What Is Gynecomastia?
Gynecomastia refers to the development of excess breast tissue in males. It can result from an imbalance between estrogen and testosterone, although the specific cause is often unknown.
Certain medications, medical conditions, weight changes, marijuana use, and anabolic steroids can contribute to or worsen breast enlargement.
Gynecomastia may involve:
- Excess fatty tissue
- Excess glandular breast tissue
- A combination of fat and glandular tissue
- Excess skin in more advanced cases
During your consultation, Dr. Boswell will evaluate the composition of your chest and determine which surgical approach is most appropriate for your anatomy and goals.
Who Is a Candidate for Gynecomastia Surgery?
Gynecomastia surgery may be appropriate for healthy men who are bothered by excess breast tissue and have realistic expectations about what surgery can achieve.
Good candidates generally include men who:
- Are physically healthy and emotionally prepared for surgery
- Have persistent breast enlargement that has not responded to other measures
- Are at or near a stable, healthy weight
- Have sufficient skin elasticity to allow the chest to reshape after surgery
- Are dissatisfied with the appearance of their chest
- Understand the potential benefits, limitations, and risks of surgery
Teenagers may also be candidates in certain circumstances. However, because adolescent gynecomastia can sometimes resolve naturally, the timing of surgery should be carefully considered.
If excess weight is contributing significantly to the appearance of the chest, Dr. Boswell may recommend reaching a stable weight before surgery. Likewise, if medications, anabolic steroids, marijuana, or another underlying factor may be contributing to breast enlargement, addressing that factor may be recommended before proceeding with surgery.
How Gynecomastia Surgery Works
Gynecomastia treatment is customized according to whether the chest enlargement is primarily caused by fat, glandular tissue, excess skin, or a combination of these factors.
Liposuction
When excess fatty tissue is a significant component of gynecomastia, liposuction may be used to contour the chest.
Through small incisions, a thin cannula is inserted beneath the skin to remove excess fat and improve the shape of the chest. Liposuction can provide effective contouring while minimizing visible scarring.
Glandular Tissue Excision
Firm glandular breast tissue cannot be removed with liposuction alone. When this tissue contributes to the enlargement, it may need to be surgically excised.
Excision may be performed alone or combined with liposuction. In many cases, the glandular tissue can be removed through an incision near the areola or through the small incisions used for liposuction.
When a substantial amount of tissue or skin must be removed, larger or additional incisions may be necessary. This can result in more noticeable scars.
Skin Removal for Significant Gynecomastia
When significant breast enlargement has stretched the skin, the skin may not contract adequately after fat and breast tissue are removed. In these cases, skin removal may be necessary to achieve a flatter chest.
For men with severe gynecomastia and substantial skin excess, a more extensive procedure may involve removing excess skin and breast tissue and repositioning the nipple and areola. In the most advanced cases, the nipple and areola may need to be repositioned as a full-thickness skin graft.
This approach produces a flatter chest contour but results in more extensive scarring.
What Happens During Gynecomastia Surgery?
Gynecomastia surgery is generally performed on an outpatient basis under general anesthesia.
The procedure typically takes approximately 1½ hours when liposuction and glandular tissue excision are performed. More extensive procedures involving significant skin removal and nipple repositioning may take approximately 2½ hours.
A small drain may occasionally be placed to help remove excess fluid during the initial healing period. After surgery, the incisions are dressed and the chest may be wrapped or placed in a compression garment.
During your consultation, Dr. Boswell will explain the surgical techniques that may be appropriate for you and develop a treatment plan based on your chest anatomy and desired outcome.
Recovery After Gynecomastia Surgery
It is normal to experience some soreness, swelling, bruising, and temporary changes in sensation following surgery. Prescription or over-the-counter medications may be recommended to keep you comfortable during the early recovery period.
A compression garment is commonly worn during the initial healing period to help control swelling and support the new chest contour.
Your Recovery Timeline
Walking:
You should begin walking on the day of surgery.
