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The development of male breast tissue can be surprising and upsetting. The most common age for this occurrence is during puberty, when hormone levels change, but it can also occur in adulthood. Whether it’s on one side, like the man shown below, or on both sides, Gynecomastia can be a source of frustration for men both in and out of clothing. Fortunately, treatment is available in the form of Gynecomastia Reduction Surgery.

Unilateral Gynecomastia

Gynecomastia can involve either one or both male breasts. When gynecomastia develops on only one side it is referred to as Unilateral Gynecomastia. The asymmetry calls more attention to the breast, and makes gynecomastia even more obvious. The fullness is noticeable in shirt that cling, especially light, solid colors. Often, my patients present with multiple layers of loose fitting, patterned clothing to disguise their chest.

Unilateral (one sided) gynecomastia - corrected with male breast reduction surgery

Sometimes, gynecomastia occurs on only one side, making it more obvious than when it is bilateral (on both sides). Gynecomastia reduction provided this patient symmetry and the option to confidently wear tight shirts.

The patient above is in great shape, and works hard to maintain his physique. Unfortunately, it does not matter how lean you are as gynecomastia does not respond to weight loss, and in this case, the lack of fat makes the asymmetry more obvious.

Gynecomastia Reduction, a short, outpatient surgical procedure was performed to remove the excess breast tissue. The incision is hidden along the edge of the areola. The result is restoration of the contours he has worked hard to achieve. Now he can wear any shirt he chooses, or go shirtless, without embarrassment.

Cold Weather and Gynecomastia

For patients with Gynecomastia, cold weather is a double blessing. Firstly, the layered look fits in nicely with the weather. Secondly, cold weather causes the muscles beneath the nipple to constrict, smoothing out the puffy nipple. In the case below, his chest contour looks smooth; however, as the skin warms, the muscle relaxes, allowing the gynecomastia to push the nipple outward, as seen in the chest above. Pinching the nipple can temporarily hide puffy nipples, but my patients are looking for a more permanent solution.

Gynecomastia reduction - side view of before and after male breast reduction

These Gynecomastia Reduction before and after pictures show the change in contour possible with male breast reduction. In the after photo, the skin follows the contour of the muscle and the nipple does not puff out when warm.

In the above case, a combination of Liposuction and direct excision of the gland was used to achieve the best outcome. This combo provides safe, predictable results and the ability to adapt to each patient’s specific needs. Soft fatty tissue can be suctioned away with liposuction, while the firm breast tissue beneath the nipple can be directly excised.

Larger Gynecomastia Reduction

Larger amounts of breast tissue require larger excisions and consideration of the skin’s ability to recoil. For younger men with good skin tone, removing the bulky breast tissue allows the skin to recoil naturally. It can then conform to the shape of the underlying muscles, as seen in the Gynecomastia Before and After Pictures shown below.

Male breast reduction before and after pictures.

These male breast reduction before and after pictures show a dramatic change in breast volume after reduction. Since he had good skin tone, he did not require skin excision. The natural recoil of the elastic skin conforms to his muscles after surgery.

Liposuction was not very effective in removing the excess breast tissue in this case, because the gland was large and consisted of very firm glandular tissue rather than fat. The majority of the removal was performed via small incisions around the lower half of the nipple areolar complexes. The result is a firm chest that no longer bounces with motion, and a happy patient.

Gynecomastia Reduction with Skin Reduction

Sometimes, the skin is too loose for simple removal of the breast tissue and chest wall fat. When the skin needs to be tightened, Male Breast Reduction Surgery is performed.

Some people are prone to having excess chest skin, but most commonly it is the result of massive weight loss. When the skin is loose before surgery, additional surgical interventions are required to address the problem. Removing the excess tissue from beneath the loose skin causes the skin to lose support. The result is that the skin deflates and falls further, much like the final phase of letting air out of a balloon. Additionally, without tightening the skin, the normal healing process can lead to additional irregular skin folds and bizarre skin motion with muscle flexion.

Male breast reduction with skin resection and "free-nipple" skin grafts

Extreme weight loss calls for an extreme makeover. In this case, the excess skin was removed and the nipples repositioned as skin grafts.

This gentleman has worked very hard over the last three years to lose weight. A combination of mind-set, diet and exercise has led to a remarkable transformation. However, loose chest skin serves as a constant reminder of his former self. Despite his transformation, he remained self conscious and was uncomfortable showing his chest.

Before Male Breast Reduction Surgery, his chest skin was very loose. In fact, you can see a brown spot on his left chest above his nipple at about 10:30 in the before picture. The same spot is seen below the nipple at eight o’clock in the after picture. The skin from just below the brown spot all the way down to the bottom of the breast was resected. The scars are placed in the inframammary fold (IMF) to keep them inconspicuous. The after picture is just a few weeks after surgery, so the still healing scars are red and obvious. As the scars heal, they fade into the shadow of the IMF and become harder to see.

You may have noticed that this patient’s nipples were located in the skin that was removed to tighten the chest. In fact, they were removed from the specimen like skin grafts, reduced in size and then replaced onto the chest in the desired positions. Temporary numbness is expected, but sensation often returns to the nipples via the skin nerves under the nipple grafts.

Above, I mentioned changes in temperature, or pinching, can temporarily improve the appearance of the chest. In this before picture, the patient’s right chest has the typical appearance of “warm” gynecomastia with an enlarged, puffy areola. His left chest, on the other hand, has the tightened appearance of a cold, or in this case, recently pinched nipple. Unfortunately, the improvement only lasts a few minutes, while surgery provides more permanent results.

Male Breast Reduction Consultations

If you are considering Gynecomastia Reduction this Spring, consult an experienced and Board Certified Plastic Surgeon. In the San Francisco Bay Area call (925) 943-6353 to schedule a private, informative consultation appointment.

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