Male Breast Reduction (Gynecomastia)
Commonly referred to as “man boobs”, enlarged male breasts (either one or both breasts) can result in self esteem issues that my lead to the wearing of heavy shirts and sweaters and the avoidance of athletic activities that may reveal the condition to others. This can especially hold true for adolescent males who may be the subject of teasing from their contemporaries and thus experience social trauma. However, this is not an unusual condition and is present in an estimated 40-60 percent of the male population.
The causes of gynecomastia can be varied and in a significant number of cases the causes can be unknown. However, contributing factors can be the use of steroids, medications containing the use of estrogen, alcohol, hormonal imbalances and heredity factors. The results are an increase in fat and glandular tissue in the breasts that cannot be addressed with diet or exercise. In some cases, exercise may even make the condition more noticeable.
Candidates for Gynecomastia Procedures
An initial consultation with a qualified cosmetic surgeon is essential to determine if this procedure is right for you. Good candidates for surgery include those who have firm and elastic skin that will allow for effective re-shaping of body contours.
Gynecomastia surgery should be performed when the patient has passed puberty and fully mature, physically and emotionally. This will also allow the opportunity for the condition to correct itself, as it does in some cases by age 18 or 19. Exceptions to this may be in cases where the emotional trauma is severe. This should be discussed, with the plastic surgeon, in a free consultation with the patient and parents in order to make an informed decision.
The procedure depends on the extent of the gynecomastia. In some cases, liposuction is indicated and in others, the surgical removal of excess fat, glandular tissue and skin is necessary. The procedure is similar to a female breast reduction, in this respect. The procedure is performed using either local or general anesthesia and takes between three and four hours. The procedure is usually performed on an outpatient basis.
Liposuction would be used in cases where the cause of the gynecomastia is simply fatty deposits in the breast area as opposed to excess skin and glandular tissue. In the liposuction procedure, small incisions are made near the nipple and the excess fat is suctioned out through a thin hollow tube (cannula). The results, although permanent, may be less noticeable should subsequent obesity occur.
In he case of surgical removal of glandular tissue, an incision is made at the lower edge of the areola and the glandular mass is removed through this site. This area is subsequently contoured (sometimes with the assistance of liposuction).
In rare instances where the excess skin also needs to removed, incisions are made underneath and around the areola as they would be in a female breast reduction or breast lift. The incisions are then sutured and bandages will be applied to protect the area.
It is advised that the patient have someone to drive him home after the gynecomastia surgery due to the effects of the anesthesia. Downtime is limited with the procedure and the patient usually returns to work within a week – longer in cases of strenuous work activity. There will be some pain along with bruising and swelling and the doctor will typically prescribe pain medication for this.
Also an elastic pressure garment will be prescribed for 3-6 weeks in order to assist with the healing process. There should be also be no exposure of the surgical area to the sun for 6 months after surgery. The patient will enjoy a more firm and contoured chest that can later be further enhanced with exercise.
Complications and Side Effects
Complications and side effects from gynecomastia surgery are rare, but can include an adverse reaction to anesthesia, bleeding, infection and excess fluid accumulation under the skin. The amount of scarring is dependent on the procedure, but is usually minimal. There can also be asymmetry issues involving size of the breasts and placement of the nipples.
In some cases, additional surgery may be indicated in order to correct asymmetry issues. The most important thing to note is that even though complications are relatively rare, the possibilities should be discussed, in detail, with your doctor prior to surgery.
Costs of Gynecomastia Surgery
The costs of gynecomastia surgery are dependent on the extent of the procedure and the credentials of the cosmetic surgeon. Costs are usually broken down into three major components: the surgeon’s fee, anesthesia and facility fees. The total costs and fees should be discussed with your doctor prior to surgery, but in general, the expenditure will run between $2500-$3200.
You should also consult your health insurance provider regarding coverage. However, gynecomastia surgery is not usually covered by medical insurance. But most surgeons offer multiple options for financing in order to make the procedure more affordable.
Things to Know Prior to Surgery
Before making the decision to have gynecomastia surgery, there are several things that you need to determine. First of all, it’s important to know the qualifications of the surgeon who will be performing the procedure. When choosing a surgeon, you should look for a board-certified plastic surgeon. The surgeon chosen should have extensive experience in all types of breast surgery.
Please note that the type of certification is important. There are more than 150 self-designated boards, but only a handful that are designated by the American Board of Medical Specialties (ABMS), such as the American Board of Plastic Surgery. You should also request to see a sizable number of before and after photos as well as obtaining patient references.