Returning to work:
Many patients can return to work within approximately 3–7 days, depending on the nature of their job and how they are feeling.
Strenuous activity:
More strenuous exercise is generally restricted for several weeks. Dr. Boswell will provide specific instructions based on your procedure and recovery.
Chest impact:
Activities that could result in a blow to the chest should be avoided during the early healing period.
Swelling and bruising:
Most of the initial swelling and bruising improves during the first several weeks, although residual swelling can persist for several months.
Final results:
Your chest will continue to change as swelling resolves and the tissues settle. It may take several months to appreciate the final contour.
Gynecomastia Surgery Results
Gynecomastia surgery is designed to create a flatter, firmer, and more naturally contoured chest.
The results are generally long-lasting when you maintain a relatively stable weight and avoid factors that may contribute to recurrent breast enlargement. Significant weight gain can change the appearance of the chest, and gynecomastia associated with marijuana or anabolic steroid use may recur if those substances are continued.
Because every patient's anatomy and degree of gynecomastia are different, Dr. Boswell will discuss the results you can realistically expect during your consultation.
Risks and Potential Complications
As with any surgical procedure, gynecomastia surgery has potential risks and complications. These may include:
- Infection
- Fluid accumulation
- Swelling and bruising
- Temporary or permanent changes in sensation
- Skin injury
- Irregularities or contour changes
- Rippling or loose skin
- Asymmetry
- Changes in skin pigmentation
- Scarring
- Loss of nipple sensation
- Need for additional surgery
Significant differences between the two sides of the chest or nipple position may occasionally require a secondary procedure.
Protecting healing skin from sun exposure is also important because pigmentation changes may become more noticeable or permanent with sun exposure.
Gynecomastia FAQ
How Long is Gynecomastia Surgery?
The surgical time depends on the technique required. Liposuction combined with excision of glandular tissue typically takes approximately 1½ hours. More extensive surgery involving skin and breast tissue removal with nipple and areola repositioning may take approximately 2½ hours.
What Form of Anesthesia is Used for Surgery?
Gynecomastia surgery is performed under general anesthesia.
Is Gynecomastia an Inpatient or Outpatient Surgery?
In most cases, yes. Gynecomastia surgery is typically performed as an outpatient procedure. An overnight stay may occasionally be recommended when extensive surgery or other medical considerations warrant additional observation.
What are the Side Effects of Gynecomastia Surgery
Temporary swelling, bruising, soreness, numbness, and a burning sensation may occur during the early recovery period.
What are the Risks of Gynecomastia Surgery?
Potential risks include infection, fluid accumulation, skin injury, contour irregularities, asymmetry, pigmentation changes, changes in nipple sensation, visible scarring, and the possibility of additional surgery.
How Long is the Recovery Process?
Many patients can return to work within approximately 3–7 days, depending on their occupation and individual recovery. More strenuous activity generally requires a longer period of restriction.
Swelling and bruising can continue to improve for several months, and the final result may take time to become fully apparent.
How Long Do the Results of Gynecomastia Surgery Last?
The results are generally long-lasting. Maintaining a stable weight can help preserve the surgical contour. If gynecomastia was related to marijuana or anabolic steroid use, continued use may contribute to recurrent breast enlargement.
A Flatter, More Confident Chest
If enlarged breast tissue is affecting how you feel about your appearance, gynecomastia surgery may offer a way to create a more defined and balanced chest contour.
Dr. C.B. Boswell and the team at Body Aesthetic Plastic Surgery & Skincare Center provide individualized care from your initial consultation through recovery. If you would like to learn more about gynecomastia surgery in St. Louis, contact BodyAesthetic Plastic Surgery.
Schedule a Consultation for Gynecomastia Surgery in St. Louis
If you would like to learn more about gynecomastia surgery in St. Louis, contact BodyAesthetic Plastic Surgery & Skincare Center today to schedule your consultation with Dr. Boswell and his experienced plastic surgery team.