A male breast reduction involves reducing the volume of glandular (breast) tissue, adipose (fatty) tissue, and sometimes excess skin of the male chest wall due to gynecomastia. Typically men with larger breast tissue may feel self conscious or embarrassed about their chest, frequently choosing to avoid shirtless situations because of the appearance of their full chest. Gynecomastia, which means ‘woman-like breast’ is a condition in which there is overgrowth of the breast tissue (proliferation) that results in the development of firm rubbery tissue beneath the nipple and fatty tissue around the chest wall. Gynecomastia results from a hormonal imbalance at the breast tissue level causing the excess growth. This can be due to hormonal changes, obesity, certain medications, drug use (including marijuana and steroids), alcohol, hereditary factors, and in many cases for unknown reasons. It can affect just one breast, or both breasts, and may cause widening of the nipple & areola, and in some cases droopiness (ptosis).
The male breast reduction procedure accomplishes a few important goals to improve the chest wall appearance:
- reduce the breast volume by removing excess breast and fatty tissue
- improve symmetry of the two breasts
- improve the overall chest contour
- reduce any excess skin if required
There are a variety of different male breast reduction surgical techniques. Dr. Sharma will go over your options during the consultation and determine what will work best for you. Typically the procedure involves liposuction through a small incision at the lower part of the areola. This helps to reduce the fatty tissue and improves the contour of the chest wall. Sometimes, if there is excess glandular breast tissue below the nipple, a semi-circular incision is made around the lower half of the areola to cut out the firm rubbery tissue. In severe cases, with excess skin and droopiness, a more extensive operation is required to remove the extra skin and re-position and reshape the nipple and areola. Dr. Sharma will discuss the pros and cons of each of the scars and techniques with you to determine what is best for your individual needs.
Frequently Asked Questions
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Am I a Good Candidate?
Healthy, non-smoking patients who have these features typically make good candidates for a male breast reduction procedure:
- excess breast volume (fatty and/or breast tissue)
- chest wall asymmetry – one breast larger than the other
- a desire to improve the shape of the male chest and feel more confident
- realistic goals and expectations
- abstinence from drugs contributing to the gynecomastia (e.g.: anabolic steroids, marijuana, etc)
- no reversible medical causes to explain the gynecomastia (e.g.: abnormal hormone levels in the blood)
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What happens on the day of surgery?
Surgery takes place in the operating room with you asleep under a general anesthetic, and can take 2-3 hours. Markings are first made before going into the OR to plan how much breast tissue to remove. Once you are asleep, fluid is typically injected into the breasts and on the lateral sides to minimize pain and bleeding and liposuction is done to remove the excess fatty tissue from the sides of the breasts and to improve the aesthetic appearance. The incisions are then made very carefully around the lower half of the areola and the denser breast tissue is removed from each breast and weighed to give you an objective amount of volume reduction. The blood supply is preserved to the nipple without detaching it. All of the stitches are dissolving underneath the skin to give you the best possible scars. Generally drainage tubes are NOT required. Paper tapes and gauze dressings are applied. You are placed into a post-operative compression garment to minimize bruising/swelling. After surgery, you will be in the recovery room for a couple of hours and monitored closely. All post-operative instructions and prescriptions will be given to you before going home. Generally, no overnight stay is required and you will be able to go home the same day of surgery with a responsible adult.
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What happens after surgery?
Recovery is a gradual process. You are encouraged to take it easy but still get up frequently for short walks to reduce the risk of blood clots in the legs from immobility. The first 3-4 days you may need some of the prescribed pain medications, and will be recovering from the anesthetic and medications you were given. Most patients are needing only Tylenol or Advil after that. You will be able to shower directly over the paper tapes after 2 days. Generally it is a good idea to take 1-2 weeks off work, depending on what type of work you do. At 4 weeks from surgery you will typically feel fully recovered. You will have to avoid heavy lifting and vigorous exercise up until about 6 weeks from surgery. The final breast shape can take up to 3 months before all residual swelling has completely subsided.
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