Male breast reduction: The physical and emotional recovery process

You most likely think of women when comes to breast procedures in plastic surgery. Women do, in fact, make up the vast majority of patients. However, men are increasingly more accepting of plastic surgery as it has become significantly less taboo during the past decade.

Among the most common procedures for men is gynecomastia surgery, more simply known as male breast reduction. This procedure is popular in all age groups and involves removing excess tissue in the breast area that cannot be eliminated through diet and exercise alone.

One unique aspect of male breast reduction is postoperative recovery. Not only do patients need to focus on the physical recovery of their chest, but they also need to work through the emotional aspects the physical change brings as well.

We spoke with ASPS Member Surgeons Douglas Senderoff, MD, FACS, and Darrick Antell, MD, FACS, to gather insights about male breast reduction and what patients can expect during their recovery, both physically and emotionally.

The male patient profile

Although women make up the majority of plastic surgery patients, some plastic surgeons specialize in the treatment of male breast reduction, so their practices attract more men.

"Male patients usually account for only 20 percent of a typical plastic surgery practice," said Dr. Senderoff. "In my surgical practice, located in Manhattan, over 50 percent of my patients are male due to my very busy gynecomastia practice."

Any male with overdeveloped breast tissue may be a candidate, but there is a common demographic that seeks plastic surgery.

"Patients are 25 to 60, with the majority in the 25 to 35 range," said Dr. Antell. "The most frequent complaint is not being able to wear a golf shirt without being self-conscious of their breasts. Men want to maintain a professional edge and achieve a look that has eluded them with diet and exercise alone."

Most patients are adults, but some have been bothered by how their chest looks since childhood. Some try several different options to reduce their enlarged breast tissue before turning to plastic surgery.

"The typical gynecomastia patient in my practice are males in their 20s, 30s and 40s who have been dealing with concerns about their chest for years, sometimes dating as far back as puberty," said Dr. Senderoff. "Most of my patients are fit and committed to a healthy lifestyle and have been unsuccessful and improving their chest appearance, even after weight loss, diet and exercise. Many of these patients were never aware of a remedy for their enlarged breasts."

The male breast reduction process

While the exact procedure does not substantially differ between men and women, there are some notable differences in preoperative, operative and postoperative procedures.

"The typical preop process for a male breast reduction patient includes a detailed medical history and physical with attention to possible hormonal issues, as well as any medications which may have contributed to the breast hypertrophy (larger chest muscles because of exercise)," said Dr. Senderoff.

Once the patient is in surgery, that's where the transformation begins. Plastic surgeons can achieve results men could never accomplish at the gym, no matter how much time they spend doing bench presses. Some skin may be removed during female breast reduction, but this is typically not the case in male breast reduction.

"I regularly palpate (examine by touch) the breast on physical exam," said Dr. Antell. "If the tissue is mostly fat, then I can liposuction that out, but most of the time, there is a lump of actual breast tissue behind the areola, making it stick out like an ice cream cone with or without a shirt on. The area behind the areola, which is removed, is like a stack of quarters. I can do more in the operating room in one to two hours than they could ever do in a gym in five years. Breast tissue behind the areola simply cannot be decreased with diet and exercise alone."

After surgery, patients should expect to rest for several weeks before getting back to the normal routine. It may be tempting to go back to the gym and work on those pecs, but the body will need time to heal.

"The postoperative course for male patients is usually easier for men than women as there is less suture line healing," said Dr. Senderoff. "I allow my patience to shower within a few days of surgery, but stress that exertional activities should be avoided for several weeks.  A compression garment is placed on the patient immediately after surgery and patients are advised to wear this garment for two to three weeks. The compression garment is more important for male patients as skin contraction is more critical to the success of the male breast reduction than the female breast reduction."

Getting the most out of male breast reduction

As with any surgical procedure, there are certain steps you can take to set yourself up for success when having a male breast reduction procedure.

When seeking out a surgeon to perform your male breast reduction, it's important to make sure that you are choosing one who is an expert in the procedure.

"Is important to seek a consultation from a board-certified plastic surgeon who is experienced in gynecomastia surgery," said Dr. Senderoff.

Additionally, it's critical to know whether the facility where the procedure is done is properly accredited.

"Most of these operations are performed in private facilities and you should be sure the operating room is certified and that the doctor has privileges to perform the operation in a hospital, to be sure the doctor has proper training," said Dr. Antell.

Next, request examples of their work from potential surgeons.

"Ask to see before and after photos and be sure that there is a good vibe in the office," said Antell.

The examples can help you better determine if the surgeon is the right fit for the results you seek.

So many men are frustrated with the appearance of their breasts and don't realize a safe and effective treatment option is readily available. Consult with a board-certified plastic surgeon who is an ASPS member to see if the procedure is right for you.

Although it may not be a well-known procedure, male breast reduction has a special place in plastic surgery for the confidence it gives men of all ages.

"I have found gynecomastia surgery to be one of the more rewarding surgical procedures that I perform as it leads to a high satisfaction rate for patients with minimal complications," said Dr. Senderoff.

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.