Though rarely discussed, gynecomastia is actually quite common—affecting 40 to 60% of men. Physiologic gynecomastia occurs when hormone levels associated with adolescence lead to formation of excessive breast tissue. This usually resolves with time but that is not always the case. Other reasons for gynecomastia may include hormone supplements, heredity, drug side effects or certain medical conditions. For those who feel self-conscious about their appearance, male breast reduction surgery can greatly improve overall confidence.
“I see so many men with gynecomastia. Men of all ages. The common thread among them all is the constraints that gynecomastia puts on their life. Many will avoid activities such as swimming or certain sports because it becomes difficult to hide. Some wear layered clothing in an attempt to hide the fullness. The great news is that surgery can help so many of these patients.” — Michael Lee, M.D.
The surgery to correct gynecomastia should be performed on healthy, emotionally stable men. While men at any age can benefit from treatment, those going through puberty are followed to see if the gynecomastia resolves. Correction of gynecomastia is usually permanent. However, there are times where the process may recur. This is a significant concern when gynecomastia is related to hormones or other instigating factors that are continued after the operation. Dr. Lee will emphasize the importance of discontinuing any contributing factors during patient consultation. Some patients also have a significant amount of fat in the chest area. This can occur in the setting of gynecomastia. Dr. Lee treats most patients with a combination of liposuction and resection of the gland. It is key for men to know that if they gain weight after surgery, the chest may reflect this change.
The best candidates should be close to their ideal weight, and have firm, elastic skin that will reshape to the body’s new contours. If you are a young man or adolescent, care must be taken to first exclude hormonal abnormalities, drugs or medical conditions contributing to this condition.
Since the procedure removes fat and/or glandular tissue from the breasts, the result is a chest that is flatter, firmer and better contoured. In extreme cases excess skin is removed to achieve this outcome. A history and physical are part of the evaluation, as the treatment is determined by an underlying cause. Examples include liver disease, use of estrogen medications, steroids, beta blockers, antacids and marijuana. Referral to an endocrinologist may be recommended.
During the exam with Dr. Lee, if there is something that deviates from the norm, a mammogram or ultrasound may be suggested. The patient must be compliant in wearing post-surgical garments to retain the new shape. These include a special vest for 2 weeks and an Under Armor® compression shirt for an additional 10 weeks.
There are strict guidelines against lifting weights for 6 weeks after gynecomastia surgery. Lower impact activity is encouraged and will be made clear in your follow up visit with Dr. Lee.
The sun should be avoided for the first year unless a strong sunblock is applied so scars do not become pronounced.
For the vast majority of patients, gynecomastia treatment can be a permanent cure, especially if the condition was related to puberty and hormones. The use of steroids can negatively influence the result. If the chest was fatty, gaining weight may return the chest to its original appearance.
Dr. Lee’s priority in gynecomastia is to insure that a thoughtful, artistic approach is used. In true gynecomastia the gland has taken the place of the normal tissue. In total removal of the gland, a vacuum may inadvertently be created, depressing the nipple area. Dr. Lee removes the majority of the gland but when necessary leaves just enough tissue to minimize the chance of this occurring. There is also careful consideration given to symmetry so that the final result is relatively equal on both sides of the chest. Dr. Lee is adamant about proper scar care. The result is that many patients can barely see the two small scars created to correct gynecomastia.
The exam Dr. Lee performs during consultation is very important to gather health history and determine the ratio of excess fat and size of the gland to be removed. This exam will tell if excision of the gland alone will solve the concern, or if a combination of gynecomastia excision and liposuction will be the better surgical plan to address a fatty chest.
The aesthetic aspect of gynecomastia cannot be ignored. For Dr. Lee the approach will differ depending upon the individual. Is the patient a workout warrior? A young man? An older man? Liposuction can sculpt and shape the male chest to blend with the overall torso.
The first incision is small—less than 1/4” and is hidden in the armpit. A second small incision is made along the bottom border of the nipple. Both heal beautifully and are usually imperceptible after about a month.
Contact our office to schedule a private consultation with Board Certified Plastic Surgeon, Dr. Michael Lee. This is the next step to determine which Park Cities Cosmetic Surgery procedure is the best option, giving you the desired outcome after surgery. Dr. Michael Lee will spend time with you to learn about your medical history and your expected outcome for surgery, as well as explaining the procedure in detail and answering all of your questions.