WHAT IS GYNECOMASTIA?
Gynecomastia is the enlargement of male breast tissue caused by a hormonal imbalance between testosterone and estrogen. It often occurs during puberty and usually resolves on its own, but it can become permanent in older men, sometimes requiring male breast reduction surgery.
Though not a serious health issue, gynecomastia may cause breast pain and emotional discomfort, affecting self-esteem. It typically appears as glandular tissue under the nipple, sometimes causing soreness and misshapen growth.
Gynecomastia surgery is performed to reduce enlarged breasts in men. Liposuction and excision are ideal methods for removing male breast tissue. Extreme cases may require the removal of excess skin and reposition of the areola and nipple.
Male patients living with gynecomastia are considering their options for plastic surgery. This is not always an easy decision, it requires careful consideration of the patient’s symptoms and health status to determine if male breast reduction surgery is the most appropriate avenue for treating this condition and restoring masculine chest appearance.
WHAT CAUSES GYNECOMASTIA?
PHYSIOLOGIC CAUSES
This condition is commonly seen in males in their early to mid-teens and typically recedes by the time they reach the age of 18. About one quarter of all gynecomastia cases are physiologic in nature, which means that no treatment options are necessary. Patience is the best possible solution to a problem that will disappear on its own as excess fat in the breasts decreases naturally.
PHARMACOLOGIC CAUSES
Enlarged male breasts can result from medications, drugs, or supplements that disrupt hormone levels, including hair loss treatments (finasteride, spironolactone), antibiotics (ketoconazole, metronidazole), blood pressure drugs (amlodipine, verapamil), GI medications (cimetidine, omeprazole), hormones (steroids, estrogen), psychiatric drugs (Valium, amitriptyline), and cannabis use. Stopping the offending substance often resolves the condition, but further treatment may be needed if symptoms persist.
PATHOLOGIC CAUSES
Gynecomastia may also be caused due to a variety of serious health issues. Tumors found in the breast, the brain, the testicles, or the adrenal gland are among the leading pathologic causes of this condition. Certain chronic diseases of the liver, kidneys, and thyroid have also been shown to cause enlarged male breasts. If a male patient is experiencing any of these health problems, a full medical diagnosis by a plastic surgeon must be made before any breast tissue treatment options can be recommended.
IDIOPATHIC CAUSES
In some instances, the cause of gynecomastia could be a development of fatty tissue runs in the family. A brother, an uncle, perhaps a father, some or all have had enlarged male breasts at some point in his life and a patient's condition can be directly correlated to a hereditary link. It is not entirely uncommon to have excess fat in the breasts well after puberty has come and gone without any other attributable health issue. Don't worry, there are effective options for treating idiopathic causes of enlarged male breasts and most plastic surgeons won't recommend surgery to correct the problem.
PSEUDOGYNECOMASTIA
Men who are showing the symptoms of gynecomastia may not actually have the condition. Males concerned about excess fat buildup in the breasts could be dealing with pseudogynecomastia instead of the alternative. This is common in males who are overweight or obese and those who have lost weight but have not seen the skin of the breast retract as expected once the fatty tissue has been reduced or eliminated.
Why choose Dr. Wiser?
What techniques are used for gynecomastia treatment?
In cases whe the excess breast tissue is the root cause of gynecomastia, liposuction is usually the best form of treatment. This is performed using a cannula, which is a long, thin tube that is inserted in through many tiny incisions.
That cannula the releases the excess fat before using vacuum suction to remove it. There are many liposuction techniques from which to choose, the most effective method to target the concerns of the patient is decided upon before the procedure is started.
For cases where fatty tissue or excess skin removal is the reason for gynecomastia, excision techniques will be necessary to correct the problem. Male patients who want a sculpted chest that looks natural may require excision to reduce or reposition the areola or nipple to achieve the desired results. It is not uncommon for liposuction and excision techniques to be used together for the desired bodily aesthetic.
Are you a candidate for gynecomastia surgery?
The cause and symptoms of gynecomastia can be varied and in some, but not all cases, plastic urgery is the best option to solve the problem. However, gynecomastia surgery as part of the male breast reduction process is not always the right fit for each individual. We must first ascertain if any male patient is a good candidate for gynecomastia surgery.
The following criteria are just some of the important factors that can demonstrate whether or not a male patient should undergo this type of surgical procedure:
The gynecomastia is unable to be treated through treatment options other than surgery.
The patient is in good physical health with no current life-threatening illness or health condition.
The patient is a non-smoker and does not use recreational drugs.
The shape and growth of the breast has stabilized and fully developed.
