Male Breast Reduction
Male Breast Reduction Quick Facts
- Best Candidates: Men who are seeking to reduce the size of enlarged breasts (gynecomastia)
- Procedure Length: 1 to 2 hours
- Inpatient/Outpatient: Usually Outpatient
- Anesthesia: General or local with sedation
- Results: Permanent
- Procedures in 2020: 18,575 (source: American Society of Plastic Surgeons)
As many as 40% to 60% of men are affected by gynecomastia, or enlargement of one or both breasts. Men who are affected by this condition are often embarrassed and self-conscious about their appearance.
Male breast reduction is a surgical procedure to remove excess fat and/or glandular tissue from the breasts. The majority of gynecomastia patients successfully achieve an improved chest contour with breasts that are more flat, firm and masculine.
The procedure information contained in this article will give you a good introduction to male breast reduction. Schedule a consultation with a Top Plastic Surgeon to receive a medical examination and discuss your male breast reduction options.
Male Breast Reduction Overview
During male breast reduction, the breast size is reduced by surgically removing breast tissue from behind the nipple, liposuctioning fat from the breast or a combination of both. Rarely, excess skin must also be removed to reduce sagging. The specific approach used by your plastic surgeon depends on the extent of breast enlargement and the amount of glandular tissue, fat and skin that are present.
What is Gynecomastia?
The term "gynecomastia" is derived from Greek terminology for "woman-like breasts." Gynecomastia, the enlargement of one or both male breasts, is a common condition experienced by an estimated 40% to 60% of men. This condition, characterized by the presence of excess fat and/or glandular tissue at the breasts, is usually benign but can be a sign of underlying health problems.
Gynecomastia occurs when levels of estrogen in the body increase compared to testosterone. Men naturally produce a small amount of estrogen, but estrogen levels that are elevated and out of balance with testosterone can trigger the development of female characteristics, foremost of which is excessive breast size. Natural changes in hormone levels as well as certain medications and medical conditions can upset the balance between these hormones and contribute to the incidence of gynecomastia.
The specific cause of gynecomastia is unknown in many cases. However, contributing risk factors can include:
- Hormone therapy
- Use of anabolic steroids
- Use of marijuana and other street drugs
- Drinking alcohol in excess
- Anti-androgens, AIDS medications, anti-depressants, antibiotics and other medications
- Hypogonadism, tumors, hyperthyroidism, liver failure and other medical conditions
As many as half of adolescent boys develop some degree of breast enlargement as a result of hormone changes during puberty. Gynecomastia in adolescents usually subsides on its own within a few months to 2 or 3 years.
How Male Breast Reduction is Performed
The surgeon begins by making a small incision at the lower perimeter of the areola (the dark area of skin surrounding the nipple) or in the underarm. Excess glandular tissue is carefully excised, or cut out using a scalpel. If liposuction is necessary, a slender tube called a cannula attached to a suction pump is inserted through the incision and used to remove excess fat. If the procedure involves removal of a large amount of tissue and/or fat, excess skin may be removed to allow the skin to conform to the new shape of the breast.
A small surgical drain may be used to prevent the collection of excess fluids. Incisions are covered with a dressing and the chest tightly bandaged to hold the skin firmly in place.
Male breast reduction usually takes from 1 to 2 hours to complete, depending on the specific procedure. The surgery is usually performed as an outpatient procedure in your plastic surgeon's office, in an outpatient surgery center or in a hospital. However, an overnight stay in the hospital may be necessary in some cases.
Surgery to treat gynecomastia can be performed using local anesthesia with sedation or general anesthesia. Local anesthesia numbs the area of surgery and is combined with a sedative to render drowsiness. Under general anesthesia, you will sleep throughout the procedure. The type of anesthesia used depends on the extent of the procedure and the preferences of the surgeon and the patient.
The best candidates for male breast reduction are men who are bothered by overly enlarged breasts (gynecomastia) and are seeking to improve their appearance with a more flat, firm and masculine chest.
Generally, the best candidates for male breast reduction:
- Are emotionally stable and in good physical health.
- Want to improve their appearance and have reasonable expectations.
- Have been evaluated for underlying medical conditions.
- Have fully developed breasts.
- Have skin with enough elasticity to conform to the new chest contour.
Men who believe they may have gynecomastia should first see their physician to be evaluated for medical problems that may contribute to the condition. Men who are overweight may be advised to attempt to reduce breast volume through weight loss and exercise before considering surgery. Discontinuing excessive drinking or use of anabolic steroids, marijuana or other drugs that are linked to gynecomastia may also resolve the problem without surgery.
