Certain characteristics are perceived by the human eye as either being more masculine or more feminine. Since the days of Homer, a smooth, flat chest has been equated with an ideal male aesthetic. Michelangelo’s David is a prime example. For some men, however, no amount of weight on the bench press or skinless chicken is going to deliver this desired look. Gynecomastia, or “male boobs”, is a medical condition that entails an increase in breast glandular tissue, fat or a combination of the two. Incredibly common, it affects up to 36% of young men and 57% of older men in the Boston area. Often due to an imbalance in estrogen and testosterone levels, younger patients may grow out of the condition.
For those that do not, there are a number of different viable treatment options for reducing the size of your chest. The right one is going to depend on what is driving your gynecomastia, your tolerance for downtime and your individual anatomy.
- Gynecomastia Consultation in Boston
- Understanding Gynecomastia
- Drugs May Induce Gynecomastia
- Health Conditions & Gynecomastia
- What is Pseudogynecomastia?
- Treatment Options for Fat Reduction in Chest
- Surgical Gynecomastia Procedure
- Male Chest Reduction and Contouring for Massive Weight Loss Patients
- Gynecomastia Recovery
- Frequently Asked Questions about Gynecomastia
Board-Certified Plastic Surgeon, Dr. Sean Doherty, is an expert in all areas of body contouring. He has a particular passion for gynecomastia procedures since, as a man himself, he understands the devastating toll that the condition can take both physically and emotionally. Some men with an excess of chest tissue are so self conscious that they won’t wear certain clothing like polo shirts, or participate in certain activities like swimming or going to the beach. If you think that you may have gynecomastia, the first step is to schedule an in-person consultation.
Gynecomastia Consultation in Boston
One of the positive aspects of the internet is that it can be a great tool for disseminating information. Historically, men with gynecomastia did not talk about it, not even with their own doctor. It was a condition of shame and silence. Today, however, patients are able to research gynecomastia online. This has helped men to realize that they are not alone, and to be more open about discussing their dissatisfaction with the appearance of their chest. The downside of the world wide web is that no medical procedure is a one-size-fits-all. What works to reduce one man’s chest may not be the right treatment option for you. This is why it is critical to schedule an in-person consultation with a board-certified plastic surgeon.
During your meeting, Dr. Doherty will listen closely to what bothers you about your torso. He will inquire into your medical history, family history and any prior procedures that you may have had. Then, he’ll perform a thorough physical exam to assess the:
- Degree of fatty tissue
- Excess gland tissue
- Skin laxity, if any
If your issue is due to fat alone, you may be able to improve the appearance of your chest with liposuction or a non-surgical fat reduction technique such as SculpSure® or CoolSculpting®. Most men, however, will need gynecomastia surgery. It is a relatively straight forward procedure in which Dr. Doherty removes the excess glandular tissue and fat from the breast area in order to deliver the firmer, more flat, masculine-looking chest that you desire.
Gynecomastia Surgery Before & After Photos
*Each patient is unique and individual results may vary.
Understanding Gynecomastia
Understanding gynecomastia is critical. The right treatment option is going to depend on the driving factor, or factors, of the fullness in your chest. In general, men do not like the idea of surgery. They will always prefer something that is less involved. However, if you have excess glandular tissue, the only way to truly improve your appearance is going to be with a surgical removal.
Gynecomastia occurs when there is an imbalance in your estrogen and testosterone levels. This can surprise patients as many did not know that all men have some degree of estrogen, and if the levels get too high, the end result is gynecomastia also known as “man boobs”. There are three peak onset periods for gynecomastia:
- Infancy: This usually resolves within 2-3 weeks of birth.
- Puberty: Hormonal fluctuations can lead to swollen breast tissue. Again, this may resolve on its own within 6 months to 2 years.
- Adult Age: 50-69 is the peak age for gynecomastia. It is estimated that 1 in 4 men in this age bracket will be affected.
Drugs May Induce Gynecomastia
Aside from age, alcohol and certain street drugs can cause your estrogen levels to rise and your testosterone levels to drop, leading to gynecomastia. These drugs include:
- Marijuana
- Amphetamines
- Heroine
- Methadone
Furthermore, certain prescription drugs may also adversely affect your hormone balance. These include:
- Anabolic steroids
- Anti-androgens for prostate enlargement
- Ulcer medications
- Some medications for heart issues
- Diazepam and other anti-anxiety meds
- Tricyclic antidepressants
- Chemotherapy
- Antibiotics
If you take one of the above and can go off of it, this may be an effective method for reducing the size of your chest. This should ONLY be done under the guidance of your prescribing doctor.
