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 can 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. Most of the time workups are negative and no known cause can be found. If gynecomastia persists and fails to resolve after a long period of time, surgery may be indicated. As most physicians consider this condition cosmetic, don’t count on getting insurance to cover the cost of the surgery.
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 no skin removal will be necessary as the skin will contract and not sag. In severe cases with major breast ptosis (sagging), skin removal will be needed. This can be performed by removing skin from around the areola or by performing a formal breast reduction. Sometimes these procedures will be staged (performed at separate times). Most surgical corrections take less than 2 hours and are performed as outpatient procedures. A garment is worn for 2-3 weeks and all sutures dissolve and do not need to be removed. Drains may or may not be used to remove excess fluid. Complications can include seromas, bleeding, nipple loss, infection, and scarring. Occasionally ultrasound or steroid injections will be needed to encourage healing. Remember that when having surgical correction of gynecomastia, it will take 3-6 months to see the final results so be patient.
Our main goal in treating gynecomastia is to limit scarring and produce a normal appearing breast. Make sure you understand what type of procedure will be performed and where the scars will be located.