WHAT IS GYNECOMASTIA?
Gynecomastia is a condition in which the male breast tissue becomes enlarged or overdeveloped in boys or men due to a hormonal imbalance of testosterone and estrogen. The result is an increase of excess breast tissue in one or both of the breasts. This condition often affects young boys who are going through puberty and, in most cases, will correct itself over time.
However, there are other causes for gynecomastia and the condition can become permanent in older men, resulting in the necessity for male breast reduction surgery. While gynecomastia is not a serious health concern, boys and men who suffer from the condition may experience pain in the breasts. There may also be a self-esteem component as this condition can cause emotional discomfort due to embarrassment or lack of confidence in one's physical appearance.
Gynecomastia will typically manifest in the form of an accumulation of glandular tissue located under the nipple. There may be a sensation of soreness on or around the affected area. The breast tissue may continue to grow larger and slightly misshapen.
WHAT CAUSES GYNECOMASTIA?
Gynecomastia may be the result of many possible causes:
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 may also be due to taking certain medications, drugs, or nutritional supplements that have been shown to cause this condition in males.
Among the biggest culprits are medications such as finasteride, cyproterone, and spironolactone, which are often prescribed to treat conditions like hair loss and enlarged prostate and are formulated to block the production of male hormones.
Other common pharmacologic reasons for excess fat in the breast tissue include the following:
- Antibiotics (Isoniazid, Ketoconazole, Metronidazole)
- Blood pressure medications (Amlodipine, Verapamil, Enalapril, Nifedipine)
- GI medications (Cimetidine, Ranitidine, Omeprazole)
- Hormones (Anabolic steroids, Estrogen, Growth Hormone)
- Psychiatric medications (Valium, Phenothiazine, Amitriptyline)
- Cannabis users may also experience the symptoms of gynecomastia
Pharmacologic causes of gynecomastia can be reversed by stopping the use of the medication or supplement that is contributing to the condition. If the condition is not resolved, additional treatment may be required.
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.
HOW DOES MALE BREAST REDUCTION (GYNECOMASTIA REPAIR) WORK?
There are multiple male breast reduction procedure options available. Liposuction is a common choice, plastic surgery is another. Some patients might require a combination of the two. Each case is different and so the best gynecomastia treatment option is tailor-made to address the needs of the patient.
Performing male breast reduction surgery is done using a local anesthetic to numb the areas where incisions will be made or if preferred, general anesthesia is administered for sedation. The fat and glandular tissues are removed during the surgical procedure along with any excess skin, if necessary.
Once the procedure is complete, the patient will need to wear a compression garment to keep swelling to a minimum and promote healing. This is outpatient surgery, patients can go home on the same day.
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.
Contact UsWhat 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.
Plastic surgery for male breast reduction
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.
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.
Gynecomastia Treatment/
Male Breast Reduction Before & Afters
WHAT IS DISCUSSED DURING THE GYNECOMASTIA SURGERY CONSULTATION?
An initial consultation is extremely important for helping us better understand the concerns of a patient's gynecomastia symptoms and build the best and most effective treatment plan for male breast reduction surgery. A physical examination will demonstrate the severity of the enlarged breasts and a diagnosis made. The last stage of the medical workup is to rule out any pathologic cause of gynecomastia. It is done by performing comprehensive lab work and in several cases medical imaging of the breasts. From there, treatment options will be discussed and recommendations made for addressing the issue.
The patient should take this opportunity to ask any and all questions related to his condition, his appearance, his concerns for treatment, and any other pressing concerns. The initial consultation will also help us determine if the patient is a good candidate for gynecomastia surgery or if this surgery is the best option to address the condition.
Once a treatment option is decided upon, the consultation process will also cover any additional problems that need to be addressed with respect to the physical appearance of the patient's breasts. Excess skin removal, repositioning of the nipples, and reduction of the size of the areolas and nipples may also be necessary and these can be discussed at length prior to the surgical procedure.
