What Is Male Breast Reduction?
Men who have developed excess breast tissue, clinically know as gynecomastia, can call on plastic surgeon Dr. Anureet Bajaj for male breast reduction surgery.
Male breast reduction surgery, clinically known as reduction mammaplasty, corrects a condition known as gynecomastia, or a female-appearing chest. This is not caused by excess fat, but rather excess breast tissue. Gynecomastia isn’t an uncommon occurrence; a large percentage of the male population suffers from excess breast tissue, more typically infants, boys during puberty, and older men. Alternatively, others experience pseudogynecomastia, a condition in which men may be predisposed to store excess fat in their armpit or chest. This is typically more apparent in overweight or obese men.
Gynecomastia is not a serious condition, but it can be a source of embarrassment or self-consciousness. In extreme cases, gynecomastia can cause the breasts to sag and the areolas to stretch. By removing this excess tissue with male breast reduction surgery, patients can gain a chest that is flatter and more masculine in appearance, increasing self-confidence.
Gynecomastia vs Pseudogynecomastia
Gynecomastia and pseudogynecomastia both result in enlarged male breasts, but the causes differ.
Gynecomastia is an abundance of glandular (breast) tissue, while pseudogynecomastia is due to adipose tissue, or fat deposits surrounding the nipples.
This small distinction makes a significant difference in the treatment method. Gynecomastia requires surgical excision to reduce the amount of breast tissue, while pseudogynecomastia may improve by diet and exercise and can be treated with liposuction. Men can experience one or the other, while some men experience a combination of both. During gynecomastia surgery, Dr. Bajaj often uses liposuction as an adjunct to help reduce excess fat deposits.
Causes of Gynecomastia
There is no single factor that causes gynecomastia. However, the underlying cause is a disruption in the natural balance between testosterone and estrogen. Therefore, gynecomastia occurs when either the levels of testosterone are reduced or the levels of estrogen are increased.
Estrogen is a key sex hormone in women that is responsible for physical changes such as breast growth. Men also have estrogen in their bodies, but a much smaller amount. However, sometimes men possess an abnormally large amount of estrogen which causes physical changes like feminized breasts. Typically, the increased estrogen levels will not adversely affect your health.
As men age, their testosterone level decreases. As estrogen is responsible for a woman’s physical changes, testosterone is responsible for a man’s physical changes. So, with age causing a decrease in testosterone, estrogen becomes more prominent and can create feminized features, such as the development of breasts.
The thyroid gland plays an important role in the body as it controls metabolic rate, produces hormones, and regulates heartbeat. Hyperthyroidism refers to a condition when the thyroid gland is overactive and produces more hormones than necessary. This can lead to gynecomastia caused by an increase in estrogen. Liver and kidney disease may also result in the development of gynecomastia.
Normal chromosomal makeup is XX for women, and XY for men. Although rare, chromosomal abnormalities can occur such as Klinefelter Syndrome, or XXY. The extra female chromosome can have no effect on the body, while for others it can lead to weakened muscles, less body hair, and enlarged breasts.
Some common medications can also lead to the development of breast tissue in men. These include: anti-estrogens used to treat prostate enlargement or prostate cancer, anabolic steroids (which may result in gynecomastia in bodybuilders), AIDS medications, anti-anxiety medications such as Valium (diazepam), tricyclic antidepressants, some antibiotics, ulcer medications such as Tagamet, and heart medications such as digoxin.
Other drugs which can cause gynecomastia include: marijuana, heroin, amphetamines, and alcohol.
Gynecomastia can be categorized into 4 grades. These are based on amount of breast tissue, feminization of the breasts, and condition severity.
Grade 1: Mild – Small amount of tissue surrounds the areola.
Grade 2: Moderate to High – Moderate enlargement of breast that passes the areola boundary.
Grade 3: High & Visible – Skin redundancy in addition to moderate enlargement of breast that passes the areola boundary.
Grade 4: Severe & Feminine – Profound enlargement of the breasts with feminized breasts and skin redundancy.
Good Candidates for Male Breast Reduction Surgery
Male breast reduction surgery is a great option for men who are looking to:
- Correct gynecomastia
- Enhance delineation of chest muscles
- Remove excess fat on the male chest
- Improve self-confidence
- These men must be in good health, be able to stop smoking for at least a month, and are close to a stable weight. Furthermore, we will need to ensure that the gynecomastia is not caused by a more serious medical condition.
It is also important to have realistic expectations of the surgery and what it can accomplish. There is no age restriction, but it is ideal to undergo this surgery once breast development is complete. If teenagers opt to get male breast reduction surgery, they may need to undergo additional surgeries in the future due to the breast continuing to develop.
Gynecomastia Surgery Consultation
At your consultation with Dr. Bajaj, you will explain your concerns about your chest and your aesthetic desires. She will perform a thorough examination of your chest, ruling out alternative possibilities such as hematoma, breast cancer, cyst, or lipoma. She will also determine if you have gynecomastia as opposed to pseudogynecomastia. Your medical history will also be discussed.
Once it is confirmed through examination and possible tests such as a mammogram, both you and she together will then determine the best personalized treatment process that will provide optimal results.
Breast Reduction Surgery Preparation
To get the best possible results, please follow any instructions given during your consultation. This includes general instructions as well as personalized preparation tools to benefit you specifically. Some of the general preparation guidelines include:
- Arrange for a friend or family member to drive you home after your surgery.
- Take four to five days off from work to ensure you heal properly.
- Do not smoke, drink alcohol, or take any anti-inflammatory medications for a month prior to your procedure.
- Fill all prescriptions as you will need some right after your surgery.
- Complete any medical examinations Dr. Bajaj assigns you.
- Have plenty of gauze and ice packs stocked in your home that will last you the duration of your recovery.
The procedure is performed at our accredited in-office surgical facility, and patient are under the care of a board-certified anesthesiologist.
To begin, Dr. Bajaj will make an incision around the nipple areola. Through the chosen incision, she will access the breast tissue and directly excise it. Liposuction is the used to remove excess fat from the chest area. This improves the contours of the chest after surgery. The ratio between breast tissue and adipose tissue differs for each patient, so Dr. Bajaj pays extra attention to how much of each should be removed to provide you with contoured yet natural-looking results.
Dr. Bajaj will close the incisions with sutures and apply a surgical dressing to cover them. A compression garment will be placed around your chest to maintain the new slimmer contours and help reduce swelling.
Recovery After a Gynecomastia Procedure
The procedures take between two to four hours depending on your specific case and whether you undergo additional body contouring procedures. You will need to limit your activity, but Dr. Bajaj will let you know when you can get back to your normal routine. Most individuals can return to work in five to seven days, although it will be two to three weeks before you can resume strenuous activities. Any postoperative discomfort will be managed by medication prescribed by Dr. Bajaj.
You will need to continue to wear the compression garments for several weeks, but after this time, you will begin to see the benefits of male breast reduction surgery. While it can take a few weeks for the swelling to completely dissipate, you will soon be able to appreciate a more masculine-appearing chest. The appearance should be long-lasting, as long as you maintain a healthy diet and exercise. Any resulting scarring is small and will fade overtime.