Gynecomastia is the enlargement of the breast in adult males caused by excessive growth of the breast tissue. Although gynecomastia does not cause any major health problems, it can lead to poor self-image and have psychological effects.
It is important to determine the cause of the gynecomastia. In rare instances, it can be caused by a hormone-producing tumor, but in most cases, it is related to benign causes. Benign causes can include genetics, obesity, marijuana use, anabolic steroid use and some medications.
Weight loss and discontinuing the inciting causes can help improve symptoms, but oftentimes surgery is required to remove the excess tissue contributing to the breast enlargement. Surgery is typically performed as an outpatient procedure.
In cases where the enlargement is primarily due to an excess of fatty tissue, liposuction may be the best surgical option. When glandular tissue and excess skin are present, a male breast reduction procedure can be performed to achieve the best results. The incision is typically placed around the areola but can vary depending on the patient’s anatomy and skin removal needs.
Regardless of the type of procedure performed, the underlying chest muscles are not affected. Surgery usually takes about 2-3 hours. In some cases, surgical drains may be necessary to prevent fluid build-up at the surgery site. Some practices use an ERAS (Enhanced Recovery After Surgery) protocol which includes local anesthetic injected to the surgical site to minimize pain and discomfort following surgery. As a result, narcotics are rarely necessary for pain control.
Patients can expect to be back home the same day with some restrictions (i.e. no running or heavy lifting). Full recovery and release from all restrictions can be expected after six weeks.
It is important to note, surgery does not completely remove all breast tissue, so gynecomastia can return especially if the inciting cause is continued (e.g. marijuana/steroid use). It is important to discuss all options with a board-certified plastic surgeon to determine the best treatment plan.