For some men the chest is a significant cause of stress and embarrassment. Even wearing shirts cannot hide the puffiness in many cases. Going to the beach, lake or socializing at the pool can be filled with anxiety and dread. Gynecomastia in men is actually very common. However, many men do not like to talk about it and find it difficult to convince themselves to seek treatment. The good news is that surgery can be an amazing opportunity to improve the chest area and regain confidence.
Gynecomastia Surgery comprises of several techniques to remove the tissue (and sometimes excess skin) that causes puffiness of the chest and nipple regions. The type of technique depends on the type of tissue that is producing the puffiness and how much if any extra skin there is.
In general there are two types of Gynecomastia:
- True Gynecomastia: This is represented by firm fibroglandular tissue behind the nipple. This is often felt as a discreet mass with well defined borders when pinching the chest. It is typically directly behind and around the nipple region. This is usually associated with minimal to no excess skin or chest/nipple droop. This is associated with many prescription medications as well as marijuana and anabolic steroids to name a few. Most commonly however, it is due to unknown reasons.
- Pseudogynecomastia: This is represented by fatty tissue that produces puffiness of the chest and is usually more widespread compared to true gynecomastia. Men are often of normal weight but have unevenly distributed fatty tissue in their chest compared to other areas.
Surgical Techniques of Treatment:
- Direct Excision: This is the most common way to treat True Gynecomastia. Most often a small half moon incision made at the lower junction of the areola (pink color) and chest skin. Thru this small incision, the firm fibroglandular tissue is removed leaving a much improved contour of the chest and nipple region. The pectoralis major muscle is not disrupted during this surgery. Liposuction is usually ineffective because the firm tissue does not get removed easily with the liposuction cannula.
- Liposuction: This is the most common way to treat pseudogynecomastia. Usually performed thru 2 small holes, the fatty tissue is removed using power assisted liposuction cannulas. Like in the direct excision technique the muscle is not disrupted.
- Skin removal with free nipple graft: This technique is reserved for patients that have chest ptosis (droop) in which the Nipple points downward and/or excess skin that needs to be removed in addition to either fibroglandular tissue or fatty tissue.
- Combination of the above: For some patients a combination of techniques may end up producing the best results.
Dr. Lefkowitz will listen to your concerns and help you develop an individualized treatment plan that best suits your goals and lifestyle.
