What is male breast reduction for gynecomastia?

Man with gynecomastia.Did you know that overdevelopment of breast tissue can occur in up to 60 percent of men? The problem often begins in adolescence and may not resolve on its own. People with this problem are highly self-conscious about the way their chest looks. Male breast reduction (gynecomastia repair) will eliminate this problem by excising excess fat and glandular breast tissue from underneath the nipple and areola.


How is male breast reduction performed?

The traditional approach uses large disfiguring incisions on the chest wall to flatten the overall contour. Although improvements in contour are possible with this technique, the presence of large scars can lead to psychological and emotional stress. 

Dr. Panossian’s technique involves a limited-incision style whereby the breast is reduced through a single remote incision. Through this incision, a solution of diluted epinephrine is injected into the deep and superficial layers of the breast. This solution is identical to what is used in standard liposuction. This allows decreased swelling and bleeding during the liposuction portion of the surgery. Dr. Panossian uses either Power-Assisted Liposuction (PAL) or Ultrasound-Assisted Liposuction (UAL) in cases of dense breast tissues. Fat is removed with this technique widely over the chest wall. The connections between the glandular breast tissue any overlying nipple and skin are then divided through the same incision. This tissue is then grasped and extracted to complete the process. The process is repeated on the opposite breast. A compression garment or firm wrap is then placed at the end of the surgery.


What is the recovery?

Male breast reduction is usually an outpatient procedure. Discomfort me last for several days following surgery and is well-controlled usually with oral pain medications. Bruising may be present and can last for 2 or more weeks. Swelling may persist for several weeks. The elastic compression garment will need to be worn for six weeks to ensure proper healing. Mild swelling may persist for several months after the surgery.

Patients are encouraged to walk on the same day as their male breast reduction surgery. Having someone pick you up and help you at home for the first 24 hours is also advised. People usually return to work 1 to 2 weeks following surgery. Stitches placed are usually dissolvable. Gentle exercise may begin in 2 weeks, but aggressive activities, heavy lifting, and sports should be avoided for 6 weeks. Sun exposure should be limited for 6 to 12 months. Otherwise, the scar can be covered with tape or with liberal application of sunblock. Dr. Panossian will go over his unique scar management protocol to achieve the best possible results.


What are the risks and complications?

As with most plastic surgery procedures, complications are infrequent and are usually minor. Risks of bleeding, infection, and anesthesia complications can occur with virtually all surgeries. In addition, there is a risk of fluid accumulation underneath the chest skin. This fluid accumulation can be blood or a type of normal lymphatic fluid, called a seroma. Often, these fluid accumulations can be sucked out with a needle in the office on one or more occasions. However, in the case of large or recurrent accumulations, an additional surgery may be required to decompress it. 

Other problems of gynecomastia surgery can include noticeable scars or subtle pigmentation changes in the breast area. Loss of breast skin sensation or numbness can occur. Asymmetry may be present with respect to differences in the nipple and areola or with the overall reduction volume. Much of the asymmetry may resolve with further healing and subsidence of swelling. However, significant asymmetry may require a second surgery to remove additional tissue.

Dr. Panossian’s staff is available at all times to discuss pre- and postoperative instructions and to address any potential problems following surgery.