Are you considering gynecomastia surgery? You are not the only one. Enlarged breasts affect 40 – 60% of men and can seriously disturb their work and social life.
Gynecomastia, nicknamed man boobs or moobs, is a disorder that causes an increase in the volume of the mammary glands in men. This condition can make a man feel self-conscious about his appearance.
Fortunately, there is a solution! And you don’t have to hide behind oversized shirts anymore. Male breast reduction surgery can effectively reduce breast size in men while flattening and improving the chest contours.
By removing excess glandular tissue and fat, you can obtain a more masculine chest appearance. Surgery can also be used to tighten the breast area after significant weight loss causing sagging skin.
Breast reduction is the most popular surgical procedure for men. However, this complex surgical treatment requires a reconstructive surgeon with wide experience in the field.
Medical Solutions Barcelona
WHAT IS GYNECOMASTIA?
Gynecomastia, also called enlarged male breasts, is a disorder that causes an increase in the volume of the breast glands in men. It affects six out of every ten adolescents. It is also common in men over 50. Three out of every ten adults have enlarged male breasts. Although, it is also reported that it can affect up to 40 – 60% of men.
The condition can be due to hormonal imbalance, genetics, obesity, or certain drugs. It causes a combination of excess breast glandular and fatty tissue, affecting one or both breasts.
Gynecomastia, which appears during puberty, is normally benign and goes away naturally after three years. However, in the case of those whose breast development doesn’t disappear, and in older men, plastic surgery can be considered with excellent results.
WHAT KINDS OF GYNECOMASTIA ARE THERE?
Pubertal gynecomastia appears during puberty due to hormonal changes and disappears naturally. So, if you are going through puberty, you can be reassured that your gynecomastia will usually improve with time. For that reason, it is recommended to wait.
If it doesn’t resolve itself, then it is necessary to remove the breast surgically.
Secondary gynecomastia is related to the use of certain medications (corticosteroids, anabolic steroids, diuretics, antacids) or certain medical conditions.
Pseudogynecomastia is caused by an increase in fat tissue in a man’s breast because of obesity or lower testosterone production in old age. Hence, it appears due to a hormonal imbalance.
WHAT CAUSES GYNECOMASTIA IN OLDER MEN?
Various factors can cause gynecomastia in older men:
- Reduction in the production of testosterone, which is related to aging.
- Accumulation of fatty tissue (mainly because overweight).
- Increase in the production of a hormone called Luteinizing, which stimulates the production of estrogens in the testicles.
- Certain medical conditions, such as kidney and liver diseases, hyperthyroidism, testicle, or adrenal tumors.
- Some medications: diuretics, antiandrogens used to treat prostate diseases, antihypertensive drugs and digoxin. Also, antidepressant medications and statins for the treatment of hypercholesterolemia.
- Marijuana use.
WHAT IS INVOLVED IN MALE BREAST REDUCTION SURGERY?
Male breast reduction is the surgical option for men with gynecomastia. Diet and exercise alone are useless in this case. However, gynecomastia surgery is not suitable for men who have large breasts from being overweight. You have to lose weight first!
When patients suffer from gynecomastia, they usually present lumps in their breasts with or without excess fat. Surgery to remove the fat tissue involves liposuction. In this case, your consultant plastic surgeon will make a small incision on each side of your chest, around the areola, or within your armpit. Through these incisions, he will insert a thin hollow tube to loosen the excess fat and suck it out using a vacuum.
In some cases, the patient will also need surgical removal of the excess glandular breast tissue. The surgeon will make an incision in the margin of the nipple-areolar complex.
Doctor Benito, a renowned surgeon in plastic reconstruction and male cosmetic surgery, has developed a minimally invasive technique for male breast reduction.
It combines liposuction and the use of a “shaver.” This device allows the extraction of the mammary gland and the accumulated fat using a small incision (less than 1 cm) on the side of the chest.
“This technique, published in Aesthetic Surgery Journal, is applicable in the majority of cases. Although there are patients who need to have the glandular tissue extracted through the areola or through the armpit”, explains Doctor Benito.
If your breast enlargement is mainly fat accumulation (pseudo-gynecomastia), liposuction alone can give you great results.
Surgery usually takes 90 minutes and is done under general anaesthetic. It is treated as a day case procedure. However, sometimes, you may need to stay in hospital for one night.
HOW IS THE RECOVERY AFTER GYNECOMASTIA SURGERY?
The recovery time from gynecomastia surgery is different for every patient. But in general, patients can return to work after 7-10 days. Moderate pain is expected.
Usually, a drain is left in to avoid bruises and prevent the buildup of blood and fluids. Also, sleeping with your upper body slightly elevated can help diminish swelling and bruising.
Avoid sleeping on your stomach for at least three weeks! A dressing is applied for 24 hours. Then, you will have to wear a compression garment for a month or so. This compression vest helps support your chest while it heals.
After having the stitches out, it is recommended to start with massages. On the other hand, you should avoid stretching. For the first two days, don’t move your arms a lot or use them to lift yourself in bed.
