How plastic surgeons help men with gynecomastia
One of the most visibly defining features of the feminine form is the breasts. Large, small, voluminous or perky, when people think about breasts, they tend to think of the female form. Yet, all humans have breast tissue. Generally, before puberty, boys and girls both have a small amount of breast tissue. It's the hormonal changes that occur during puberty that trigger an increase in breast growth and development.
However, hormonal changes, health conditions, medications and other factors can also trigger breast growth and development in boys and men. Breast growth in men, because of the traditional implications of male and female body ideals, can be embarrassing, hard to hide and difficult to discuss. Men may feel ashamed, vulnerable and self-conscious about their bodies, hiding their physique behind bulky clothing.
You don't have to be ashamed about carrying extra breast tissue, but if you find yourself struggling with your self-image and are looking for a way to improve the appearance of your chest and increase your confidence, a plastic surgeon may be able to help.
What is gynecomastia?
Gynecomastia is a condition characterized by an increase in the amount of breast tissue in boys or men. An increase in benign glandular tissue generally causes this growth in breast tissue. Yet, obesity and excess adipose (connective) tissue can sometimes also appear as excess breast tissue in males. Even strict dieting and intense exercise will not reduce the size of the breasts.
The most common cause of gynecomastia is a hormonal imbalance, meaning varying levels of the hormone estrogen and testosterone in men. Estrogen is predominantly considered a "female" hormone, and testosterone is a "male-dominant" hormone, but men and women have both hormones in their systems. Men can develop gynecomastia when they have high estrogen levels, or their estrogen levels are out of balance with their testosterone levels.
Natural hormonal changes, especially at puberty, can lead to the enlargement of breast tissue in boys. Medications such as anti-androgens, anabolic steroids, ADHD medications, ulcer medications and opioids can also cause gynecomastia. Medical conditions, herbal products and recreational drugs can also lead to an increase in male breast tissue. Statistics suggest that 50 to 70 percent of males have palpable or discernible breast tissue.
How can plastic surgery combat gynecomastia?
How do you know if you are a candidate for surgery to treat gynecomastia? It's time to do some soul-searching. Ask yourself how comfortable you are in your skin and whether excess breast tissue impacts your health and self-esteem.
You have no reason to feel like less of a man or self-conscious about yourself when a significant portion of the male population has noticeable breast tissue. However, if it bothers or concerns you, board-certified plastic surgeons who are ASPS members have options that can help you feel more confident in your body.
"A man with excess volume in the chest region who is an appropriate candidate for surgery, healthy enough to undergo an outpatient surgery under general anesthesia, at a normal body weight, a nonsmoker and regular exerciser," said Karen Horton, MD, MSc, FACS.
She also recommended that men with the condition consider the cause of their gynecomastia before surgery.
"Other causes of gynecomastia should be ruled out, including a hormone imbalance due to pituitary issues, excessive THC use and other potential causes such as anti-androgen medications for BPH," said Dr. Horton, recommending that patients seek more information on the causes of gynecomastia.
Although Dr. Horton has never personally seen a case of gynecomastia caused by excessive THC use, some research indicates a potential link between high levels of THC and the development of excessive breast tissue in men.
Treating gynecomastia means evaluating a patient's condition and reviewing their aesthetic goals. Gynecomastia surgery may include fat removal, glandular tissue removal, excess skin removal or a combination of these procedures to remove fat and tissue and sculpt the chest.
"The recovery process may vary, depending on the extent of gynecomastia and the specific procedures required to treat the condition," said Josef Hadeed, MD, FACS. "For example, men who only require excision of a minimal amount of breast tissue will have a shorter recovery process compared to men who undergo more extensive resection of breast tissue and excess skin. In general, though, most men can expect to have swelling in their chest and be asked to wear a compression vest for several weeks after the surgery. Work can generally be resumed in one week, but typically, it may be four to six weeks before being cleared to exercise again."
Dr. Horton noted that men may also experience temporary swelling, numbness, bruising and a firm tissue texture called "edema," which can take several months to dissipate. Yet, the results can be life-changing for some.
"Men can expect less prominence in the breast region and a less feminine look," said Dr. Horton. "They can build up their pectoralis major muscles through pushups and bench press exercises to complement their chest contour before and after surgery. Scars are permanent and may take a full year to fade, especially in darker-skinned patients."
Benefits of gynecomastia surgery
There are risks involved with any surgical procedure. Be aware surgery may change sensitivity to the chest.
"Men should ask about loss of sensation to their nipples, especially if their nipples are an important erogenous zone to them," said Dr. Horton.
Yet, for men feeling self-conscious about their appearance, the benefits can be stunning and may help them achieve the confidence they thought they had lost.
"Once excess male breast tissue and fat are surgically removed, it should be a permanent correction," said Dr. Horton. "It is important to maintain a healthy body weight after surgery and avoid anything that may have contributed to the gynecomastia formation in the first place."
Surgical options for male breast reduction can profoundly impact a patient's sense of self.
"The benefits of undergoing surgery to treat gynecomastia are that the excess breast tissue is removed, thereby restoring a more masculine appearance to the chest," said Dr. Hadeed. "This can have a tremendous psychological benefit to the patient, as they may no longer be self-conscious about the appearance of their chest."
Men should be open with themselves and their doctor about their medical issues, drug use and how gynecomastia impacts their physical and mental wellness.
"They are usually concerned about how they can avoid recurrence of their 'moobs' (man boobs)," said Dr. Horton. "It is important to try to determine the cause of gynecomastia, which can be secondary to testosterone supplementation in the form of injectable steroids or other hormone-containing supplements. Even seemingly benign 'muscle-building' ingredients can contain precursors to testosterone, which can have a negative feedback loop on testosterone production by the brain, resulting in estrogen production and breast tissue formation."
A plastic surgeon is not there to judge you. They are there to offer support and options to help you look and feel your best. With that said, never be afraid to ask questions and engage in an honest dialogue with your board-certified plastic surgeon.
To find a qualified plastic surgeon for any cosmetic or reconstructive procedure, consult a member of the American Society of Plastic Surgeons. All ASPS members are board certified by the American Board of Plastic Surgery, have completed an accredited plastic surgery training program, practice in accredited facilities and follow strict standards of safety and ethics. Find an ASPS member in your area.
