What is gynecomastia?
Gynecomastia is a common condition that affects up to two-thirds of adolescent males as a result of a hormone imbalance during puberty. In most teens, the excess glandular tissue resolves naturally over time. But in approximately 1 out of 4 men, the excess tissue persists, resulting in features such as a puffy nipple, a breast mound, or other unfavorable contours like overdeveloped or enlarged breasts. You may have gynecomastia if you feel rubbery, firm tissue under your areola (nipple area) or firm tissue that extends to the outer part of your chest.
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Can a plastic surgeon improve gynecomastia?
Yes, a plastic surgeon can remove excess tissues to improve the appearance of the chest. This procedure is colloquially called male breast reduction or gynecomastia surgery (reduction mammaplasty is the technical term). San Diego board certified plastic surgeon Dr. Katerina Gallus has over 15 years of experience performing male breast reduction for gynecomastia.
You may be a good candidate for male breast reduction if…
- You have enlargement of one or both breasts
- You are self-conscious about the condition
- You are motivated to improve your appearance through surgery
- You are at a stable, healthy weight
- You are not taking blood thinner medications or using nicotine products
How gynecomastia surgery works
There are several ways to approach excess male breast tissue, but the most common ways involve a combination of direct removal (excision) of the glandular tissue and liposuction. If you have excess tissue and skin, you may also require skin excision in addition to surgical reduction of the breast tissue.
What to expect from the procedure
Male breast reduction surgery is most often performed under general anesthesia to offer maximum comfort and ensure safety. The surgery usually takes 1-2 hours depending on your degree of gynecomastia and individual surgical plan. Dr. Gallus will carefully mark the areas of excess tissue and fat and mark the planned incisions on the breast(s) prior to surgery.
Dr. Gallus will begin with small incisions on the chest to infuse saline fluid containing lidocaine (for numbing the area) and epinephrine (to decrease bleeding) in the chest area. Using liposuction, Dr. Gallus will then remove the unwanted excess fat from the breast. Next, a small incision is extended around the bottom edge of the areola, and the excess glandular tissue is removed. Glandular tissue feels firm or rubbery—differing from fatty tissue—so direct excision in conjunction with liposuction is the most effective treatment to achieve optimal results. In certain cases, skin excision is performed, so be aware that the type of incision and technique used is tailored to your individual appearance and desired outcome.
Once the tissue is removed and an optimal chest contour is achieved, the incisions are closed with absorbable sutures. Most patients do not require drain placement. Surgical dressings are applied and a compression vest is placed to ensure that swelling is minimized and a smooth contour is maintained.
Our preferred liposuction technique
At Restore SD Plastic Surgery, we utilize the SAFELipo™ liposuction technique to safely and consistently offer optimal results. The procedure starts with power assisted liposuction (PAL®). PAL® uses small vibrating cannulas (hollow metal tubes) to assist in loosening and suctioning the unwanted fat cells. PAL® decreases surgeon fatigue (compared with traditional lipo) and improves surgical precision—all while reducing tissue trauma for a quicker recovery.
Recovery after surgery
Gynecomastia is an outpatient surgery, so once you have recovered from anesthesia you are able to go home with a responsible adult. You should arrange to have a friend or loved one stay with you for the next one to two days. Here is what you can expect in the weeks following gynecomastia surgery:
- Some surgical pain is expected and is treated with pain medications.
- Most patients will not have drains to care for.
- While you will be able to shower the next day, you should refrain from soaking in a tub or swimming for 2 weeks.
- You will be able to engage in normal daily activities such as eating and walking after 24 hours, but intense physical activity and exercise should be avoided for 4-6 weeks.
- Most patients return to work after 1-2 weeks.
- You will wear the compression vest for 4-6 weeks after surgery.
During the recovery period, you will have follow-up with Dr. Gallus and will be guided back to your usual activities. Most complications occur from getting too active too early, so select a surgical date that allows an appropriate amount of time to heal and gradually return to your more vigorous activities.
Dr. Katerina Gallus is board-certified by the American Board of Plastic Surgery (ABPS) and has over a decade of experience in cosmetic breast and body surgery, facial rejuvenation, and breast reconstruction. A trusted surgeon, her opinions are nationally respected, and she is a requested expert for meetings, panels, and journal articles.
Commonly combined procedures
In many cases, gynecomastia surgery can be combined with other aesthetic procedures; the most common combination procedure that patients choose is liposuction for other areas of the body. We can often use SAFELipo™ to address stubborn fat around the waist, for example, easily and safely during the same procedure as male breast reduction.