Gynecomastia is an extremely common condition for men. It’s defined as a fullness in the male chest and affects close to 50% of men in the Boston area alone. Historically, gynecomastia was something that men were ashamed to talk about. Many didn’t seek treatment because they didn’t know that treatment was an option. But, thanks to the internet and social media, things are changing. Men are no longer suffering in silence. They are now more aware that gynecomastia is not only easily treated, but also that there is an array of different treatment options. That’s the good news. The downside of getting your information off the web is that many patients think that they can address their gynecomastia with liposuction alone instead of a surgical excision of the breast gland. The reality, however, is that this is rarely the case.
I pride myself on always being honest with my patients about what a procedure can and cannot achieve. It’s a core tenet of my practice philosophy. Making certain that you have realistic expectations is a huge component of a successful result with any procedure. When it comes to gynecomastia in particular, the key to a happy patient is getting rid of the fullness in the chest. If this can be done with just liposuction, great. But it does neither of us any good for you to have a procedure that simply won’t work. It all comes down to your individual anatomy.
Liposuction only Addresses Excess Fat
Liposuction is one of my favorite procedures. It is both physically and artistically demanding. Incredibly effective and versatile, the only problem with liposuction is that it can only address excess fat. But here is the simple truth when it comes to gynecomastia: it is usually the result of excess glandular tissue and excess fat. Men, like women, have breast tissue. For any number of reasons including:
- Certain medications
- Recreational drug use such as marijuana
The balance between your level of estrogen and testosterone can get out of whack. And when there is too much estrogen, the result may be excess glandular breast tissue. The best way to address this tissue is to remove it surgically.
The only time that liposuction works for treating gynecomastia on its own is when the fullness in the chest is solely the result of excess fat. I find that my male patients in their 50’s-60’s tend to have this clinical situation. In such cases, I will first recommend changes to your diet and exercise routine. Losing weight and toning your muscles may be the simplest way to reduce the size of your chest. However, I find that the excess fat in the chest for this group of men is often diet and exercise resistant. I seriously speak to these patients about liposuction on its own.
Gynecomastia Surgery & Scars
For everyone else, however, the best treatment option for your gynecomastia is going to include some combination of surgical excision of the breast gland and liposuction. No man likes to hear that he needs surgery, especially on his chest. It’s frightening to think about potential scars in an area that is so exposed. But the important thing to keep in mind when it comes to incisions on the chest is that they are:
- Typically camouflaged
- Heal really well
Gynecomastia is one of my specialties. I love helping men to feel self-confident by simply improving their chest profile. Gynecomastia surgery can literally be life-altering for some patients. But any surgery is going to leave a scar. I do everything in my power to create thin and fine incisions. Ideally, I place them in the border between your areolar and chest skin. In cases where this isn’t possible, I may recommend laser and/or microneedling treatments down the road to improve the scar. Bottom line, I have many tools in my arsenal for delivering the most tolerable incisions possible for your individual needs.
How to Treat Puffy Nipples?
One of the hallmarks for many men with gynecomastia is puffy nipples. It is embarrassing and usually prevents those who are afflicted from going anywhere without a shirt. This can limit your activities such as visiting the beach, a pool party or even just exercising outdoors. My goal with every gynecomastia procedure is to make your life more pleasant. Puffy nipples are usually due to:
- Excess breast gland
- Too much fat
The best way to address puffy nipples is with gynecomastia surgery to get rid of the excess glandular tissue and liposuction to address the excess fat. Typically, when I remove what is causing the swelling of the areola, the loose and puffy areola tissue retracts and improves. Sometimes, even with the most qualified surgeon, this puffiness may persist after surgery. When this happens, I have found that the best solution is an areolar reduction. I speak to all my patients about this concern PRIOR to surgery so they know to expect me to be looking for it after surgery.
An areolar reduction sounds scary, but it’s really not. During this surgical procedure, I will make an incision around the outside of your areolar where any scar is well hidden in the transition between the darker nipple and lighter chest skin. I will typically liposuction beneath the area to remove any excess fat. Next, I will trim down the size of your areolar so that they are in proportion with your new, smaller chest. When there is less areola tissue, it tends to be less puffy.
With all gynecomastia surgeries, whether they involve a surgical excision or liposuction, I will require you to wear a compression garment for 3 weeks after surgery. The compression garment serves a couple of really important functions. It:
- Reduces swelling
- Diminishes post-operative discomfort
- Speeds healing
- Helps ensure that the skin on the chest lays as flat as possible
The most important thing with gynecomastia is to choose the treatment option that is going to work. All men want a smooth, flat chest. No one wants to have more surgery because the first one didn’t do the trick.