Gynecomastia comes from the Greek terms “gyne” which means woman and “mastos” which means breast. In medical terms, gynecomastia means abnormally large breasts in men. Commonly found in young teenagers, gynecomastia typically resolves in the majority of cases. For the 10% of cases that do not disappear naturally, severe psychological consequences follow, such as feelings of embarrassment, shame, and anxiety.
Causes of gynecomastia can include steroids, obesity, tumors, drug abuse, certain syndromes, liver disease, and many medications. However, most of the time, workups don’t find a cause. If gynecomastia persists and fails to resolve after a long period of time, we can perform surgery. As most physicians consider this condition cosmetic, don’t count on getting insurance to cover the cost of the surgery.
What is the process like?
Surgical correction of gynecomastia involves first performing an aggressive liposuction of the entire breast. This allows for removal of large amounts of fat and breast tissue and also stimulates the skin to shrink up. The next step is to make an incision around the areola and remove the abnormal breast tissue which lies beneath the nipple and areola.
In the majority of cases, we don’t need to remove skin as the skin will contract and not sag. However, in severe cases with major breast sagging, we will need to remove skin. We may remove skin from around the areola. Also, we may perform a formal breast reduction. Sometimes we perform these procedures at separate times.
Most surgical corrections take less than 2 hours. We perform them as outpatient procedures. You’ll wear a garment for 2-3 weeks. The sutures dissolve so they don’t need removed. We may or may not place drains to remove extra fluid.
Complications include seromas, bleeding, nipple loss, infection, and scarring. Occasionally, you’ll need an ultrasound or steroid injections to encourage healing. Remember that it takes 3-6 months to final results from surgery.
We want to limit scarring and produce a normal-appearing breast. Make sure you understand the procedure and know the location of scars.