Male Breast Reduction (Gynecomastia Surgery)

Gynecomastia is a condition that can occur in men of any age and is characterized by overdeveloped and enlarged breasts. There are several conditions that can cause this, including:

• Hormonal changes
• Heredity 
• Obesity 
• Use of certain drugs

Though this condition is not dangerous the overwhelming majority of the time, it can cause emotional discomfort to men and impair their self-confidence.

Some symptoms of gynecomastia include:

• Excess localized fat
• Excess glandular tissue development
• Excess skin in the breast area
• Presence unilaterally (one breast) or bilaterally (both breasts)

Not every man who suffers from gynecomastia is a good candidate for a male breast reduction. Candidates for surgery will generally be:

• Men whose condition cannot be corrected through alternative medical treatments
• Men with good, stable physical health
• Nonsmokers and non-drug users
• Men whose breast development has stabilized 
• Men who are bothered by the feeling that their breasts are too large 

Adolescents whose breasts are still developing may benefit from surgery, but will likely need more surgeries in the future, should their breast development continue. 

Unfortunately, male breast reduction is very much a cosmetic procedure, and insurance will usually not cover it. But every insurance policy is different, so carefully review your own insurance policy to determine whether or not your male breast reduction could be fully or partially covered. Many plastic surgeons argue that there are certain criteria that should render male breast reduction as being eligible for insurance coverage. 

Costs of gynecomastia surgery can vary widely, but the average fee across the United States is roughly $4000. While insurance does not cover this procedure, some plastic surgeons may offer financing plans for their patients, so always be sure to ask Dr. Wall about any cost concerns you have.

The average fee referenced above does not include other fees associated with surgery such as:

• Anesthesia fees
• Hospital or surgical facility costs
• Medical tests
• Post-surgery garments
• Prescriptions for medication
• Surgeon’s fee

The surgeon’s fee will be based on your particular surgeon’s level of experience, the geographic location of your surgeon’s office, or the type of procedure your surgeon chooses. It’s important to remember not to choose a surgeon based on the surgeon’s fee; your comfort with the surgeon is just as important as the cost of the surgery.

Consultation

You will need to schedule a consultation with Dr. Wall before having a male breast reduction. During this consultation, Dr. Wall will asks questions about:

• Your goals and hopes for the surgery
• Any medical conditions you suffer from, drug allergies, or medical treatments 
• Current medications, vitamins, herbal supplements, alcohol, tobacco, and recreational drug use
• Previous surgeries you have had

Dr. Wall will also use this consultation to discuss potential risks and complications of the surgery with you. If surgery is the recommended course of treatment, photographs will be taken for your medical records, and exact measurements of your breast area will be taken.

Preparation

When you are preparing for a male breast reduction, you may need to:

• Stop smoking, if you are a smoker
• Avoid taking aspirin or other anti-inflammatory drugs that have blood-thinning side effects
• Get lab testing or a full medical evaluation
• Take certain medications or adjust some of the medications you are already taking

You should arrange for someone to drive you to and pick you up from surgery. 

A male breast reduction will generally follow the same steps:

• Anesthesia. For this procedure, intravenous sedation and general anesthesia are the most common options. Dr. Wall will be able to recommend the option that’s best for you.
• Liposuction technique. This technique is used primarily when the underlying cause of the gynecomastia is excess fatty tissue. A cannula, a thin, hollow tube, will be inserted in the breast area through several small incisions. The cannula is shifted back and forth, loosening the excess fatty tissue, allowing it to be suctioned out with a vacuum.
• Excision technique. If the underlying cause of the gynecomastia is glandular breast tissue or excess loose skin, excision techniques are recommended. With the incision technique, glandular tissue or skin will be manually cut away. If the surgery will include the movement of the nipple or areola to achieve a more natural masculine look, excision is also recommended.
• Combination of liposuction and excision techniques. Occasionally, male breast reduction requires a combination of excision and liposuction. Dr. Wall will be able to recommend the best course of action for you.

There are risks associated with any surgery, and some potential complications associated with male breast reduction in general. You will be asked to sign consent forms, and each individual person must decide if the rewards outweigh the risks. 

Some potential risks of male breast reduction include:

• Allergic reactions to tape, suture materials, glues, topical preparations or injected agents
• Anesthesia risks
• Bleeding
• Blood clots
• Potential breast asymmetry 
• Changes in nipple or breast sensation. These may be temporary or permanent.
• Damage to deeper structures like nerves, blood vessels, muscles and lungs. These can also be either temporary or permanent.
• Deep vein thrombosis, cardiac and pulmonary complications
• Fluid accumulation
• Fatty tissue found in the breast may die, also known as fat necrosis 
• Poor wound healing
• Unfavorable scarring, although Dr. Wall typically tries to hide scarring in the natural contours of the chest
• Infection
• Possibility of revision surgery 

Each patient will be given individual instructions on how to care for their surgical site, but there are some general guidelines and expectations about recovery.

A small, thin tube will be placed under the skin to drain away excess fluids. This tube is only temporary and will be removed at some point after surgery as the tissue heals. Dressing or bandages will be applied to any incisions that were made during surgery, and a support garment may be used to help manage any swelling and support the new contours of the chest.

Once you’ve arrived at home, avoid excess movement or any activity that would place excessive force on your surgical site. Following Dr. Wall’s instructions is absolutely essential to your recovery and the success of your procedure.

Scarring from male breast reduction is usually permanent, though most scars will be concealed within the contours of the breast. Scars will fade over time. Though there are results immediately visible, final results may take 3-6 months to manifest.

In some cases, another surgery may be necessary later in life to tighten and reposition the breast tissue again, but this is not particularly common. 

This surgery can increase the confidence and self-esteem of any man that suffers from gynecomastia surgery, but it is important to remember that all surgical procedures are serious, and require serious thought and consideration. 

It is also important that you follow your Dr. Wall’s instructions post-operation, in order to get the best possible results from your male breast reduction.