HOW TO PREPARE FOR GYNECOMASTIA SURGERY?
Always keep in mind that good candidates for gynecomastia surgery are patients who are in good physical health. That may require making some lifestyle changes now, before the surgical procedure, so the recovery process and results of the surgery are highly successful.
At WiserMD we do not leave anything to chance. Dr. Wiser performs an elaborate lab work to assess your body’s condition. If any abnormalities are found, Dr. Wiser will treat them first, and make sure they are normalized prior to surgery.
The healing process that follows gynecomastia surgery requires available nutritional elements in increased amounts to be utilized by the immune system. At WiserMD you will be given a special nutritional supplement to replenish your body and optimize it for healing.
Although the chances of infection following male breast reduction surgery are slim, we at WiserMD are reducing them closer to zero. Dr. Wiser prescribes all his patients with an evidence-based special anti-septic soap to shower with a week prior to surgery. This action minimizes the skin bacteria population, which are the most common cause of post surgical infection.
Perhaps the most important of these changes is diet. Less sugar consumption and eating more fruits and vegetables are hardly a secret plan for living a healthy life. We've been hearing these recommendations since we were kids. When it comes to preparing for gynecomastia surgery, they become even more imperative for optimal health and self confidence.
Regular exercise is also a major contributing factor to that success. Cutting down on alcohol and eliminating tobacco are two of the best things to do prior to surgery. Lastly, any hormonal supplements and steroidal products must be avoided in the lead up to the procedure.
A healthy patient is a successful patient and making these lifestyle changes now will go a long way towards a speedy recovery and successful outcomes for male breast reduction surgery.
RECOVERING FROM GYNECOMASTIA SURGERY
Every patient is different and that can affect recovery times. The average recovery period after a male breast reduction procedure is around four to six weeks. The chosen procedure and treatments for resolving male breast enlargement can have an impact on the expected recovery time of the patient.
Regardless of the type of gynecomastia surgery that is performed, allowing ample time for healing and recovery is paramount for successful post-surgery outcomes. This means taking time off from work, resting at home, and avoiding all types of routine and strenuous activity, especially exercise.
The first 48-72 hours after gynecomastia surgery can bring pain, discomfort, and soreness throughout the chest. Pain medication may be prescribed and should be taken to relieve symptoms when necessary. Some swelling in the chest may also be evident and a compression garment worn to reduce those symptoms. Dr Wiser implements new techniques for pain management, by blocking the sensation to the breasts for the first 12-24 hours after surgery.
In the weeks after the surgery has taken place, any pain, discomfort and swelling should decrease while a slow, gradual, and above all, cautious resuming of normal activities can begin. Do not expect to return to an everyday routine immediately.
A post-op consultation will be conducted to review all of the do's and don'ts that will be vital to a successful healing period over the next few weeks. Continue wearing a compression garment and taking any prescription medications that are recommended after the procedure is performed.
HOW MUCH DOES GYNECOMASTIA SURGERY COST IN NEW YORK?
Determining gynecomastia surgery cost in New York is not unlike trying to determine the recovery time of the procedure before any consultations or diagnoses are made. Since every patient's needs and treatment options are different, it's very difficult to know what the costs will be until a treatment plan is decided upon.
Once an initial consultation is performed and there is a clearer picture of the severity of the condition and the procedures necessary for reducing or eliminating the problem, only then will there be an accurate estimate as to the cost for treatment.
But many insurance plans do cover the costs of gynecomastia surgery in full or in part as per the insurance provider and the limits of coverage outlined in the patient's policy. Dr Wiser’s team is very experienced in finding your insurance coverage, and making recommendations about your next steps.
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.
FREQUENTLY ASKED QUESTIONS ABOUT MALE BREAST REDUCTION SURGERY
The following are some of the most commonly asked questions about male breast reduction procedures. These and other questions can be covered during an initial consultation with Dr. Wiser:
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.