedure and will be performed in Dr. Tolson’s state-of-the-art, AAAASF-certified operating room in Cumming, Georgia. The surgery generally takes two hours, after which you will be moved to a recovery room where one of his staff will monitor you before you are released. If a drain has been put in place, Dr. Tolson or his staff will go over how to care for it before you are released. You will need to schedule a follow-up visit within five to seven days to have any sutures removed.

Recovery

You will see immediate results from your breast reduction procedure. As with any surgery, bruising and swelling are to be expected. You will be sent home with a compression wrap on and will need to continue to wear your compression garments according to Dr. Tolson’s instructions. For best results, plan on having full rest the first three days. You will be able to sit and stand and move about the house, but don’t do any work or lifting. You should be able to return to work in three to five days as long as it’s not a heavy lifting job.

The bruises will begin to dissipate around two to three weeks. The swelling may take up to three months to fully disappear. You may have a temporary loss of sensation around the operation site. This is normal, and feeling should be fully restored after no more than one year. You will want to avoid sun exposure for at least six weeks as the sun may lead to permanent discoloration of the scars. Any loose skin should tighten around six months to one year out. If you had glandular excision performed, you may have spontaneous areolar shrinkage, up to fifty percent, take place.

Most people only have to do a male breast reduction once in their life. As long as you maintain a stable, healthy weight and don’t take any medications that can cause tissue growth, your breast reduction should be stable. The incision lines are permanent scars, but they will fade with time, leaving you with a great, new look. Most men feel free to take off their shirts and press a few rounds in the gym without any qualms. They have reclaimed their confidence.