What to Know About Gynecomastia and Gyno Surgery
Gynecomastia Causes
Gynecomastia refers to enlarged breasts in men. While large male breasts can be inherited, gynecomastia often results from a hormonal imbalance caused by an endocrine disorder or medications like testosterone replacement therapy and anabolic steroids, weight loss, or weight gain.
Good Candidates for Gynecomastia Surgery
You may be a candidate for gyno surgery if you have enlarged, swollen, or overdeveloped breasts that cause embarrassment or discomfort, and prevent you from participating in activities or affect your psychological well-being. Candidates for gyno surgery have conditions that can’t be corrected through medications or by stopping certain medications. You must also be healthy and not have any illness or condition that could increase your risk of surgical complications. Importantly, your body weight should be at a healthy level to maximize your results and prevent issues with healing after surgery.
Gynecomastia Surgery Cost
Gynecomastia surgery may be covered by your insurance in certain severe cases with extra skin and breast tissue. However, insurance does not cover surgery performed for purely cosmetic reasons and if your gynecomastia is less severe it may not be a covered benefit. After a comprehensive consultation with our plastic surgery, you can meet with our financial counselor. They will give you an estimated cost to help you determine if this is the right approach for you.
You May Have Scars
Your surgeon will use the natural contours of your breasts to minimize scarring as much as possible. Gynecomastia surgery may be performed through tiny incisions if done with liposuction alone but may require larger incisions depending on the severity of your gynecomastia. Your surgeon will discuss the best approach to your case during your consultation.
Your Initial Consultation and Tests
An initial visit with your plastic surgeon may take place via telehealth or in person. We will discuss your reasons for pursuing gyno surgery and your goals. To determine if you are a candidate for male breast reduction surgery, your surgeon will review your family history, general health status, lifestyle habits such as smoking, previous operations, any medications you may be taking, and conditions that can put you at risk for surgery.
During an additional in-person visit, your breasts will be measured and assessed for size and shape, and photographs may be taken for your medical record. Before treatment is recommended, you will also undergo one or more of the following tests.
- Blood tests may be necessary to evaluate your hormone levels. Pre-surgical testing also requires several blood tests to assess your liver and kidney function and to determine if you have an infection, a blood disorder, or anemia, that may have gone previously undetected.
- A mammogram may be performed to detect any underlying breast abnormalities. Gynecomastia can increase your risk for male breast cancer. Additional imaging, including ultrasound and MRI, may also be requested.
Gynecomastia Treatment Options
We will recommend a treatment that may include nonsurgical options or surgery.
Non-Surgical Treatment
If gynecomastia is caused by a hormonal imbalance, medication may be prescribed. These are best discussed with your primary care provider or an endocrinologist. Plastic surgeons do not prescribe these medications. Options include testosterone replacement therapy, an estrogen receptor modulator such as tamoxifen, which has been shown to reduce breast volume; or clomiphene, which stimulates hormone production.
Alternatively, your surgeon may recommend that you lose weight, quit smoking, or discontinue medication before surgery to ensure you experience the best possible outcome.
Surgical Options
If surgery is recommended, we will discuss your options, the expected outcome, potential risks and complications, and your post-operation recovery.
Gynecomastia Procedure and Recovery
Gyno surgery typically includes one or more of the following procedures.
Liposuction
If your main concern is having prominent nipples and you do not need a lot of breast tissue removed, we may only perform liposuction. You will be sedated, and a small thin tube called a cannula is inserted through tiny incisions in the breast. Excess fat is loosened and sucked out through the tube to recontour the chest.
Surgical Removal
Most often, liposuction is combined with surgical removal of excess fat and tissue. The most common technique involves an incision that encircles the dark area around the nipple (areola). Another incision follows the natural curve of the crease beneath the breasts. Excess fat and glandular tissue are removed.
Breast Lift
If the weight of excess breast tissue causes the breasts to sag and stretch the areola, your plastic surgeon will perform a breast lift, and then reposition and resize the areola at the same time.
The procedure is performed under general anesthesia and typically takes about one to two hours. It may be performed in an outpatient ambulatory surgery center or may require an overnight stay. Sometimes a second procedure is required to tighten the skin and achieve optimal cosmetic results.
