Male Breast Reduction Surgery Bellevue
Gynecomastia is a condition of over-developed or enlarged breasts in men that can occur really at any age. Most commonly this process starts during adolescence and usually resolves. However, in certain men this breast tissue persists and does not go away. Hormonal changes, heredity, obesity, use of certain drugs, etc. can all play a factor in causing Gynecomastia. Gynecomastia is caused by some of the following: excess fat deposit growth, excess breast tissue growth, excess skin and tissue. If you have Gynecomastia, it can lead to psychological consequences such as emotional stress which can ultimately have an effect on your self-confidence. Men complain about how their chest looks on a shirt, especially aorund the nipple area. For some, their quality of life can be severely affected. Some of the most intimate moments can be impacted. Your relationship with your significant other, going to the gym, hanging out at the beach, or any time your upper body is exposed.
Gynecomastia must differentiate from lipomastia. Lipomastia is excess fat on the chest and not true glandular breast tissue. It is important to distinguish between the two because the treatments are different. Most men have an element of both. Fat and glandular tissue as well as skin excess. Gynecomastia tissue is firm and may feel like a disk or hard ball under the nipple area most commonly.
Male Breast Reduction Surgery or Gynecomastia Correction Surgery ultimately reduces the size of your breasts and will help flatten and contour your breast tissue. Sometimes with very severe cases, your breast tissue can become stretched and your nipples can sag and stretch as well. In this case, techniques associated with a breast lift procedure can help shape and contour your chest. Liposuction alone to the breasts may be an option in some patients or a combination of surgery and liposuction. This will be determined by Dr. Parikh during your consultation. Being a world class trained and board certified plastic and reconstructive surgeon, Dr. Parikh is versatile and can perform the whole spectrum of gynecomastia operations. A tailored customized consultation will determine which approach is best for you to achieve a flat chest.
Approaches to male gynecomastia breast reduction
There are different techniques to remove male glandular breast tissue. This can range from liposuction alone for more fatty element chests to large skin resections including free nipple grafts for large breasts on men. Liposuction works well on fatty deposits and what is left behind maybe the gynecomastia tissue. This may be removed from an incision under the nipple from 3-9 o’clock or periareolar incision. Larger chests with loose skin excess may need 360 degrees perioaroelar skin patterns or sunrise type pattern IMF (inframmanry) incisions to remove all the tissue. Free nipple grafting involves removing the nipple areola complex entirely and then skin grafting it to an ideal site on the newly contoured chest. The ideal male nipple areola is oval in shape and close to the IMF crease and slightly lateral. Dr. Parikh can go through all the various techniques with you during consultation.
Signs of Gynecomastia
The symptoms of gynecomastia can include feeling or seeing a lump underneath the nipple area. This can vary in size and be on one side. Usually it is seen on both sides, but one side may be smaller than the other. Men may complain of “puffy nipples”, the nipple area may swell or puff out with exercise or heat. The male chest may never reduce in size despite hard exercise or dieting. Most often very fit individuals will have gynecomastia and just cannot contour their chest no matter how hard they worked. Gynecomastia can also be painful and cause discomfort at times.
Certain medications are drugs are related to the cause of gynecomastia. These include antidepressant medications, diuretic medicine, anabolic steroids, marijuana uses or alcohol. There are also congenital causes such as Klinefelter’s syndrome or hormonal imbalances where the estrogen levels are too high.
Candidates for Male Gynecomastia Breast Reduction:
All men with symptoms and signs of gynecomastia are candidates for surgery. Men who are generally healthy are ideal candidates. Lipomastia candidates are good for liposuction only usually. Some may need skin excess removal. True gynecomastia patients that have had a mass for over 1 year without any resolution or reduction in the mass can consider surgical treatment. The mass should be present for at least one year prior to considering surgery.
Male Gynecomastia Breast Reduction Cost
Cost of the procedure is based on 1. Anesthesia Fees 2. Facility Fees and 3. Surgeon Fees.
Range is from $6000 to $8000 USD for all combined charges. Prices may vary based on length of time and complexity of the case. Pricing includes all follow up appointments and care. There are no hidden fees.