Health Conditions & Gynecomastia
Certain health syndromic conditions can also cause a hormone imbalance. These include:
- Klinefelter’s syndrome
- Aging
- Tumors on the testes, adrenal glands or pituitary gland
- Hyperthyroidism
- Kidney failure
- Cirrhosis or liver failure
- Malnutrition
Again, this is why it is so important to be assessed in-person, and to be brutally honest with your doctor about your health and lifestyle choices. While there is no “natural” do-it-yourself cure for gynecomastia, if it is the result of taking certain drugs or a medical condition, it should resolve once those drugs are stopped or your medical condition improves.
*Each patient is unique and individual results may vary.
What is Pseudogynecomastia?
One of the negative sides of doing your research online is that there can be a lot of confusing information such as the difference between pseudogynecomastia and gynecomastia. Both are caused by a hormone imbalance and both can result in a swelling of the breasts. The former, however, is due to an excessive amount of stubborn fat in your pectoral region while the latter is due to both excess glandular tissue and fat.
Many men don’t realize that they have glandular breast tissue, just like women. And when your hormone levels get out of whack, it may result in an inflation of your chest which may mimic breasts or “moobs”. For patients with pseudogynecomastia who are also overweight, the first course of action is to safely and sustainably lose the excess weight. This will often lead to an improvement in your gynecomastia with potentially no need for further intervention. And even if it doesn’t deliver your ideal shape, it is always a good idea to be within 10 pounds of a maintainable goal weight before considering any kind of aesthetic procedure. When some of the excess volume is gone, it may also make it clearer that the main issue is excess gland.
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Treatment Options for Fat Reduction in Chest
For those patients at a stable weight who still have excess fat in their chest area, liposuction is Dr. Doherty’s treatment option of choice. He will suction away the fat through a cannula or small, metal tube. The procedure can be performed in the office under local anesthesia or in an operating room under general anesthesia. Dr. Doherty prefers liposuction, as opposed to non-invasive body contouring, as it gives him the most access and control in order to slim down and re-sculpt your chest. While it is surgery, the incisions are so small that you won’t even need stitches. Having said that, this is a procedure that requires some downtime for recovery. You will also need to wear a compression garment in order to speed up your healing, and improve your results. This is why some patients like the idea of a non-surgical body contouring technique instead.
SculpSure® and Coolsculpting® are two of the most popular non-surgical techniques for eliminating excess fat. The former uses the heat of a laser to destroy the fat cells in the treatment area while the later cools the fat cells to a point where they can no longer survive. While neither requires extensive downtime or incisions, they also don’t deliver as robust of a result. Furthermore, while liposuction is a one-and-done procedure, any non-surgical technique is going to require multiple treatments, spaced 6-8 weeks apart. Also, all forms of noninvasive body contouring are known to be only moderately effective for the stubborn “fit fat” that is typical in gynecomastia patients.
Surgical Gynecomastia Procedure
Most of Dr. Doherty’s Boston area gynecomastia patients need a surgical procedure as their chest fullness is the result of both fat and glandular tissue.
During this procedure, he will perform liposuction first to debulk your chest, and then make an incision around the areola through which he’ll remove the extra tissue. The areola sometimes, though rarely, needs to be reduced in order to accommodate your new chest size. This will be discussed with you in detail during your initial consultation. Once the extra glandular tissue is excised, Dr. Doherty will use further liposuction to remove the additional fat and resculpt your chest into its ideal shape. This surgery is typically performed in the operating room under general anesthesia.
Male Chest Reduction and Contouring for Massive Weight Loss Patients
In general, gynecomastia procedures do not address extreme excess and loose skin as the latter is not generally an issue. The exception to this rule is in patients who have undergone massive weight loss either on their own, with the help of a weight loss drug or some form of bariatric surgery. Oftentimes, particularly in patients who have been heavy for many years, the skin on the chest has stretched past its natural ability to re-form over your new slimmer contour. In such cases, Dr. Doherty will perform a male chest reduction to remove the excess glandular tissue, fat and extra skin. In addition to the incisions around your areola, he will typically make another one underneath your chest in the pectoral fold to remove the excess skin. This will result in a visible scar, but most weight loss patients find this to be a fair trade-off for the flat chest of their dreams.
