Male Breast Reduction (Gynecomastia Surgery)

Introduction

Gynecomastia is the growth of breast tissue in men. Though normally not a health threat, male breast growth can cause men to feel self-conscious or embarrassed by their appearance. Through male breast reduction surgery, Toronto plastic surgeon Dr. Lawrence Tong can help patients achieve more masculine contours to their chest. Dr. Tong understands the unique and personal motivations of men who seek this form of body sculpting surgery, and his compassionate approach and advanced technique make him well-qualified to treat men who suffer from gynecomastia.

What is Gynecomastia?

The development of excess glandular breast tissue in men is called gynecomastia. Gynecomastia is commonly due to hormonal changes during puberty. In most men, breast development in puberty is temporary, but for a small minority, it may be permanent. Weight gain may also be a contributing factor in breast development; many patients have breast enlargement due to fatty tissue accumulation (lipomastia). Although gynecomastia technically only refers to enlargement of the glandular tissue, most people refer to any form of male breast enlargement as’ gynecomastia’ , Many patients treated by Dr. Tong actually have a combination of both lipomastia and gynecomastia.¹

Whatever the cause of male breast growth, patients are often embarrassed by their appearance. They choose to avoid situations where men commonly remove their shirts, such as swimming, changing in a public change room, or going to the beach. A male breast reduction is a procedure performed by Board-Certified Plastic Surgeon Lawrence Tong, MD that can make the chest look normal by reversing the changes associated with male breast development.

What is Male Breast Reduction?

Gynecomastia surgery improves the contour of the male chest by removing the breast tissue and associated soft tissues that contribute to the unwanted appearance. This is accomplished by:

• Removing glandular breast tissue (gynecomastia)
• Removing fatty breast tissue (lipomastia)
• Removing the stretched excess skin (when required)
• Elevating and or reducing the nipple-areolar (when required)
• Correcting ‘puffy nipple’ appearance (when required)

Dr. Tong will carefully evaluate your situation to determine which surgical techniques are needed to accomplish your optimal appearance.

Issues to Consider with Male Breast Reduction Surgery

Correction of male breast enlargement by removal of the offending tissues does not equate to total removal of tissues from the area. The most common complication from male breast reduction surgery is removing too much tissue and causing a depression. This problem is difficult to fix and may look worse than the original concern. Dr. Tong exercises extremely careful judgment during surgery to prevent this from happening.

In addition to selecting a surgeon who is experienced in gynecomastia surgery, it is important to determine whether the cause of a man’s breast growth requires medical treatment. In most men, gynecomastia is caused by hormonal changes attributed to puberty or late middle age. However, there are certain disease processes, or side effects from particular drugs, that can also cause male breast enlargement. These may include:

• Liver failure
• Cirrhosis
• Kidney failure
• Tumors
• Glandular disorders
• Side effects of prescription medications, such as heart medications, steroids, AIDS medications, certain antidepressants, cancer drugs, and prostate medications
• Street drugs, including heroin, methadone, amphetamines, and marijuana

These factors must be identified and dealt with before considering male breast reduction surgery. During your consultation, Dr. Tong will evaluate you to make certain that surgery is an appropriate treatment for you.

Which Type of Gynecomastia Treatment is Right for You?

In male breast reduction surgery, the severity and composition of the breast enlargement dictates which type of surgery is required and which incisions will be used. It is useful to conceptualize the problem by breaking it up into the three different tissue components: i)Fat, ii) Gland, and iii) Skin For many patients, a combination of procedures such as Liposuction and glandular removal are commonly employed to help restore a more masculine appearance to a chest impacted by gynecomastia.³

Types of Surgery for Different Forms of Male Breast Enlargement

Scars After Male Breast Reduction Surgery

Any surgical procedure will leave some type of scar. As a highly experienced plastic surgeon, Dr. Tong specializes in obtaining the least visible scars with the least visible placement. The specific type and degree of scarring is determined by the method of male breast reduction surgery.

Clothing will cover any of these scars. The periareolar scar sits at a normal border between the darker and lighter skin of the areola edge. With your shirt off, the Liposuction and periareolar scars tend not to be visible to other people. Chest hair will also help hide any scars.

