Causes of Gynecomastia

While the development of excess breast and/or fatty tissue in the male chest is fairly common, it may occasionally resolve on its own as an adolescent matures through puberty, resulting in a generally normal and flat chest appearance. A number of factors can contribute to enlarged breast tissue in men, including:

  • Elevated hormone levels during puberty
  • Steroid use
  • Obesity
  • Medication side effects
  • Chronic liver disease
  • Hereditary conditions
  • Regular use of marijuana

With gynecomastia, it is not uncommon for breast tissue to enlarge asymmetrically; sometimes, excess tissue may even be present in one breast, but not the other. The clinical evaluation of a patient with gynecomastia is usually a thorough medical history and physical examination. In the vast majority of cases, there are no abnormal hormone levels or other endocrine abnormalities to explain the condition. However, genetic influences can also play a role.

What are the Symptoms of Gynecomastia?

Although gynecomastia typically doesn’t pose any physical health risks and its correction is not considered a medically necessity, the appearance of enlarged breasts in men often causes emotional and/or psychological distress. In general, gynecomastia can be characterized by:

  • An accumulation of fat around and behind the nipples
  • Swelling or protrusion of the nipples
  • Asymmetry or disproportion between both breasts
  • Excess glandular tissue
  • Breast tenderness

As a result of the physical symptoms of gynecomastia, other effects of the condition frequently include low self-esteem, a lack of confidence, and a negative body image. In turn, it is not uncommon for male gynecomastia patients to avoid social situations that involve removing their shirt.

True Gynecomastia vs. Pseudogynecomastia

The appearance of excessive male breasts is typically distinguished by either true gynecomastia or pseudogynecomastia, two conditions that are often combined under the general term “gynecomastia.” Since the physical indications of both forms of gynecomastia resemble each other, many patients are unaware which of the two conditions they actually exhibit. True gynecomastia is the result of excess glandular or breast tissue in the chest, usually with no apparent etiology that can be identified. In contrast, pseudogynecomastia—refers to an accumulation of stubborn fat in and around the nipples and breasts, making the male breasts look similar to female breasts. In some cases, pseudogynecomastia can simply be improved by using liposuction to remove the excess fat and decrease an individual’s breast size. While they may involve different surgical techniques to treat, both sub-types can result in the same symptoms for the patient— namely, self-consciousness and a poor body image. Dr. Rowin will carefully evaluate you and fully explain the best approach to correct your enlarged breasts.

Male Breast Reduction Procedure

Male breast reduction surgery eliminates excess breast tissue, resulting in a flatter and more normal appearing male chest. Liposuction is often included to remove excess fat, but abnormal breast tissue cannot be removed via liposuction alone and therefore requires an incision to be placed along the edge of the areola (the pigmented area around the nipple). Your plastic surgeon will discuss the specifics of your treatment plan after a careful consultation and physical examination. When undergoing treatment for gynecomastia, it is not uncommon for men to occasionally combine the procedure with other enhancement options—such as liposuction of the back or flanks—in order to achieve a more attractive outcome overall. Our surgeon would be happy to speak with you about the most ideal options for your ultimate goals.

To see examples of male patients who underwent breast reduction surgery, or gynecomastia correction, please visit our before-and-after photo gallery.

Highly Rated Patient Results

For Male Breast Reduction (Gynecomastia Surgery)

Male Breast Reduction Recovery

Immediately following surgery, you will most likely wear a support garment for a brief period in order to minimize swelling and promote proper healing of your new chest contour. There will be some degree of normal post-operative bruising and swelling; however, discomfort from this surgery is often minimal and should be manageable with oral pain medication. While strenuous exercise and aerobic activity should be avoided for at least four weeks in most cases, work and other daily activities can usually be resumed within a week. We will give you specific instructions regarding recovery in person.

The results of surgery are typically immediately visible. At approximately six weeks your fine scars may be a bit pink and itchy, after which they will begin to settle down until they will hopefully be almost invisible by one year after surgery. Men who undergo male breast reduction surgery are usually among the most satisfied individuals at our practice. Gynecomastia patients’ newfound ability to remove their shirt or workout without fear of embarrassment is often life-changing.

Will I Have Scars From Gynecomastia Surgery?

Our plastic surgeon understands the importance of ensuring that scars from male breast reduction remain as undetectable as possible. Although a scar from any surgical procedure involving incisions is inevitable, Dr. Rowin approaches gynecomastia surgery very meticulously and typically limits all incisions to the natural contours around the nipples. Due to his skillful technique with regard to incision placement and wound closure, patients generally experience little visible scarring, if any, once fully healed. Proper scar-care during the recovery process can allow the best healing of your incisions and increase the likelihood that they fade as time passes.

Can Exercise Be Used to Treat Gynecomastia?

The effectiveness of exercise on male breast enlargement is dependent on the nature of your unique condition. If your gynecomastia is a result of excess glandular breast tissue, exercise will have no effect on the appearance of male breasts. On the other hand, if your gynecomastia is related to obesity, weight loss and exercise can sometimes provide improvement aesthetically; however, it is very rare for gynecomastia to be completely resolved with exercise alone. In most cases, there will be some degree of visible breast tissue and surgery is the only treatment option to completely remove the excess breast tissue.

Does Male Breast Reduction Result in Excess Skin?

Patients who have good skin elasticity generally don’t worry about excess skin after surgery, as the skin can contract and tighten to their new chest contour. However, for those with poor skin elasticity or a large amount of excess breast tissue, additional procedural steps may be required to remove extra skin during the operation. Our surgeon will perform a thorough examination of your needs and make you fully aware of your surgical expectations during a consultation.

If you would like more information on treatment for gynecomastia, or if you would like to schedule a confidential consultation, please contact Plastic Surgery of the Carolinas.

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