cOSMETIC PROCEDURES > BREAST > male breast reduction
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Male Breast Reduction
Excess breast tissue in men (gynecomastia) is very common, however it can affect your self confidence. Dr. Abedi will provide an individualized surgical plan to best improve your chest contour with the least amount of visible scars.
What is gynecomastia?
Gynecomastia is a condition of over-developed or enlarged breasts in men that can occur at any age. The condition can be the result of hormonal changes, heredity, obesity, or the use of certain drugs. Gynecomastia can cause emotional discomfort and impair your self confidence. Some men may even avoid certain physical activities and intimacy simply to hide their condition.
Gynecomastia is characterized by:
Excess localized fat
Excess glandular tissue development
Sometimes excess breast skin
Presence unilaterally (one breast) or bilaterally (both breasts)
What is Male Breast Reduction?
Plastic surgery to correct gynecomastia is technically called reduction mammaplasty. The procedure reduces breast size, flattening and enhancing the chest contours. In severe cases of gynecomastia, the weight of excess breast tissue may cause the breasts to sag and stretch the areola (the dark skin surrounding the nipple). In these cases the position and size of the areola can be surgically improved and excess skin may be reduced. The chest can further be contoured with liposuction to help define the pectoralis major muscle definition.
Is it right for me?
You are physically healthy and of relatively normal weight
You have realistic expectations
Your breast development has stabilized
You are bothered by the feeling that your breasts are too large
Adolescents may benefit from surgery, although secondary procedures may be needed in the future should breast development continue.
Surgical correction of gynecomastia is best performed on:
Men whose condition cannot be corrected through alternative medical treatments
Healthy individuals who do not have a life-threatening illness or medical conditions that can impair healing
Non-smokers and non-drug users
Consultation and Preparing for Surgery
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Your surgical goals
Medical conditions, drug allergies, and medical treatments
Current medications, vitamins, herbal supplements, alcohol, tobacco, and recreational drug use (including steroids and marijuana): There are a number of medications and drugs that can lead to gynecomastia and stopping them can occasionally reverse the changes seen.
Previous surgeries
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Evaluate your general health status and any pre-existing health conditions or risk factors
Perform diagnostic testing to determine the underlying cause of gynecomastia; this may include testing of your endocrine function and is often performed by an endocrinologist. Dr. Abedi recommends endocrinology assessment specially in unilateral cases or adolescents.
Order additional diagnostic tests such as ultrasound to assess the breast tissue
Examine your breasts and may take detailed measurements of their size and shape, skin quality, and placement of your nipples and areolas
Take photographs for your medical records
Discuss your options
Recommend a course of treatment
Discuss likely outcomes of gynecomastia correction and any risks or potential complications
Discuss the use of anesthesia during your procedure
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Get lab testing or a medical evaluation
Take certain medications or adjust your current medications
Stop smoking
Avoid taking aspirin, anti-inflammatory drugs, and herbal supplements as they can increase bleeding
The Procedure
STEP 1: Anesthesia
Medications are administered for your comfort during the surgical procedure. Your anesthesiologist will make recommendations on the type of anesthesia based on your history and general health.
Step 2: Liposuction
In cases where gynecomastia is primarily the result of excess fatty tissue, liposuction techniques alone may be used. This requires insertion of a cannula, a thin hollow tube, through several small incisions. The cannula is moved back and forth in a controlled motion to loosen the excess fat, which is then removed from the body by vacuum suction.
Step 3: Excision
Excision techniques are recommended where glandular breast tissue or excess skin must be removed to correct gynecomastia. Excision also is necessary if the areola will be reduced or the nipple will be repositioned to a more natural male contour. Incision patterns vary depending on the specific conditions and surgical preference. Most often the only incision is along the lower areola border which is well hidden.
In more severe cases of excess skin and gland, more extensive incisions may be used which are depicted below.
Step 4: Liposuction & Excision
Excision techniques are recommended where glandular breast tissue or excess skin must be removed to correct gynecomastia. Excision also is necessary if the areola will be reduced or the nipple will be repositioned to a more natural male contour. Incision patterns vary depending on the specific conditions and surgical preference. Most often the only incision is along the lower areola border which is well hidden.
risks and safety
The decision to have gynecomastia surgery is extremely personal, and you'll have to decide if the benefits will achieve your goals and if the risks and potential complications are acceptable. You will be asked to sign consent forms to ensure that you fully understand the procedure and any risks and potential complications.
The risks include:
Reactions to tape, suture materials, glues, topical preparations, or injected agents
Anesthesia risks
Bleeding (hematoma)
Breast asymmetry
Breast contour and shape irregularities
Changes in nipple or breast sensation may be temporary or permanent
Damage to deeper structures - such as nerves, blood vessels, muscles, and lungs - can occur and may be temporary or permanent
Deep vein thrombosis, cardiac and pulmonary complications
Fatty tissue found in the breast might die (fat necrosis)
Fluid accumulation (seroma)
Infection
Persistent pain
Poor wound healing
Possibility of revisional surgery
Unfavorable scarring
RECOVERY AFTER SURGERY
After surgery, dressings or bandages will be applied to your incisions and a compression vest may be used to minimize swelling and support your new chest contour as it heals. A small, thin tube may be temporarily placed under the skin to drain any excess blood or fluid that may collect. This is usually done when significant liposuction is performed in conjunction with surgical gland removal.
Before leaving the hospital or surgical facility, Dr. Abedi will give you specific instructions that include how to care for the surgical site and drains, medications to apply or take orally to aid healing and reduce the potential for infection, specific concerns to look for at the surgical site or in your general health, and when to follow up with her office. You will be instructed to wear the compression vest around the clock for the first 2-4 weeks depending on your healing. There are tapes on your incision which stay on for 2 weeks or until they fall. You will be instructed to continue taping your incisions with silicone tapes for the first 3 months to optimize the appearance of your scars.
It's very important to follow Dr. Abedi’s instructions and attend follow-up visits as scheduled to ensure your progress is on track.
The final results of male breast reduction are permanent in many cases. However, if gynecomastia resulted from the use of certain prescription medications, drugs (including steroids), or weight gain you must be fully free from these substances and remain at a stable weight in order to maintain your results.
When you go home
If you experience shortness of breath, chest pains, or unusual heart beats, seek medical attention immediately. Should any of these complications occur, you may require hospitalization and additional treatment.
results
The results of male breast reduction/ gynecomastia surgery are immediately visible. Over time, post-surgical swelling will resolve and incision lines will fade. The final results will appear over the next few months. Incision lines are permanent, but will continue to fade over time.
Will there be scars?
Any surgical treatment to correct gynecomastia will require incisions. While most incision lines are concealed within natural contours, some may be visible and are a necessary result of breast reduction surgery.
All scars are permanent, even though some scars may be concealed in the natural contours of the chest. The practices of medicine/surgery is not an exact science. Although good results are expected from your procedure, there is no guarantee. In some situations, it may not be possible to achieve optimal results with a single surgical procedure.
Another surgery may be necessary:
To perform additional tightening or repositioning of the breasts
To treat any complications that may occur
The medical services plan covers the cost of gynecomastia surgery in special cases only. However, liposuction or other contouring procedures that may be performed at the same time with gland excision are never covered. It is best to schedule a consultation with North Vancouver breast surgeon, Dr. Nasim Abedi. Call 604-983-9985. We look forward to meeting you.
Cost may include:
Anesthesia fees
Hospital or surgical facility costs
Medical tests
Post-surgery garments
Prescriptions for medication
Surgeon's fee
Follow up visits fee
cost
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