GYNECOMASTIA

WHAT IS GYNECOMASTIA?

Both men and women have breast tissue beneath the nipple areolar complex. Gynecomastia is enlargement of male breast tissue. In its mild forms, it can cause a puffy appearing nipple and in its more severe forms, can cause the appearance of developed feminine-appearing breasts. This condition is a common medical problem and leads to embarrassment, poor self-esteem, and avoidance of intimacy for many men. A dramatic improvement can be achieved with surgical correction. After surgery, patients no longer feel self-conscious removing their shirts at the pool or wearing more tailored clothing.

WHAT CAUSES GYNECOMASTIA?

Most cases of gynecomastia are related to adolescent hormone changes. While some cases reverse over time, others persist. A smaller subset of cases are due to other causes such as certain medications, anabolic steroids, marijuana use, hormone imbalances which tend to occur in middle age, or testicular tumors. Evaluation by a primary care physician and possible laboratory testing are important before surgical management to rule out more serious conditions.

WHAT IS PSEUDOGYNECOMASTIA?

Pseudogynecomastia is excess fatty tissue related to weight gain that mimics the appearance of gynecomastia. Patients often have a combination of fatty deposition (pseudogynecomastia) and breast gland enlargement (gynecomastia).

HOW IS GYNECOMASTIA TREATED?

After the cause of gynecomastia has been identified and adequately treated, surgical correction can be performed to remove excess tissue and create a flat chest contour, restoring masculine appearance. The surgical plan is dependent on a patient’s individual anatomy and typically includes some combination of liposuction, gland removal, areolar reduction, and skin removal. For milder cases of gynecomastia, Liposuction is performed through very small incisions that are hidden in the axillae (arm pits) or areolar border. If there is glandular tissue remaining after liposuction, it is removed through one or two incisions around the areolar border. The size of the areola may also be reduced through these incisions. For patients with significant skin excess, skin is removed through an incision that is placed below the pectoralis muscle and the nipple is relocated as a free graft.

WHAT IS RECOVERY LIKE AFTER GYNECOMASTIA SURGERY?

Recovery is fairly easy and patients return to work and daily activities within a few days. We ask all patients to limit exercise to walking only in the first two weeks with a gradual return to cardio then weightlifting over the next few weeks. Patients are provided with a compression vest to wear in the first few weeks to reduce swelling. Some patients require closed suction drains after surgery that stay in placed for up to 1 week. These drains help prevent a complication called seroma, accumulation of fluid created by the body in response to surgery.