Gynecomastia is a condition characterized by enlarged breast tissue in males. The condition can affect males of any age, from adolescents to men of advanced age.
Males who suffer from gynecomastia often feel extremely self-conscious about the problem, and may hesitate to engage in activities that require them to remove their shirt, such as swimming or going to the beach.
At Michaels Aesthetic and Reconstructive Plastic Surgery, we understand that gynecomastia can negatively affect a male’s emotional health. This is particularly true of adolescent boys, who may be teased by their peers at school. However, there is a solution: male breast reshaping surgery. With male breast reshaping, Washington D.C. / Maryland plastic surgeon Joseph Michaels, MD, FACS, sculpts the chest area, correcting the contour and appearance of the male chest, so patients no longer feel self-conscious and can live their life with improved confidence.
The onset of gynecomastia often takes place during puberty and may resolve on its own; however, it can also persist into adulthood. Gynecomastia can also occur with advanced age. The most common cause of gynecomastia is a change in one’s hormone balance. Other factors that typically cause gynecomastia are the chronic use of certain medications such as steroids (which can stimulate hormone fluctuations) and use of certain drugs such as marijuana. In addition, enlarged male breasts can be the result of massive weight gain or loss.
Males with clinical gynecomastia suffer from enlarged glandular breast tissue within the chest. Some males also have significant excess fat in the chest area that makes their chests appear enlarged. When it is mainly excess fat that causes the appearance of enlarged male breasts, the condition is referred to as pseudo-gynecomastia.
To treat true gynecomastia, Dr. Michaels will directly remove the excess breast tissue. In many cases, this can be performed using a special type of liposuction called ultrasound-assisted liposuction. If any glandular breast tissue remains, it may need to be excised through a small incision placed around the areola (the darker skin that surrounds the nipple). He may also need to excise extra skin from the chest area, if present. To treat pseudo-gynecomastia in patients with a good degree of skin elasticity, he performs liposuction to sculpt the chest. If excess skin is present, this will also need to be excised to achieve the optimal contour.
Gynecomastia surgery is usually performed on an outpatient basis, under general anesthesia.
During your consultation, Dr. Michaels will carefully listen to your specific aesthetic concerns. He will conduct a comprehensive history to see if there are any medical or reversible causes of your male breast enlargement. He will then perform a physical exam to assess your chest anatomy, looking specifically at the amount of excess glandular breast tissue, as well as the degree of excess fat and skin in the region. He will also evaluate your skin tone and quality to help determine which surgical approach to recommend to optimize your chest contour and to help you achieve your aesthetic goals.
Male breast reshaping surgery takes between one and three hours, depending on how complex the case is and if Dr. Michaels needs to combine multiple surgical techniques.
Before & After Photos
Excessive Glandular Tissue
If Dr. Michaels is treating an individual who has enlarged glandular breast tissue with good skin elasticity and minimal loose skin in the chest area, he will often perform ultrasound-assisted liposuction. The trade name for this technology is called VASER. This procedure involves the use of small incisions placed around the chest, through which a probe that emits ultrasound frequency is first inserted and used to break up the dense male breast tissue and any fat that is present. This tissue is then removed using traditional liposuction techniques, and the same incisions. If any glandular breast tissue remains, a small incision placed around the areola (the darkly pigmented skin surrounding the nipple) is used to excise the residual breast tissue.
Enlarged Glandular Tissue
For males with enlarged glandular tissue, as well as overly enlarged areolas or a minor degree of extra skin in the area, Dr. Michaels will first remove the excess glandular tissue, in a similar manner as described above, using ultrasound-assisted liposuction. He will then create an incision that runs around the perimeter of the areola. Through this incision, Dr. Michaels will excise any excise skin to help decrease the size of the areola and to remove a mild degree of extra skin from the chest itself.
Males who have experienced major weight loss often have a substantial amount of excess skin throughout the chest. They may also have residual excess fat (pseudo-gynecomastia) in the chest region. To remove an extensive amount of skin from the area, the Dr. Michaels performs a specialized procedure that removes an elliptical shape of skin from the lower chest and elevates the nipple-areolar complex to its optimal anatomical location along the lateral border of the chest (pectoral) muscle. This procedure allows for the maximal amount of skin removal while optimizing the chest’s new contour.
1-3 hours (depending on the extent of the procedure)
Temporary swelling, bruising and some pain
Pain, bleeding, infection, asymmetry, damage to nerves (in rare cases), incomplete improvement
1 week: back at work. 1-2 weeks: light exercise only. 3-4 weeks: more strenuous activity allowed. 8-12 weeks: swelling resolves and patient can resume normal activity.
Dr. Joseph Michaels is a board certified plastic surgeon who is sought out by patients throughout Maryland, Washington D.C. and Northern Virginia. To schedule a private consultation with Dr. Michaels and learn more about male breast reshaping (gynecomastia treatment), contact Michaels Aesthetic and Reconstructive Plastic Surgery by calling (301) 468-5991 in Bethesda, Maryland or (703) 957-8610 in Fairfax, Virginia or by clicking here.