The Male Breast Reduction Procedure

Depending the type of surgery required, male breast reduction may be performed under local anesthesia, general anesthesia, or IV sedation. General anesthesia is most commonly utilized except in the most minor degrees of severity.

Gynecomastia correction is carried out by removing the unwanted tissues as dictated by the particular anatomy: fat tissue, glandular tissue, or excess skin. Dr. Tong carefully reshapes the patient’s chest so that it looks flat, but not scooped, with techniques that include Liposuction, glandular tissue removal, excess skin removal, and lifting of the soft tissues.

Near the end of surgery, Dr. Tong positions the operating bed so the patient is sitting upright. This allows his chest to be assessed in the most accurate manner while Dr. Tong makes surgical adjustments to achieve the best possible results. Once completed, he uses plastic surgical techniques to sew the incisions closed. A surgical drainage tube is often used, especially if the area of the glandular tissues extends beyond the areola. If utilized, the drainage tube exits from the same stab incision utilized for the liposuction. After the last stitches are placed, the patient is placed in a surgical chest compression garment and gently awakened from anesthesia.

Recovery after Gynecomastia Surgery

Following your male breast reduction surgery, the anesthetic effects gradually subside as you recover in the post-anesthetic unit, monitored by our registered nurses. After the anesthesia has worn off, you will be able to go home accompanied by a friend or family member. Patients who have surgery performed with local anesthetic only can drive themselves home immediately. If liposuction is utilized, patients are supplied with a compression vest which is worn during the initial 3 weeks of healing.

Once at home after gynecomastia surgery, you should rest. You may perform non-strenuous activities such as watching television, making meals, and reading, but nothing more vigorous. The chest may be swollen and have visible bruising during the first 1-3 weeks. You should expect the chest to feel sore for 7-10 days; your pain medication should be used during this time. A majority of patients return to (non-strenuous) work after 5-7 days.

At one week after surgery, you will see Dr. Tong to have stitches removed and your progress assessed. If a drainage tube was utilized at your surgery, it will be removed. You will likely be allowed to start light exercise (e.g. walking) at 1-2 weeks after surgery. Avoid strenuous activity (jogging, martial arts, weight lifting) until 4-6 weeks after surgery.

The chest may initially look fuller than before your procedure. This is entirely normal, as it takes between 1-3 months for the swelling to fully settle. As the swelling subsides, you will notice that the chest has a more natural look, feel, and shape.

In addition to the first post-operative visit, you will see Dr. Tong at 6 weeks and 6 months after surgery. Post-op photos will also be taken at these visits to document your progress.

Your Male Breast Reduction Surgery Consultation

Dr. Tong and our team at Yorkville Institute of Plastic Surgery understand that gynecomastia can have deep emotional implications, as does male breast reduction surgery. During your private consultation with Dr. Tong at our Toronto practice, he will listen carefully to all of your concerns and goals. He will then explain the proposed treatment plan, and take the time to ensure that all of your questions are answered to your full satisfaction. It is our goal to make sure each patient feels fully educated so that he is able to make a confident choice about treatment.

To learn more about how Toronto gynecomastia surgeon Dr. Lawrence Tong can help with male breast enlargement, set up a consultation by giving us a call at (416) 972-0999, or let us give you a call. Just fill out our contact form and we will call you on the same or the next business day. No physician’s referral is needed.

How to Choose the Best Plastic Surgeon For You

¹ Mayo Clinic. Enlarged breasts in men (gynecomastia). Available: https://www.mayoclinic.org/diseases-conditions/gynecomastia/symptoms-causes/syc-20351793. Accessed May 21, 2020.
² The Cleveland Clinic. Enlarged Male Breast Tissue (Gynecomastia). Available: https://my.clevelandclinic.org/health/diseases/16227-enlarged-male-breast-tissue-gynecomastia. Accessed May 21, 2020.
³ Glenn D Braunstein, MDBradley D Anawalt, MD. Patient education: Gynecomastia (breast enlargement in men) (Beyond the Basics) Available: https://www.uptodate.com/contents/gynecomastia-breast-enlargement-in-men-beyond-the-basics. Accessed May 21, 2020.