Gynecomastia Correction (Male Breast): Advanced Art of Cosmetic Surgery

Advanced Art of Cosmetic Surgery Thomas M. DeWire, Sr., MD, FACS Specializing in Cosmetic Plastic Surgery Richmond, Virginia, USA


	Body Contouring
	*Gynecomastia*

Gynecomastia Treatment or Correction of Male Breast Over-development:
	Male breast over-development or Gynecomastia is generally a bilateral and symmetrical anatomical abnormality of male breast maturation. Occasionally due to endocrine hormone abnormalities, the process most often occurs with no apparent cause in adolescent or fully mature males. Obesity may be a contributing factor, but equally often the problem is simply due to undesirable pectoral fat storage and some element of glandular tissue enlargement in the male breast. Certain medications may also contribute to the development of Gynecomastia, especially drugs used for hormonal treatments of some male cancers. Gynecomastia usually does not signal the presence of any "disease", but since Breast Cancer does occasionally occur in older males, the finding of unilateral (one-sided) male breast enlargement must be considered a particular danger, and biopsy is usually warranted. Although the anatomical finding of Gynecomastia does not usually represent a disease, it is a source of teasing, and anguish, in adolescent males, and certainly a source of significant embarrassment in adult men. As such, the surgical correction of this deformity has often been a covered expense under health insurance in the past. However, with the advent of "managed care" and HMO-type health insurance schemes this treatment has usually been arbitrarily labeled as "cosmetic surgery", and thus is very frequently denied by insurance companies, much like female breast over- development (see Breast Reduction Mammaplasty) has likewise been labeled as a "cosmetic problem". Treatment of Gynecomastia in my Office Surgical Suite usually entails a combination of Tumescent Liposuction contouring, and direct removal of excess glandular breast tissue which is too fibrous to be removed and shaped by liposuction technique alone. A small incision under each nipple results, and generally heals quite favorably. A compression garment is worn on the chest for about two weeks after surgery, and exercise is limited for about 3-4 weeks. Patient photos are shown below. A link to the Gynecomastia Data Sheet is found here: Gynecomastia

Photos Before and After Surgery:

Case 1: A healthy 37 yr old male with significant gynecomastia and some chest wall asymmetry.			Photos are shown before and after a combination treatment of gynecomastia by direct sub-cutaneous mastectomy excision of fibrous breast tissue, and chest wall contouring by tumescent wet liposuction technique. This procedure was done in our Office Surgical Suite under local anesthesia and mild IV sedation to maximize patient comfort. Access incisions are in the lower aspect of the areola-skin junction, and the liposuction was done via two small stab incisions (3mm) in the natural crease beneath each breast.

Case 2: Gynecomastia in a 14 year-old male is shown. Teasing is usually a problem in this age group.

Gynecomastia male breast tissue development

Male breasts

Tumescent Liposuction, and direct excision of excess breast tissue by open approach via small nipple incision, was done with the result displayed at 2 years.

Case 3: Gynecomastia in a 35 year old truck driver with deformity of shape as well as fatty and fibrous breast tissue excess.

Male pectoral breast shaping Subcutaneous mastectomy

Result at 2 - 3 months after Tumescent Liposuction and direct excision, with correction of tubular protrusion of the nipple/areola complex and the underlying breast.

Gynecomastia Data Sheet Link

Related Body Contouring Links:

To Other photo Illustrated Procedures:

Abdominoplasty (Tummy tuck)

Mommy Makeover or Post-Pregnancy Contour Restoration

Mini-tummy Tuck with Tumescent Liposuction

Tumescent Liposuction

Male Body Contouring

Gynecomastia (Male Breast Contouring)