Gynecomastia Recovery
No gynecomastia procedure requires an overnight stay. Your recovery is going to depend on your treatment option, but you can expect to feel sore for about 4-7 days. You may have some swelling and bruising in the area. The latter generally resolves in a few weeks, and may be helped along by compression as well as certain homeopathic drugs such as arnica. Most of your swelling will resolve within 3 months which is when you will be able to see 75% of your results. However, all of the swelling can take up to 6 months to fully resolve, so be patient.
Dr. Doherty has all of his gynecomastia surgical patients wear a compression vest 24/7 for the first 3 weeks following surgery, and then 12 hours a day for an additional two months. The vest will help to reduce swelling and ensure an exemplary result. Regardless of your treatment choice, Dr. Doherty asks that you refrain from any kind of exercise for 7-10 days following your procedure. He will then typically allow you to return to light cardio, but asks you to avoid any chest exercises for 4-6 weeks post-op.
To find out more about liposuction, non-surgical body contouring and gynecomastia surgery with Dr. Sean Doherty at his Boston or Brookline office, contact us today or call (617) 450-0070 to schedule a consultation.
Frequently Asked Questions about Gynecomastia
The cost of a gynecomastia procedure is going to depend on your treatment option and what type of anesthesia you’ll need. If, for example, you eat well, exercise regularly and are able to maintain a healthy weight, I may be able to reduce your chest with liposuction alone or maybe even a non-surgical body contouring technique. However, in all honesty, gynecomastia is usually the result of both excess fat and glandular tissue which will require a surgical excision. The total cost for gynecomastia surgery can range anywhere from $9,000 to $11,000. I would advise that you schedule a consultation with a board-certified plastic surgeon in your area with a lot of gynecomastia experience. It’s truly the only way to know which procedure is going to be right for your needs.
Without examining you in person, it is impossible to say. Most of the time, fullness in the chest is due to both fat and excess glandular tissue. So, improving the appearance will require gynecomastia surgery and liposuction.
No. And honestly, it won’t look right. All men have some degree of glandular tissue, chest fat and lax skin.
This can not nor should it be completely excised. The key to a great result is restoring proper proportion to your chest which always includes some degree of curve.
Both liposuction and gynecomastia surgery require an incision. And anytime that the skin is cut, it can result in a scar. This is your body’s natural healing process. The good news is that scars on the chest heal exceedingly well. I also place the incisions within the transition between the nipple and chest skin where any resultant scar is easily camouflaged. For patients who need a male chest reduction, the scars may be more severe, but most find them to be well worth it for a smooth, flat chest. I also offer my patients a number of very effective scar therapies such as silicone gels and laser treatments.
The extent of your downtime is going to be directly proportional to the intensity of your procedure choice. Most patients find the recovery fairly easy. These days, with so many people working at least part-time from home, you can be right back on Zoom the day after your procedure. The biggest deal for most patients is the compression vest. But it is also a vital part of your recovery. It makes no sense to spend the time and money to improve the look of your chest and then blow it all by refusing to wear the vest. It’s a small price to pay for a better looking torso.
In the hands of an experienced plastic surgeon, your results should last a lifetime. However, if you take up certain drugs and/or gain weight, it could adversely affect your results. A recurrence of gynecomastia is typically due to inadequate glandular excision during your initial surgery and/or liposuction alone when you also needed breast tissue removed. This is why it’s so important to see a board-certified plastic surgeon who specializes in gynecomastia. In rare cases, I have seen glandular tissue return.
Again, without assessing you in person, it is hard to say. But the beauty of aesthetic procedures is that they allow you to improve your body contour within the confines of your anatomy. Schedule a consultation to discuss your options. It may be something as simple as a non-surgical body contouring procedure and/or a skin tightening procedure such as Renuvion®.
If you live in the state of Massachusetts, Dr. Sean Doherty offers gynecomastia among his procedures. For a full list of services, please visit our Locations page.