Male Breast Reduction
(Surgery for Gynecomastia)
Despite the fact that enlarged breasts in men, also known as gynecomastia, is a relatively common occurrence, their presence tends to be associated with significant mental distress, embarrassment, low self-esteem, depression and insecurity. The impact on daily activities, social interactions and dating can be dramatic particularly in boys and younger men. Otherwise inconsequential acts such as removing one’s T shirt at a beach, pool or to play sports can be extremely terrifying. Many men will wear very baggy clothes or multiple layers even in hot weather in order to camouflage their “deformity.”
- Causes of Gynecomastia
- Gynecomastia Symptoms
- Examples of Gynecomastia
- Difference Between Gynecomastia and Pseudogynecomastia
- Gynecomastia vs. Male Breast Cancer
- Does Health Insurance Cover the Treatment of Gynecomastia?
- Can Gynecomastia Be Treated with Exercise?
- Surgical Techniques for Male Breast Reduction
- Your Surgery for Treatment of Gynecomastia
- Recovery from Surgery for Gynecomastia
- How Much Does Male Breast Reduction Cost?
- Male Breast Reduction Before-and-After Photos
- Frequently Asked Questions
- Additional Information About Breast Reduction from Dr. Turkeltaub’s Blog
Causes of Gynecomastia
The most common etiology of this condition relates to the effects of elevated hormonal levels occurring during puberty. A majority of these enlargements do spontaneously resolve following puberty. There are many other causes of gynecomastia including:
- Steroid abuse
- Medication side effects
- Illicit drugs such as marijuana
- Hormonal imbalances such as caused by tumors
- Chronic liver disease
- Genetic disorders
The primary symptom of gynecomastia is the enlargement of glandular tissue in the breasts. Though most often occurring in both breasts, on occasion it may just be present on one side. There can also be asymmetric involvement with one side significantly larger than the other.
This overdeveloped tissue is often accompanied by extra fat for many individuals. In extreme cases, there may be a relative excess of lax skin associated with drooping of the breasts and cup sizes that can be a “C,” “D” or even larger.
Tenderness of the breasts may be present infrequently. It is extremely rare that this enlargement is associated with substantial pain.
Examples of Gynecomastia
The extent of the enlargements can range from being imperceptible to all but the male involved to massive, overly projecting, drooping double D or larger breasts.
Mild Gynecomastia in a 16 year old male with
enlargement localized to the areola area.
Moderate Gynecomastia in a 16 year old male
Severe Gynecomastia in a 14 year old male
Difference Between Gynecomastia and Pseudogynecomastia
The term “gynecomastia” is often used to universally describe excessive breast tissue in males, but the condition may more appropriately be categorized as “pseudogynecomastia” when fat tissue is the cause of the enlargement.
In true gynecomastia, extra glandular tissue is the main cause of overly large male breasts. Often manifesting during puberty as a result of hormonal fluctuations, this accumulation of tissue typically resolves naturally for most males. However, in the event the condition does not resolve on its own, the most effective treatment is direct surgical excision of the excess glandular tissue. (For additional causes, please reference the list above.)
In pseudogynecomastia, the primary cause of enlarged male breasts is the development and buildup of an abnormal quantity of fatty tissue, which is often linked to an excess of weight. Some males may find that diet, weight loss and exercise (including certain chest-related weight lifting techniques) helps to improve pseudogynecomastia, but the majority of individuals require fat removal via liposuction to comprehensively resolve the condition.
Since true gynecomastia and pseudogynecomastia have virtually the same symptoms, distinguishing between the two conditions is not always possible until the time of surgery. For this reason, selecting a breast surgeon who is highly proficient and has considerable experience in both direct tissue excision and liposuction is essential to helping ensure you receive the safest, most effective treatment and best possible outcome.
Gynecomastia vs. Male Breast Cancer
According to the National Institutes of Health (NIH), about one percent of all breast cancers occur in men. Gynecomastia, a condition characterized by the overdevelopment of male breast tissue, has never been shown to be associated with an increased risk for breast cancer. Nevertheless, it is important to discern the differences in glandular tissue in gynecomastia versus male breast cancer.
Gynecomastia due to glandular tissue overgrowth presents as a smooth, firm growth underneath the nipple and/or areola. This condition may be present in one or both breasts and often is associated with tenderness in the area. Contrarily, male breast cancer typically appears as an irregular growth with a rubbery or hard feel. The tumor can form anywhere on the breast, including underneath the nipple, but breast cancer is more likely to be confined to one breast as opposed to both.
For those who are unsure and/or concerned about any irregularities found on their chest, it would be quite prudent to have a qualified medical professional perform an evaluation. When detected early, the success rate of breast cancer treatment for men can be quite high. As for gynecomastia, when male breast reduction is skillfully performed by a board-certified plastic surgeon, the outcome can be quite dramatic and rewarding—physically and mentally.
Does Health Insurance Cover the Treatment of Gynecomastia?
Considering it to be an aesthetic issue, insurance companies do not provide coverage for the surgical treatment of gynecomastia. Board-certified plastic surgeon Dr. Steven H. Turkeltaub does offer special and affordable package pricing in conjunction with the outpatient center and the anesthesiologist that can help make your surgical treatment a reality.
Can Gynecomastia Be Treated with Exercise?
