What is Gynecomastia?
Gynecomastia is a condition of over-developed breasts in men in which the breast tissue enlarges. The condition may occur in one or both breasts and starts as a small lump beneath the nipple. Although usually benign, the breast often grows unevenly.
What causes Gynecomastia?
In some cases, the cause may be unknown. The condition can also occur due to fluctuation in hormonal changes. The changes in hormones include an increase in estrogens or a decrease in testosterone. Among older men, it also consists of an increase in body fat. There are dozens of known contributing factors to the development of this condition.
Some of these include:
- Steroid Abuse
- Thyroid disease
- Testosterone deficiency
- Liver or kidney failure
- Chronic kidney disease
- Tumors in the testicles, stomach, or pituitary gland
- Congenital syndromes present at birth
- Natural aging
- Some prescription medications and medication containing estrogen
- Use of herbal testosterone additives
- Klinefelter Syndrome
- Gilbert’s Syndrome
- Testicular hormone production irregularities
Before and After
More Gynecomastia Examples
What are the benefits?
A square, chiseled chest is the sign of a man who is fit and confident. Unfortunately, it may seem like only a dream for men living with Gynecomastia. This condition affects almost half of the male population. Thankfully, Dr. Brent performs breast reduction for men who want to tighten and tone their chests. Dr. Brent has seen remarkable increases in self-confidence in his male patients.
Who is a candidate for Male Breast Reduction?
You may be a candidate for male breast reduction if you are:
- Normal weight
- The feeling that your breasts are too large
- Have reasonable anticipations of the surgery results
Teens benefit from male breast reduction as well if their condition has been present for more than two years or if the problem is severe. In some teens, secondary procedures may occur later if breast development continues.
What should I expect during the consultation?
Your initial consultation with Dr. Brent requires your complete medical history. You should prepare and provide the necessary information. Dr. Brent will examine your breasts. A breast x-ray may determine how much fat and glandular tissue is in your breasts. This information will help Dr. Brent plan the best procedure for your needs. The consultation is also an opportunity for you to ask questions and express any concerns. Dr. Brent will give you specific instructions on what to do before your procedure. Instructions include:
- Proper diet
- Taking specific vitamins and medications
- Not smoking
You must follow his guidelines as smoking decreases circulation and impedes healing.
How does the Gynecomastia Reduction work?
Your male breast reduction surgery will be an outpatient procedure. The operation takes approximately one hour. Individual factors may increase the length of the surgery. Dr. Brent will use either general or local anesthesia to sedate you.
Dr. Brent will make an incision in an inconspicuous location. He chooses either on the edge of the dark skin around your nipple or in your underarm area. Through the incision, he will cut away the excess glandular tissue, fat, and skin from around your areola and from the sides and bottom of your breast. In a reduction of higher amounts of excess tissue, larger incisions may be necessary, resulting in more noticeable scars.
If Dr. Brent has determined you have excessive fatty tissue, he will consider liposuction/liposculpture. This procedure is a more appropriate surgical technique for the removal of this tissue. At the edge of your areola or in your underarm area, he will make a tiny incision, less than a half-inch in length, and insert the cannula. Dr. Brent will move the cannula through the layers beneath your skin, breaking up the fat and suctioning it out.
Removal of excess skin will adjust to fit your new breast contour. Occasionally, a small drain will go in through a separate incision to relieve excess fluids. Upon completion, Dr. Brent and his team will cover your incision and wrap you with an elastic bandage. The elastic bandage will hold your skin firmly in place.
AS SEEN ON
What are the different techniques used?
The techniques depend upon the quality and quantity of your excess tissue and skin. The two methods commonly used in breast reduction are suction lipectomy and endoscopic surgery. Lipectomy is tapered breast tissue, resulting in a natural look. Endoscopic surgery is a small, flexible tube with a light, and the camera gets inserted in your chest by tiny incisions. In some cases, liposculpture helps remove the fibrous fat and breast tissue that develops in the male chest. If the breast tissue is too dense and firm, occasionally, a small incision hidden around the areola is necessary to remove it. When the skin is very loose and thin and will not likely tighten up after tissue removal, an excisional skin procedure may be required.
In severe cases of Gynecomastia, the weight of excess breast tissue may cause your breasts to sag and stretch the areola. In these cases, the position and size of the areola can be surgically improved and reduces excess skin.
During your consultation, Dr. Brent will discuss different procedures with you. He will help you choose the procedure to provide the best optimal outcome for your situation. The options include:
The removal of the fatty tissue by suction using a negative pressure source (pump or syringe). This technique is usually performed with the tumescent method to decrease bleeding
The removal of tissue by surgical excision, usually performed through the lower part of your areola and the skin.
The procedure will typically leave inconspicuous scars.
COMBINED PSEUDOGYNECOMASTIA AND TRUE GYNECOMASTIA
Combination of surgical excision and liposuction for better breast contour
FOR THE TREATMENT OF SEVERE GYNECOMASTIA ARE:
Periaureolar (incision around your nipple-areola complex) male breast reduction:
- The procedure is for mild to moderate reductions
- Classical breast reduction with superior or inferior flaps: For more massive breasts (C, D) leaves an inverted xTx incision and Periareolar incision
- Vertical incision breast reduction: Vertical subareolar scar (not horizontal scar) in large breasts
What can I expect during recovery?
You should arrange to be driven home after your surgery and have someone help you manage for a day or two if necessary. It is normal to feel some discomfort for a few days after your procedure. Prescribed medication can reduce the pain. Bruising and swelling may occur. You will have to wear an elastic pressure garment around the clock for at least two weeks then at night for several weeks until you heal. Any extreme swelling will resolve in the first few weeks, but it may be three months or longer before your true result is visible. While you are waiting for this outcome, it is essential to begin to resume regular activity.
After the surgery, you should avoid:
- Sexual activity for approximately two weeks
- Strenuous exercise for three weeks
- Any action or job that risks a blow to your chest area for at least a month
- Exposing your scars to the sun for at least six months because sunlight will darken your scars permanently
Gynecomastia reduction surgery improves your appearance. It is essential to remember that individual results are unpredictable. The results of the procedure are significant and have patients satisfied with their improved physique.
Male Breast Reduction in Beverly Hills and Los Angeles
Dr. Brent Moelleken is a double board-certified plastic and reconstructive surgeon in Beverly Hills. He is one of the most highly skilled surgeons in the country and has received his training at Harvard, Yale, and UCLA. Due to his commitment to patient outcomes, he has been selected as one of Vogue Magazine’s “Top 10 Plastic Surgeons in America.” Contact Dr. Brent today for a consultation.