Postoperative Recovery after Gynecomastia Surgery
This is a same day procedure and the patient will go home that day after the procedure. After the procedure there may be some discomfort. Some swelling and bruising is normal. A vest compression garment will be placed after the surgery and should continue for 4 weeks. Drains are only used for large removal of tissue. Overall recovery is not very extensive. Patients usually return to work after 1 week and may start light exercise after 4 weeks. Full recovery without restriction is around 6 weeks. Showering may occur after 48 hrs. If there are any questions during the postoperative course we encourage patients to call immediately. Follow ups are close initially and will be spaced out farther with time.
Gynecomastia Surgery Complications
- Change in nipple sensation
- Loss of nipple
- Nipple indentation
- Contour irregularity
With any surgical procedure complications can occur, but are generally low. We encourage that you ask about complications during your visit with Dr. Parikh. Dr. Parikh will ensure that your safety is first and discuss any concern in great detail that is tailored to your specific medical history.
Gynecomastia generally occurs by an imbalance between higher levels of estrogen and lower levels of testosterone in males. Medications can also result in Gynecomastia development as well as certain genetic abnormalities. Gynecomastia can occur physiologically or normally in the infant stage, prepubertal or pubertal stage and in the elderly later on in life. If the gynecomastia does not resolve on its own which in most males it does, surgery may be warranted to remove the mass.
Pseudogynecomastia is enlargement of the male chest as a result of fatty tissue or Lipomastia versus actual glandular tissue or Gynecomastia. A thorough history and clinical exam will likely differentiate between the two. This is important because the treatment may differ depending on the diagnosis of Lipomastia versus Gynecomastia.
There are different views on the timing of this surgery. Once the diagnosis has been established, surgery may be indicated. Gynecomastia can resolve on its on its own in the peri-pubertal period. However, after puberty and persistence of the mass for over 1 year with no decrease in size, surgery can be performed. There are conflicting answers on the timing of when gynecomastia surgery can be done. Some plastic surgeons perform the procedure at younger ages due to stigma and traumatization that can occur as the result of gynecomastia.
There is no direct correlation between Gynecomastia leading to Breast Cancer later in life, or turning into cancer. Yes the mass may have to be differentiated from cancer on the initial workup if there is suspicion. Tests such as a mammogram or ultrasound may be needed or possibly a biopsy.
Removal of the gland can be performed a variety of ways;
- Aggressive Liposuction Techniques with Energy
- Liposuction with excision of the mass around the areola
- Excision of the mass with incisions in the lower breast crease or IMF
In general, the glandular tissue can be firm and liposuction alone is not sufficient to remove the entire mass. Most of the time an incision under the areola, around the areola or in the IMF is needed. The approach chosen will be determined at consultation. The technique is dependent on the amount of loose skin the chest has to be removed.
Yes, the procedure can be performed awake with tumescent and sedation if required. More involved gynecomastia surgery such as the inframammary approach where excessive skin needs to be removed and the gland is large, it is my preference to perform under general anesthesia.
Men may have different concerns of what areas of their chest bothers them the most. It can range from how the nipple looks “my nipples look puffy” to how the overall chest looks “It looks like a breast” The common denominator I find is that most men ara concerned about how they look in clothing specifically t-shirts. Areolas that are protruded due to gynecomastia can be bothersome where men are wearing thicker clothing or double the amount of clothing to hide the or minimize this issue. After surgery, the problem is resolved and confidence level rises. Scarring is sometimes a concern, but in my experience it really hasn’t been one.
Estrogen, Estradiol, Testosterone
Liver function tests or LFT’s, Follicle stimulating Hormone (FSH), Luteinizing Hormone (LH), Prolactin, Human Chorionic Gonadotropin (HCG), Thyroxine.
Men produce testosterone mainly for the testes. This increase rapidly during puberty and begins to slow down after the age of 30. Low T or low testosterone in men can affect their mood and behavior. Common symptoms include;
- Increased Weight
- Low Sex Drive
- Mood Swings
Low T can be detected by a simple blood test and testosterone Replacement Therapy may be required to correct the symptoms. https://revivelowtclinic.pharmacy/