What is Gynecomastia?

Case #9066

Gynecomastia refers to breast enlargement in men that can occur at any age. It is characterized by an excess of glandular breast tissue, fatty tissue, and sometimes skin. It may be unilateral (affecting one breast) or bilateral (affecting both breasts). Although rarely discussed, enlarged male breasts is a common condition. It affects approximately 40 to 60 percent of men. It may be associated with genetics, hormonal changes, obesity, certain medical conditions, and specific medications and drugs (such as steroids). When Gynecomastia has been present for over a year or two, the breast deformity usually does not reverse, despite identifying and correcting any underlying medical causes. For those men affected by gynecomastia, it can be a source of significant stress, anxiety and social embarrassment, as well as sometimes physical discomfort. It can impair self-confidence and cause many men to avoid certain physical activities and/or intimate relationships.



Gynecomastia surgery (male breast reduction) is a cosmetic procedure performed to re-contour the chest back to a more masculine appearance, thereby helping many men boost their self-confidence. The procedure is usually done to reduce fat and/or glandular tissue from the breasts, and in extreme cases, may be done to reduce excess skin. It results in a more contoured male chest form that is flatter and firmer. The procedure often incorporates liposuction to effectively remove excess fat and breast tissue through just a couple of minimal incisions. In some cases, direct surgical removal of breast tissue, with or without skin, can also be helpful.

What are the benefits of Gynecomastia surgery?

Male breast reduction surgery is a highly effective treatment with dramatic and long-lasting results. It provides many men with an enhanced sense of self-confidence from restoration of a male chest contour.



Am I a good candidate for Gynecomastia surgery?

Men seeking surgical correction of gynecomastia are typically bothered by the overall enlargement of their breasts and/or the bulging appearance of their nipples and areolas (circular pigmented skin around the nipples). 

Prior to consideration for male breast reduction, the tissue enlargement should have reached a stable level. Also, any underlying medical conditions or drugs contributing to this condition should be addressed prior to undergoing surgery. Also, men seeking this surgery should have specific goals for gynecomastia improvement and have realistic expectations of what can be achieved through surgery. 

Good candidates should be healthy enough to undergo the surgery and anesthesia. They should also be nonsmokers or willing to quit smoking for several weeks before and after surgery. 

An adult of any age may be a good candidate for gynecomastia correction. In some cases, adolescents may also benefit from this procedure; however, additional surgery may be needed in the future if breast tissues continue to develop over time.


How is a Gynecomastia surgery performed?

Male breast reduction is an outpatient procedure performed in an operating room under either monitored IV sedation (“twilight” anesthesia) or general anesthesia. The type of tissue removal procedure(s) incorporated into the surgery vary depending on the specific patient’s contour problem:

Liposuction: In many cases, where gynecomastia is mainly due to excess fatty tissue and to a lesser extent breast glandular tissue, liposuction can be very effective. Through a few small skin incisions on the chest, anesthetic fluid is instilled into the tissues. Then, a cannula (a thin hollow tube) is placed through these same incisions and moved back and forth through the tissues to disrupt and loosen the excess tissue in a controlled manner. Sometimes, ultrasound or laser energy devices may also be to help disrupt more firm tissue. A vacuum connected to the cannula by plastic tubing suctions away the disrupted, excess tissue. Our surgeons use special techniques to properly contour the chest wall using liposuction.

Direct surgical excision: In cases where there is specifically excess breast glandular tissue (especially under and around the areolas) and/or excess, sagging breast skin, direct surgical excision is often needed. The location and patterns of incisions vary depending on the specific excision procedure. Tissue removal immediately under and around the areolas may be done through small incisions at the areolas. If significant excess, hanging skin is present or a wider area of breast glandular tissue is present, additional longer incisions over the chest wall may be needed. After all direct surgical excisions, sutures are used to close the incisions. Occasionally, small flexible drains (tubes) may be placed temporarily to remove excess fluid during the early days after surgery. 


Combined liposuction and direct surgical excision: At times, due to the proportion and location of excess fat, breast tissue, and skin, a combination of liposuction and direct excision methods may be chosen to optimally re-contour the chest. 

At the end of surgery, sterile dressings are applied, followed by placement of a male vest compression garment. Following surgery, our patients arrive in the recovery room, where they rest for a couple of hours, as the anesthetic effects wear off. They are generally able to return home on the same day after surgery, accompanied by a family member or friend.

What is recovery from Gynecomastia surgery like?

Following gynecomastia correction, our patients are encouraged to maintain a male vest compression garment for several weeks to optimize comfort, minimize swelling, promote healing, and support the new chest contour over time. In most cases of gynecomastia surgery, drains are not required; if small drains are deemed necessary, these are typically removed within a few days after surgery. Some bruising, swelling, and discomfort in the early days following surgery is expected. Over-the-counter or prescription medication can address any discomfort experienced.

Our patients can typically resume most home and work activities in less than one week. Exertional or strenuous activity should be avoided for approximately 4 weeks after the procedure. The length of recovery varies slightly depending on the type of procedure(s) performed to achieve correction of gynecomastia. Our plastic surgeons schedule regular follow-up visits to monitor recovery and assure good healing.

While some results are seen within the early weeks following surgery, the long-term results are generally assessed between 6 months and one year. These results are typically long-lasting due to the permanent removal of tissue. However, if the original cause of gynecomastia was a specific medication or drug (such as steroid) or significant weight gain, then following surgery, it is important to avoid that medications or drug and to maintain a stable weight. Otherwise, there is risk of developing gynecomastia again in the future.

What will the scar look like?

All surgical procedures leave some scarring. The location and length of the scar depends on the type of surgical procedure needed to address the gynecomastia. Incisions made for liposuction access are typically very small; therefore, the resulting scars tend to be inconspicuous. Direct surgical excision of breast tissue requires somewhat longer incisions, but the scars resulting from this often can be hidden to some extent within the darker areola skin. If direct excision of excess, sagging skin over the chest is needed, this may leave longer scars. In all cases, our surgeons strive to minimize scar visibility by optimal selection of incision locations, meticulous wound closure without tension, and education of our patients on the best scar care regimen postoperatively.


Will insurance cover Gynecomastia surgery?

Health insurance plans typically do not cover male breast reduction as it is considered cosmetic. Our office does offer a variety of payment and financing options to allow easier access to men seeking this procedure.



Are there good nonsurgical options for Gynecomastia surgery?

While weight loss through diet and exercise may lead to limited improvement in excess fat deposits over the chest, most men with gynecomastia have a combination of excess fat and breast tissue, and surgical treatment with liposuction and/or direct excision of tissue is the most effective way to bring dramatic improvement for this. Also, for those men with significantly excess, sagging skin of the breasts, surgical removal remains the only good option.

Why should I have my Gynecomastia surgery performed at Samra Plastic Surgery?

Our highly skilled plastic surgeons have extensive experience in performing gynecomastia surgery. Also, they are very understanding of the specific needs and wishes of men seeking this procedure. Furthermore, our office staff is highly committed to providing you with a welcoming experience and supportive environment before and after surgery.



Contact us to set up a personal or virtual consultation today.

If you are interested in more information or seek evaluation for gynecomastia surgery, please contact us today at (732) 739-2100 to schedule a personal or virtual consultation with one of our expert plastic surgeons.