Understanding Male Gynecomastia Surgery: Causes, Procedure & Recovery

What is male gynecomastia surgery?

Male gynecomastia surgery (also known as male breast reduction) is surgery to decrease the size of enlarged breast tissue. The procedure involves surgically removing excess glandular tissue, as well as extra fat and skin, to achieve a more masculine chest contour.

Male gynecomastia surgery, Marquis Plastic Surgery, Miami, FL

What causes male gynecomastia?

Some men experience gynecomastia — characterized by enlarged or excess breast tissue—which is a condition that can develop at any age.1 This condition may result from hormonal imbalances, weight fluctuations, certain medications (e.g. some antibiotics), some health problems (e.g. liver disease), or genetic predisposition. Other classic causes are anabolic steroids and marijuana use.

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.

What are the goals of male breast reduction surgery?

Some men experience emotional discomfort and intimacy-avoidance with gynecomastia. In addition to improving the aesthetic masculine physical appearance of the chest, the procedure often contributes to increased self-confidence and a more positive self-image. The surgery improves the shape of the chest; for example, getting rid of ‘man boobs’ that are apparent when wearing tight-fitting shirts or jackets. In addition, since the scars are typically hidden, when the man is shirtless, the appearance is a much more masculine chest shape.

How is male gynecomastia surgery performed?

The surgery involves removing excess fat, glandular tissue, and sometimes skin, using liposuction, surgical excision, or a combination of both.2 The surgical approach depends on the underlying anatomy / cause. If the gynecomastia is primarily fatty tissue, then liposuction is the preferred approach since it is minimally invasive. In this approach, small incisions are typically made around the areola. Through these port sites, a thin liposuction cannula is used to suction out fat. If the underlying cause is (hard) glandular tissue or loose extra-skin, then surgical technique must be incorporated. In this scenario, the extra-skin and/or glandular tissue must also be removed, to carefully excise the extra tissue and then sculpt the chest for a more contoured, masculine appearance.3 The incisions and hidden in the crease under the breast and are then closed with absorbable sutures and surgical skin glue.
What is the downtime for gynecomastia surgery?

Recovery times vary based on the extent of the surgical procedure, but most patients can return to school / work within a few days. Patients are not permitted to lift arms above the shoulders or drive for 2 weeks, particularly while on narcotic pain killers or Valium muscle relaxing medications. Strenuous activities, including heavy lifting and exercise, are usually restricted for 2 to 6 weeks. During this period, patients are typically advised to wear a compression garment—such as a tank-style shirt—under their clothing. The compression shirt helps support healing and promotes skin retraction. If liposuction was performed as part of the surgical procedure, then lymphatic massage may be initiated within the first week after surgery.

Is there a natural way to treat gynecomastia without having male breast reduction surgery?

In most cases, no.  However, there are some lifestyle changes that can improve gynecomastia, depending on the underlying cause / anatomy. For example, diet and exercise leading to weight loss can achieve improved chest contour. In addition, exercises such as bench presses and push-ups that tighten the pectoralis muscle can definitely improve the chest contour. Reduction in alcohol intake, elimination of marijuana use, and cessation of anabolic steroids can all significantly decrease gynecomastia, if any of these are the underlying cause(s). If the cause of the gynecomastia is a side effect of a medication that is causing abnormally increased estrogen production, then medication adjustments may be necessary (after consulting with the patient’s doctor). This is why hormone levels should be checked prior to surgery, particularly in a pediatric patient.

[2] Holzmer SW, Lewis PG, Landau MJ, Hill ME. Surgical Management of Gynecomastia: A Comprehensive Review of the Literature. Plast Reconstr Surg Glob Open. 2020 Oct 29;8(10):e3161. doi: 10.1097/GOX.0000000000003161. PMID: 33173677; PMCID: PMC7647635.

[3] Kim DH, Byun IH, Lee WJ, Rah DK, Kim JY, Lee DW. Surgical Management of Gynecomastia: Subcutaneous Mastectomy and Liposuction. Aesthetic Plast Surg. 2016 Dec;40(6):877-884. doi: 10.1007/s00266-016-0705-y. Epub 2016 Sep 27. PMID: 27679453.