Male Breast Reduction (Gynecomastia Repair)

Overview

Overly large male chests can cause emotional issues and poor self-esteem for men.

Gynecomastia repair, or a male breast reduction, is a surgical procedure that removes excess chest tissue through incisions made on the chest. In addition to the reduction, the procedure also uplifts the nipples and can reduce their size to one that is in proportion with your body, thereby alleviating the discomfort associated with overly large breasts.

After massive weight loss, gynecomastia repair can eliminate a lot of the extra skin on the chest extending out to the sides of the chest as well.

Who Is a Candidate?

Gyencomastia repair is a highly individualized procedure. It can be a good option for you if you are physically healthy, but are bothered by the feeling that your breasts are too large.

Chest reduction can help you comfortably resume your normal activities of daily living, but you must be willing to accept permanent scars on the chest.

Male Breast Reduction (Gynecomastia Repair) Risks

In addition to the risks associated with anesthesia, other risks can include scarring, infection, and changes in nipple or breast sensation, which may be temporary or permanent.

From a cosmetic standpoint there may be breast contour and shape irregularities, and there may be a need for future surgical revisions. The decision to have breast reduction surgery is extremely personal and you’ll have to weigh your goals against the potential risks and complications.

Not every person is a candidate for this procedure, and your risks may be greater or different than those of other patients. Your plastic surgeon will review all potential risks and complications with you prior to the surgery.

Before the Procedure

The success and safety of your procedure depends on your complete honesty during your initial consultation with the plastic surgeon. You’ll be asked a number of questions about your:

• Health
• Lifestyle, including your reasons and expectations for the surgery
• Desired outcome

You’ll be asked about certain medications such as testosterone, marijuana, and other drugs that may cause gynecomastia as a side effect. Most cases are idiopathic, meaning there is no understood cause of the enlarged breasts in men. 

You will have to provide a detailed history of your medical condition(s), drug allergies, and use of current medications.  A physical exam will check for masses in the chest, and possibly in the testicles.

Notify your doctor of any previous surgeries or family history of breast cancer, and provide the results of any mammograms or previous biopsies. As part of the preparation, your surgeon will examine your breasts and may take detailed measurements and photographs of their:

• Size
• Shape
• Skin quality
• Placement of nipples and areolas

Some of the specific instructions you’ll receive about preparing for surgery include:

• Smoking cessation
• Medications to avoid
• When to take your prescribed medications
• Proper washing techniques
• Restrictions regarding eating and drinking the night before surgery

Procedure Details

Gyencomastia repair usually is performed through incisions made on the breasts under the nipple with surgical removal of the breast’s excess glandular tissue, associated excess fat tissue, and excess skin. In some cases, liposuction may be used in conjunction with the surgery to remove excess fat.

In rare cases where the large breast size is primarily due to fatty tissue and excess skin is not a factor, liposuction alone may be used for gynecomastia reduction. For men with large breasts, the nipples may need to be completely relocated while being preserved on some tissue on the chest. For men with lots of loose skin, the nipples may need to be removed and sewn back on as a skin graft. Larger reductions may require a scar across the entire chest.

The surgical technique used will be determined by your:

• Breast anatomy
• Composition
• Amount of reduction desired
• Surgeon’s preferences 

Several incision options are available, and your surgeon will discuss each in detail with you. Incision lines are permanent but will fade and significantly improve over time.

Type of anesthesia

Your doctor will recommend the best type of anesthesia for you, but local anesthesia along with intravenous sedation or general anesthesia can be used.

Where Will the Surgery Be Performed?

Breast reduction surgery usually is done in a hospital as outpatient surgery and you must be driven to and from the hospital by a friend or family member.  Some patients may spend the night in the hospital.

Immediate Postoperative Recovery

This is considered major surgery and following your physician’s instructions are important to the procedure’s success.  It is important that the surgical incisions are not subjected to excessive force, abrasion, or motion during the time of healing. Your doctor will give you specific instructions on how to care for yourself.

Short-term Recovery

When the procedure is complete, dressings or bandages will be applied to the incisions, and an elastic bandage will be worn to minimize swelling and support the chest as it heals. You will be given specific instructions about caring for the surgical site and which medications to take or apply directly on the breasts to aid with healing and reduce the risk of infection.

Anticipated Results

The results of gynecomastia surgery will be long lasting. Your new chest size should help relieve the physical and emotional limitations you may have experienced prior to the chest reduction. Your chest generally will have a better shape and more proportional with your physique. Over the course of time, your chest may slightly change due to aging, weight fluctuations, and gravity.