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Gynecomastia or male breast enlargement is a very common condition. It occurs in up to 60 percent of adolescent boys and young men. It may also develop later in life. In most cases, there is no apparent cause for the development of the male breast tissue, although it can occur as a side effect of some medications, significant weight gain or from some medical conditions.

Gynecomastia is a medical term that comes from the Greek words for “woman-like breasts.” While the condition is quite common, it is rarely talked about and men often feel self-conscious about the condition. It can lead to teasing, embarrassment and social trauma, causing men to avoid situations that may require that they remove their shirts, such as beaches and athletic activities.

Choosing this Surgery

Abnormal breast development may occur in adolescent boys because of natural fluctuations in hormone levels. The condition often resolves spontaneously, so no treatment is recommended in this age group unless the gynecomastia is quite severe. An evaluation by your primary physician is recommended prior to considering treatment or surgery for gynecomastia to evaluate your general health, as well as to be certain there are no underlying testicular hormone disorders or liver abnormalities causing the gynecomastia. Excessive alcohol consumption or marijuana use can cause male breast development. Anabolic steroids, herbal hormonal supplements and cimetidine (Tagamet) have been known to cause gynecomastia – as have other medications.

If a specific cause for gynecomastia can be determined, then treatment can be addressed by your primary physician or an endocrinologist. In most cases, no specific cause can be determined, and often treatment for an underlying cause does not produce full resolution of the gynecomastia. Surgical treatment is then the only way to address the gynecomastia. The best candidates are healthy, emotionally stable men.

Preparing for Surgery

Two types of surgery work best for the treatment of gynecomastia: liposuction and direct excision. Both treatment modalities are often used together to obtain the best results.

The plastic surgeons at Edina Plastic Surgery have a special expertise and skill in the treatment of gynecomastia. We begin with a comprehensive evaluation that includes a medical history and risk factors. Together, we will develop the best treatment option for your individual case. If the excess tissue is mostly soft, fatty tissue, liposuction alone may be a good option. This can be performed through small incisions along the lower edge of the areola and/or the lateral or lower chest. If the excess tissue is dense and glandular, then excision will be required – often in combination with liposuction. This is done through an incision along the lower half of the areola. The scars from these incisions typically fade very well and are generally not noticeable.

Potential incision sites using liposuction
 Periareolar incisions used for excision of gynecomastia

If the overlying skin is loose, it may not adequately tighten after the excess tissue is removed. In these cases, excision (removal) of some of the overlying skin may be recommended, although this does produce more significant and visible scars.

Excision of excess skin is occasionally required
Resulting scars

Drain tubes are sometimes placed following the procedure; these are removed within several days of the procedure. The surgeries are most often done under a light general anesthesia, in which you sleep through the entire procedure and feel no pain. Small cases may be done under local anesthesia, although there is some discomfort associated with the local anesthetic injections.

At Edina Plastic Surgery, we have a fully certified ambulatory surgery center on-site, and these procedures are performed there with your safety, comfort and privacy as our priorities. Surgeries and recoveries are more successful for patients who are as healthy and strong as possible.

> Our tips for preparing for your surgery are available here.

What You Should Know

You will likely be wrapped with a compressive dressing after surgery. A short time after your procedure, you will be able to go home and will need someone to drive you. Rest is recommended the first several days after surgery, although we encourage some walking. You may return to work within several days if the work does not involve physical labor. We recommend no heavy lifting, pushing, or strenuous activity for approximately three weeks after the procedure. You may then gradually return to full activities. A light compressive garment may be recommended for you to wear for several weeks after the procedure to minimize swelling. Some swelling is normal.

All surgeries have some associated risk. Scars are inevitable, although the scars from gynecomastia treatment usually fade to the point of being nearly imperceptible. Suboptimal scarring can, however, occur. Bleeding or infections are also risks of all surgical procedures. Occasionally a fluid collection develops where the tissue was removed, and this can require drainage. Contour irregularities or asymmetry can also occur. (Sometimes a revision of the surgery is required for optimal results.) Swelling after surgery is normal, and it can be six months before the full result from surgery is apparent. For many, however, the improvement is apparent in four to six weeks.

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