The patient has experienced emotional discomfort due to concerns over his appearance and feels gynecomastia surgery is a realistic and necessary option.
HOW TO PREPARE FOR GYNECOMASTIA SURGERY?
Good candidates for gynecomastia surgery are in good physical health, which may require lifestyle changes before the procedure to ensure optimal results and recovery.
At WiserMD, Dr. Wiser performs thorough lab tests to identify and address any abnormalities before surgery. To support healing, patients receive a nutritional supplement to strengthen the immune system and an antiseptic soap to minimize infection risks.
Key preparations include reducing sugar, increasing fruits and vegetables, exercising regularly, avoiding tobacco, alcohol, and hormonal supplements. A healthy patient leads to a faster recovery and better outcomes for male breast reduction.
RECOVERING FROM GYNECOMASTIA SURGERY
Recovery after male breast reduction typically takes 4-6 weeks, varying by procedure. The first 48-72 hours may involve pain, swelling, and discomfort, managed with prescribed medication and a compression garment. Dr. Wiser uses advanced pain management techniques to block sensation for 12-24 hours post-surgery.
Gradual resumption of activities is advised as swelling decreases. Follow-up consultations ensure proper healing and adherence to recovery guidelines, including continued use of compression garments and medications.
WHY CHOOSE DR. ITAY WISER AS YOUR GYNECOMASTIA SURGEON?
Dr. Itay Wiser is a New York Licensed and Israeli Board Certified Plastic Surgeon. The author of over fifty peer-reviewed scientific publications, Dr. Wiser is currently serving as Chief of Plastic and Reconstructive Surgery at Mount Sinai Elmhurst Hospital. Prior to this position, he completed a reconstructive microsurgery fellowship specializing in aesthetic and reconstructive breast surgery at Lenox Hill Hospital and a Lymphedema surgery fellowship program at Memorial Sloan Kettering Cancer Center.
Dr Wiser has vast experience in treating Gynecomastia and he's performed well over 500 cases of male breast reductions using different surgical approaches, in the United States and throughout the world.
His primary interest of research is patient reported outcome measurement and presents his work at plastic surgery conferences around the world. These are just some of the reasons why you should choose Dr Wiser to perform gynecomastia surgery.
How long does the surgery take?
Most gynecomastia surgery procedures take roughly one to two hours to complete. The amount of tissue that must be removed can affect the overall time of the procedure.
When can I return to work?
While it is highly recommended to avoid strenuous activities for about two to three weeks, patients typically return to work in just a few days. As long as the workday does not encompass a lot of physical exertion and caution is used at all times.
Can gynecomastia return after surgery?
Though gynecomastia surgery offers long-term results, it is possible for the condition to return after surgery. This will typically occur if the initial causes or lifestyle habits that led to the male breast enlargement are not ceased after surgery. This is why lifestyle changes must be made prior to surgery, so the patient can live a normal, healthy life after the operation is complete.
The surgical techniques that Dr Wiser uses, the reported return rate is less than 1%.
Can you build muscle after gynecomastia surgery?
Yes, it is possible to build muscle after the male breast reduction surgery is performed. However, it is important to be extremely cautious about resuming any form of exercise for roughly four to six weeks to allow a full and complete recovery from gynecomastia treatment.
Can exercise get rid of gynecomastia?
Yes and no. If your gynecomastia is mostly composed of fat tissue the answer is yes: exercise can be an effective means for male breast reduction without the need for surgery. In these cases, natural weight loss is the best solution. If your gynecomastia is mostly composed of glandular tissue the answer is no, surgery is typically performed as an effective option.
How can I sleep after gynecomastia surgery?
It's important to sleep with your back elevated at a 45 degree position for at least the first two or three weeks of recovery. It is recommended not to sleep on the stomach or on your side during that time.
What incisions are there with gynecomastia surgery?
All gynecomastia surgery for male breast reduction requires the use of incisions. The locations of these incisions are chosen carefully to conceal the scars that are left behind. We make every effort to make incisions at or near the natural contours of the breast or pigmented areas of the areola to reduce visibility. Incisions may also be placed under the armpit. In situations where there is excessive breast skin, more incisions may be needed to achieve a male-appearing breast.
HOW MUCH DOES GYNECOMASTIA SURGERY COST IN NEW YORK?
Determining the cost of gynecomastia surgery in New York depends on individual needs and treatment plans, which can only be assessed after a consultation. Once the severity of the condition is evaluated, an accurate cost estimate can be provided. Many insurance plans may cover the procedure fully or partially, and Dr. Wiser's team can assist in navigating insurance coverage and recommending next steps.