It could take nearly six weeks until you can return to your regular activities. Strenuous exercise and heavy lifting should be avoided for two months after surgery. You can drive again as long it is not painful to wear a seatbelt, which may be several weeks after surgery.
HOW ARE GYNECOMASTIA SURGERY SCARS?
In terms of scars, they will be firm and slightly red for about three months. After that time, they will start to fade until they disappear almost completely.
Most men just have scars in the armpit and around their nipples. But large breast reduction usually comes with an anchor-shaped scar across the breast crease.
However, in general terms, gynecomastia surgery is a short procedure with a speedy recovery and virtually invisible scars.
IS THERE ANY RISK IN GYNECOMASTIA SURGERY?
Gynecomastia surgery is very safe, and most patients have smooth recoveries. An impeccable surgical technique and postoperative care are essential to get good results.
However, as with any surgery, complications can occur. Rare complications include:
- Fluid collections (seromas)
- Contour irregularities
- Loss of nipple skin
- Visible scarring
It is very common to have bruising, swelling, and little lumps in the treated area. It is also possible to have a slightly uneven appearance. This can be completely normal and will settle in the following weeks.
Also, you may feel numbness or a tingling sensation due to nerve irritation. This is a transient effect that resolves in weeks or within the first six months of surgery.
HOW DO I GET RID OF LOOSE SKIN AFTER GYNECOMASTIA?
The choice of gynecomastia treatment depends on the origin of the enlargement. Also, it considers breast tissue and skin elasticity.
The main problem in patients over 50 years old is that generally, there is sagging skin involved. Thus, skin retraction is less effective. In these cases, it may be necessary to remove skin to get an effective male chest reduction.
Also, in severe cases, the excess breast tissue may cause the breasts to sag and stretch the areola. The position and size of the areola can be surgically improved and excess skin cut away.
Hence, the skin’s quality is a key factor. To achieve the best outcome from the procedure, you should be near 10% of your ideal body weight and have good skin elasticity.
Usually, the skin is able to shrink back and mold over to the new body contour after liposuction and gland removal. However, in patients with poor skin elasticity, liposuction alone will perform poorly and may require some skin reduction too.
Even then, Doctor Benito always prefers first to use liposuction and removal of the gland using a minimum incision. Then, he can decide if removing skin is really necessary.
IS IT POSSIBLE TO GET BREAST CANCER WHEN HAVING GYNECOMASTIA?
Yes, it is possible. Gynecomastia usually affects both breasts, but some patients may present with asymmetric or unilateral enlarged breasts. Breast self-exam usually detects a palpable, tender mass. It is located centrally behind the nipple. That is the feel of a normal gland.
On the other hand, breast cancer usually presents like a palpable, hard, unilateral mass. Often, it is in a fixed position, peripheral to the nipple, associated with skin changes or axillary nodes.
To rule out breast cancer, it is essential to have a thorough medical evaluation. It should include a proper physical exam, mammogram, and MRI. Also, your doctor may perform a hormonal study to determine the possible causes of gynecomastia.
So, men of this age can suffer from breast cancer! A biopsy is needed to get a definitive diagnose if there is any doubt.
HOW MUCH GYNECOMASTIA SURGERY COSTS?
Male breast reduction cost depends on the physical features of the patient and of the technique used in the surgery. Without meeting the patient, we don’t offer approximate prices as each patient is a different case.
But we know that the economic factor is important when it comes to making a decision. Therefore, we offer the possibility for the patient to come to Antiaging Group Barcelona facilities for a first, free, no-obligation visit. You can consult with the surgeon regarding all your doubts and worries.
Based on your characteristics, we will offer the best solution ant the best price.
Doctor Jesús Benito is an internationally renowned plastic surgeon in Spain. He is co-author of a non-invasive technique for the elimination of gynecomastia which does not leave a scar.
With more than 20 years of experience, Antiaging Group Barcelona is a leading clinic in Spain.
Doctor Jesús Benito
Specialist in face and body cosmetic surgery for men.
- Secretary of the ISAPS (International Society of Aesthetic Plastic Surgery).
- Former president of the Spanish Association of Aesthetic Plastic Surgery (AECEP).
- 2013 Gold Medal (Forum Europa)
Bibliography & Publications:
- Assessment of a suction-assisted cartilage shaver plus liposuction for the treatment of gynaecomastia. Aesthetic Surgery Journal 2009 Jul-Aug;29(4):302-9. Benito-Ruiz J, Raigosa M, Manzano M, Salvador L.
- Tratamiento de la ginecomastia con vibroliposuctor + shaving. Comunicación oral en la sección “Best of Europe” en el I Congreso de la EASAPS, Madrid, octubre de 2009. Benito-Ruiz J, Raigosa JM, Manzano-Surroca M, Salvador L.
- Gynaecomastia: Risk Factors, Diagnosis and Management. En: Endocrine Diseases: Risk Factors, Diagnosis and Management. Kenneth Hines (ed). Nova Publishers. 2015. Benito-Ruiz J, Manzano M.
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Antiaging Group Barcelona
Ronda del General Mitre, 84, 08021 (Barcelona, Spain)
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