Unfortunately, most of the time male breast reduction surgery is needed to fully address gynecomastia. For men whose enlarged breasts are largely related to obesity, weight loss and exercising can be very effective in improving the appearance of the breasts but they usually do not completely eradicate the problem. Surgery is often indicated as well.
When the main cause of gynecomastia is glandular tissue (with or without the presence of some excess fat), exercise alone will definitely not resolve the condition. In these situations, the direct excision of the breast tissue is mandatory for proper, effective treatment. If there is also some fat contributing to the enlargement, this component can be removed using liposuction.
Ultimately, it is important to note that although men who are overweight may see some degree of improvement with exercise and weight loss, these methods alone may not fully eradicate the manifestations of gynecomastia. For this reason, male breast reduction surgery is considered the definitive treatment for the vast majority of individuals.
Surgical Techniques for Male Breast Reduction
Men with gynecomastia have variable and increased amounts of fat and glandular tissue. Those who are obese tend to have a greater proportion of fat and will see benefits from weight loss though it usually doesn’t fully eradicate the problem. With extreme enlargements, there can also be a relative excess of skin, possibly even with drooping.
The definitive treatment for gynecomastia is surgery aimed at removing the extra tissue and recontouring the breasts. Fortunately, the results can be quite successful and dramatic. The most common approach is to use Ultrasonic assisted liposuction with or without direct excision of the enlarged breast tissue. One or two small incisions per side, usually less than 3/8″, may be the only incisions needed. They can be placed along the lower part of the nipple, in the crease at the bottom of the breast or even in the armpit. If direct excision of breast tissue is warranted, then an incision involving the lower half of the areola is typically used.
In the relatively rare situations where the breasts are massively enlarged, droopy and there is an abundance of excess skin with poor elasticity, then a much more extensive procedure with lengthy incisions needs to be considered in order to obtain appropriate correction.
Your Surgery for Treatment of Gynecomastia
The surgery to reduce the size of your breasts is done under general anesthesia as an outpatient and typically takes under two hours. Many men frequently combine this with other cosmetic procedures, particularly liposuction of their love handles and abdomen.
Recovery from Surgery for Gynecomastia
A compressive dressing will be place at the time of your surgery which will help to minimize bruising, discomfort and swelling. After two to three days, it is replaced in the office with a snug fitting elastic sports shirt like Under Armor® which is worn most of the time for one or more weeks.
Discomfort for most men is fairly mild and usually well controlled with oral pain medication. Many patients can return to work or school or work within a few days and resume sports and working out at around 2 ½ weeks. It may take from six months to a year for all the swelling to maximally resolve.
How Much Does Male Breast Reduction Cost?
As with most plastic surgical treatments, the total cost of male breast reduction surgery will include fees for the surgeon, anesthesia and usage of the surgical facility, whether it is an office, hospital or outpatient center. In addition to these expenses, the following factors can also impact the overall price of the procedure:
- The general geographical area in which the practice is located and/or the surgery is performed
- The credentials, skill, personal preferences and experience of the plastic surgeon
- The surgical technique employed by the physician (tissue excision, liposuction or both)
- The number of available surgical facilities in the region, as well as the particular facility selected
- Any postoperative medication that may not be fully or partially covered by insurance
- The current state of the economy
Since gynecomastia is considered to be an aesthetic issue in virtually all situations, the male breast reduction procedure is rarely covered by health insurance which means that patients will likely be responsible for paying all expenses out-of-pocket. In order to help make treatment more affordable, Dr. Turkeltaub’s practice partners with trusted third-party lending companies like CareCredit® to offer various breast enhancement financing and payment plan options.
For a personalized estimate of what your gynecomastia treatment may cost, please schedule a consultation with Dr. Turkeltaub. Based on a thorough assessment of your specific needs and goals, he will be able to provide a close approximation of the overall cost of your male breast reduction procedure.
Male Breast Reduction Before-and-After Photos
The psychological and physical benefits that occur as a result of undergoing surgery to correct male breast enlargement can be quite profound and rewarding.
Is it rare for a man to have enlarged breasts?A.
It is actually fairly common for men to have enlarged breasts. The underlying cause most of the time is related to the persistence of enlarged tissues that develop during puberty. There are many other causal factors as well such as obesity, anabolic steroids, many prescription medications and marijuana.
Where are the incisions most commonly placed for the surgery? Are they conspicuous?A.
Dr. Turkeltaub most commonly uses incisions placed either along the lower part of the nipple or in the crease at the lower part of the breast. Most all of the time, these heal well and can be fairly inconspicuous.
What happens to the extra skin?A.
If you have good skin tone (elasticity), most of the time it will contract and contour to the underlying structures. If you have massively enlarged breasts with or without saggy skin, excision of the excess skin may be warranted and would be discussed prior to your procedure.
How soon after surgery can I return to work?A.
If you have a relatively sedentary job, you may be able to return to work within a few days. For jobs that are physically strenuous and demanding, Dr. Turkeltaub recommends waiting approximately two weeks though you may be able to do light and modified work sooner.
Additional Information About Male Breast Reduction (Gynecomastia) from Dr. Turkeltaub
Read more about male breast reduction (gynecomastia) on Dr. Turkeltaub’s breast surgery blog.
Learn More About Gynecomastia Treatment
If you would like to learn more about gynecomastia treatment or to schedule an appointment with Dr. Turkeltaub, you can contact us at the Arizona Center for Breast Surgery.