Spotlight on: Gynecomastia correction (male breast reduction)

photos courtesy of Dr. Daniel Suver, Plastic Surgeons of Alaska

Gynecomastia is a condition where men develop excess breast tissue.  This breast tissue can be painful, interfering with physical activities, and if significant, can be a source of embarrassment, especially in the teenage years.  It can develop at various points in life, but most often manifests in a man’s teens.  Most gynecomastia will shrink and resolve on its own over the course of a few months to a year, but if it persists longer than that, it usually becomes fibrotic and will rarely regress on its own.  Gynecomastia can occasionally be a manifestation of other problems (eg. hormone producing testicular mass), but is most often random and sporadic.

Persistent gynecomastia is treated by surgery.  This can not only remove painful gynecomastia tissue, but also improves the chest contour to make it a more normal masculine shape.  I usually use a combination of direct excision of firm tissue and liposuction to ensure a smooth contour.  The surgery is performed through a small incision at the base of the areola (the colored skin around the nipple) and a small liposuction access incision through the armpit.  Some men with significant gynecomastia and very droopy skin may require further skin excision to deal with the excess.

The first patient had classic, idiopathic (random) gynecomastia.  He was treated with a small incision below the areola and a 3/16″ liposuction incision in the armpit.

Before:

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After:

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This first patient has had good retraction of his skin, and now has a flat masculine chest with a smooth, flat contour.

 

 


 

This second patient had small volume gynecomastia that only subtly changed his chest shape.  It blunted the contours of his muscular pecs.  However, his main complaint was of pain associated with the firm gynecomastia.  I treated him with an incision under the areola to remove the hard painful breast tissue, and used liposuction to ensure that there would be no step-off deformity at the periphery of the resection.

Before:

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After:

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He now has much better definition of his chest.  The puffiness at the inferior aspect of his chest is gone, and the skin is now tightened up.  He has also had resolution of the pain associated with the excess gynecomastia tissue.  Scars from the procedure are subtle and hard to identify after several months of healing.

 


 

This 31 year old gentleman has obvious gynecomastia.  Another surgeon previously operated on him, but didn’t remove all of the excess breast tissue.  I used incisions hidden around his areola to remove the tissue and performed additional contouring with liposuction to make sure he didn’t have a scooped out appearance to his chest.

Scars are still subtly visible in these one month postoperartive photos, but will continue to fade with time.

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After:

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