Male breast reduction is usually performed only on breasts that are fully developed. Teenage boys who develop an abnormal degree of breast enlargement should wait to see if the condition resolves on its own. Gynecomastia that begins in adolescence usually goes away spontaneously within 2 or 3 years.
If you believe that you may be a good candidate for male breast reduction, a qualified plastic surgeon can evaluate your condition, explain anything about the procedure you don't understand, answer all of your questions and help you decide if the procedure is right for you.
Male Breast Reduction Risks
Any surgery carries some degree of risk. Complications experienced by male breast reduction patients are infrequent and usually minor when the procedure is performed by a qualified plastic surgeon. To minimize your risk, be sure to follow all of your plastic surgeon's instructions both before and after the procedure. Contact your surgeon's office immediately if you experience any symptoms you believe may indicate a complication.
The most common risks associated with male breast reduction surgery include:
- Pain, swelling or bruising beyond normal levels
- Excessive bleeding
- Adverse reaction to anesthesia
- Excessive fluid loss
- Fluid accumulation
- Injury to the skin
- Skin rippling
- Pigmentation changes
- Excessive scarring
The scars left by male breast reduction are well-hidden at the edge of the areola (the dark skin that surrounds the nipple). The scars may be red and uneven for several months, but will eventually fade to faint lines. Your surgeon will make the incisions so that the resulting scars are as discreet as possible.
Male Breast Reduction Costs
According to the American Society of Plastic Surgeons, the national average surgeon/physician fee for male breast reduction in 2013 was $3,196. This figure does not include other costs, such as a facilities charge or anesthesia. Your plastic surgeon will provide you with complete information on costs and financing options at your consultation.
The total fee for male breast reduction can vary considerably depending on the region of the country, the extent of the procedure and your specific needs as a patient. Health insurance may cover the cost of the procedure if it is deemed to be a medical necessity. Check with your insurance company to find out if you are covered and what documentation is required, such as a letter from your surgeon.
Male Breast Reduction Consultation
If you believe that you may be a candidate for male breast reduction, the first step is to locate a qualified plastic surgeon and schedule a consultation. During the consultation, you will be examined by the doctor and discuss your options in detail. Don't hesitate to ask any questions you have about gynecomastia and your expectations for the procedure.
The surgeon will examine your breasts to assess the degree of breast enlargement and the amount of glandular tissue, fat and excess skin that are present. A mammogram, or breast x-ray, may be used to reveal the composition of the breasts and help the surgeon determine the best treatment approach. If a medical problem is found, you may be referred to a specialist for treatment.
The surgeon should fully address all of your questions and give you the full details of the procedure, including the benefits, risks, costs and recovery time. You may also ask to see before and after photos of recent patients. Be prepared to discuss your overall health and medical history, including vitamins and medications that you currently take (both prescription and non-prescription), existing medical conditions and allergies.
As the consultation concludes, you may wish to schedule your procedure, take some time to think or seek a second opinion. If you decide to proceed with the procedure, your plastic surgeon will provide you with specific instructions on how to prepare for your male breast reduction. These instructions will include guidelines for eating, drinking, and medications and vitamins to take or avoid before and after surgery.
Male Breast Reduction Recovery
Your plastic surgeon will provide you with specific instructions to follow after breast reduction surgery. To help ensure a smooth recovery, always follow his or her instructions on taking your medications, caring for your chest and resuming your normal activities.
You may feel pain and soreness in the first few days after surgery that should be easily controlled with your prescribed medication. Temporary swelling and bruising usually subsides during the first few weeks but may last for 3 to 6 months. Temporary numbness in the breasts can last up to a year. Contact your plastic surgeon's office immediately if you experience any severe pain, swelling, bruising, nausea or discharge from the area of surgery.
You may wear a compression garment for a few weeks after surgery to help reduce swelling and allow the skin to adjust to the new, flatter contour of the chest. The stitches will be removed in 1 to 2 weeks.
Most patients are up and around almost immediately and can begin light activities within a few days. Depending on the level of physical activity required, most men can return to work within a week. More strenuous activity, including moderate exercise, should be avoided for 2 to 3 weeks. Heavy lifting should be delayed for at least 6 weeks to give the scars time to heal.
Sun exposure to the chest should be avoided, or a strong sunscreen used, for at least 6 months. Sunlight can alter the skin's pigmentation and cause the scar to permanently darken.