Male Breast Reduction – Liposuction, surgery offer solutions for men of all ages

Gynecomastia is a medical condition that describes overly developed male breasts. Otherwise known as “man boobs,” what was once considered taboo, in recent years, has come out of the closet, reportedly striking one-third of men regardless of age.1 That’s according to a recent article published in the February issue of Cosmetic Surgery Times (CST).

Men with gynecomastia fall into three groups, Sydney E. Garfinkle, MD, a cosmetic surgeon who specializes in treating the condition in Fair Oaks, Calif., told CST.

  1. Boys (non-adults) who are overweight or may simply have excess breast tissue.
  2. Bodybuilders (19 to 30 years of age) who take anabolic steroids, which results in gynecomastia.
  3. Overweight men (50+ years of age) who have excess fatty tissue.

Boys
Although enlarged male breasts in young boys reportedly often resolves on its own, this group largely requires Dr. Garfinkle to remove breast tissue to get results, reports CST.

“By the time they get to me, if it’s substantial gynecomastia, in my experience, it’s not going to go away without intervention. In this young population, almost all of them require removal of the breast tissue. Many of them are overweight, and typically I do some liposuction as well as excision.”

Dr. Garfinkle recommends checking testosterone levels in this group of patients. “…If you can discern that they have adequate testosterone, then you know that there isn’t something else responsible for the gynecomastia. If there is any question of causation, I recommend an endocrinologic evaluation.”

Bodybuilders
In this population, enlarged breasts are best treated with excision, Dr. Garfinkle told CST. “I make a periareolar cut right around the edge of the nipple, usually inferiorly in the lower part of the nipple, and from there I remove the excess breast tissue.” No liposuction necessary.

Dr. Garfinkle pointed out that bodybuilders frequently go back to the gym too soon, which can cause bleeding. His solution? Needle aspiration, which, he told CST, works every time.

Overweight, 50+
In most cases, the best approach in this population tends to be both liposuction and surgery combined. However, “In some cases, especially in older men, it is not necessary to remove any breast tissue because the gynecomastia is due primarily to fat, so we perform liposuction in those cases,” CST reports Dr. Garfinkle said.

When excess skin is present and he doesn’t remove it, Dr. Garfinkle told CST that he forewarns his patients understand that while the size of the breast may be reduced, the skin may hang.

For the Best Results
Dr. Garfinkle Recommends:

  • Replacing compression garments made for liposuction patients with a nylon spandex shirt. “I have them buy one size too small so that it’s tight over the chest and holds things in place, and I have them wear that for about three weeks.”
  • Using a dermal punch in 2 to 4 places on the periphery of the nipple if it doesn’t reduce enough in size. “I put a stitch in each one of those and in a week it looks normal.”

Reference
1. Rahmani S, Turton P, Shaaban A, Dall B. Breast J. 2011;17:246-255.

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