Excess Breast Fat / Excess Breast Tissue (Gynecomastia)

Men who have excessive enlargement of their breast area are frequently self-conscious and embarrassed about it. The male image is one of a flat chest. Enlargement of the male breast area is a result of either male breast tissue hypertrophy (usually hormonal stimulation) or excessive adipose (fatty) tissue from obesity or a combination of both excessive fat and breast tissue enlargement. Sometimes as a result of either liposuction alone of a male breast with loose skin or as a result of the loss of weight the male breast may become saggy much like a woman’s saggy breast. Male breast tissue reduction aims to restore the male breast to a more natural appearance. 

Workup will include a review of the medical history, a physical exam, and lab evaluation. If a breast mass is present then a biopsy and possibly a mammogram or breast ultrasound is needed. An evaluation will help explain the reason for the breast enlargement. Frequent causes of gynecomastia are hormonal imbalances, side effects from herbal medicines or prescription medications, liver disease, obesity, pituitary or testicular tumors, among others.

Most cases of gynecomastia can be managed by liposuction alone or in combination with a skin tightening procedure if excess skin is present. If too much excess skin is present then a surgical male breast lift is indicated for optimal results. In some cases, the male breast tissue is too dense to be removed with liposuction. In those cases surgical removal of the male breast tissue is necessary. A cosmetic surgeon can help men reduce the appearance of enlarged chests with surgery. If the issue is isolated to fat, liposuction alone may be enough to achieve the desired results. 

For more information on skin tightening options click here.

Who Is a Good Candidate for Male Breast Surgery?

  • A male patient who is in reasonably good health
  • A male patient who has reasonable and realistic expectations
  • A male patient who is unhappy with a significant amount of breast area enlargement
  • A male patient who is unhappy with a significant amount of breast skin laxity

Who Is Not a Good Candidate for Male Breast Surgery?

  • A man who is not in reasonably good health with serious or poorly controlled health problems
  • A man who do not have reasonable and realistic expectations
  • A man who is excessively obese
  • A man who smokes
  • A man who wants absolute perfection

Options for Male Breast Reduction Surgery 

  • Liposuction alone
  • Liposuction combined with a less invasive skin tightening procedure
  • Male breast lift with incisions much like a female breast lift
  • Limited breast surgery to remove a localized area of dense breast tissue under the nipple-areolar area

Procedure Description for Gynecomastia Surgery

  • Anesthesia options include either general anesthesia or local tumescent anesthesia.
  • Liposuction requires several small incisions to allow cannula extraction of the excess fat and breast tissue.
  • A limited incision is made at the areola or just below the breast depending on whether fat or dense breast tissue will be removed, and the experience of the cosmetic surgeon.
  • Radiofrequency energy-based devices may be utilized to assist with skin tightening if needed.
  • Incisions are closed with sutures.
  • A dressing will be placed and either an ace wrap or male chest compression garment is applied.

Does liposuction produce permanent results?

All of the above-mentioned procedures (male surgical breast lift, excisional breast surgery, or liposuction) will produce permanent results. Liposuction permanently removes and destroys fat cells. After liposuction, the chest new shape is also more or less permanent. If a person gains weight after liposuction, the area treated by liposuction will not accumulate as much fat as other areas of the body not treated. Fat accumulates in every area of the body in proportion to the number of fat cells in each area. .A person may look disproportionate if they gain excessive amounts of weight. Aging and weight change will affect subsequent appearance over time. The final results may not be evident for several months.

Will I be in pain?

Liposuction, male breast lift, surgical breast removal can be performed with either general anesthesia in a certified outpatient surgical facility or in the surgeon’s specialized procedure room in his office depending upon various patient’s factors and amount of correction needed. Your post-operative pain will be the same with either anesthesia technique. With general anesthesia, you will experience no operative pain or discomfort. With awake tumescent anesthesia, patients will receive pre-operative medication to help them relax so that they can more easily tolerate the initial discomfort with administering the tumescent anesthesia into the treatment area. The tumescent technique produces profound and long-lasting local anesthesia of the skin and subcutaneous fat. Since the patient is awake and relaxed, they can notify the surgeon immediately of any discomfort. They can also reposition themselves to allow for better liposuction results. 

Nonsurgical skin tightening can be performed with no anesthesia, topical anesthesia or tumescent anesthesia depending upon the technique selected.

How long does Male Breast Reduction take?

Liposuction: The time required for either of these procedures depends on the size of the skin treatment area and whether RF BodyTite skin tightening or the RF Morpheus skin tightening procedure will be necessary as an adjunct to obtain the best results. Generally from the time that you arrive at the facility until the time that you are discharged home will require several hours. 

The time required for radiofrequency (RF) surface skin tightening is usually 60 minutes requiring 6 sessions and requires no anesthesia and can be done at a different time.

The time required for the radiofrequency (RF) deep skin tightening with microneedles requires more time due to approximately 45-60 minutes for the application of topical anesthesia or administration of tumescent anesthesia. Generally, a total of about 2-3 hours is needed to perform the radiofrequency deep skin tightening with microneedles procedure. The RF Morpheus skin tightening procedure can be done at the same time as liposuction or a male surgery lift or at a separate time.

How much does Male Breast Reduction Cost?

The fee for male breast reduction depends upon the procedure performed, choice of anesthesia, and if a facility fee and an anesthesia fee is required. There is a fairly large range from a few hundred dollars to two or three thousand dollars or more depending upon the extent of correction needed and any ancillary treatments for skin tightening. 

For an accurate estimate, it is necessary to have a consultation with the surgeon.

What is the recovery like?

  • HOME CARE: You will be discharged home to the care of a responsible adult.
  • ACTIVITIES: Plan to rest in bed immediately after treatment.  Later in the day, short walks are good. Resume light daily activities the following day after your procedure. Depending upon extending the procedure and your tolerance for discomfort. You may be required to miss work from a few days to 2 weeks. Resume exercise gradually as tolerated by “listening” to your body’s messages.
  • ELASTIC COMPRESSION GARMENT: Wear your compression garment for the first few weeks.
  • WOUND CARE AND DRAINAGE: Some blood-tinged drainage is expected for usually the first several days.
  • BATHING: It is preferable to shower rather than bathe for the first 7 days after surgery.
  • DIET: Resume light foods as tolerated immediately after surgery.
  • FOLLOW-UP APPOINTMENT: Usually 3-7 days after your procedure.

What are the risks of male breast reduction treatment?

As with all surgical and nonsurgical procedures, there are inherent risks. The specific risks and suitability of this procedure for a given individual can only be fully determined at the time of consultation with your cosmetic surgeon. All procedures have some degree of complications. The nonsurgical procedures have the smallest risks with the surgical options having more risks. Most are minor and rarely affect the overall cosmetic results, occur occasionally such as swelling, bruising, minor lumps and bumps, and skin numbness. Major complications are uncommon but include significant cosmetic irregularities such as lumps and bumps, poor contouring or body shape, indentations, scarring, skin necrosis, discoloration of the skin, infections, injury to the underlying nerves or blood vessels, numbness, persistent pain, the possible need for revisional surgery, bleeding or hematomas, or seromas. Some major complications can take months to resolve or improve, or maybe permanent and should be discussed with your surgeon prior to the proposed procedure.