Male Breast Reduction St. Peters & St. Louis, MO

If our doctors suspect your enlarged breasts are not the result of true gynecomastia, but instead of fat accumulation, the first step won’t be surgery. We would want the patient to try and lose the extra weight to see if this corrected his condition and decreased the breasts. If your breast enlargement is the result of a reaction to a medication, such as anti-anxiety drugs or antidepressants (which both can cause breast enlargement as a side effect), we would see if changing your medication reversed the condition. Otherwise, surgery is really the only option. That wouldn’t necessarily mean gynecomastia surgery where the excess glandular tissue is removed. We could perform limited liposuction to remove excess fatty tissue in the area. Of course, that is still surgery, although this amount of liposuction is only minimally invasive.

For men having breast reduction surgery, a logical extension of your surgical session would be to have your Renaissance surgeon also perform liposuction on the lower abdomen. This is the area where most men accumulate unwanted pockets of fat that are highly resistant to efforts to remove it through exercise or changes in diet. Breast reduction is not a difficult surgery for men, so you could also combine an injectable from our medical spa with your surgery. This could be Kybella to address a double chin, any of the line of Juvéderm or Restylane dermal fillers, or Botox or the other neuromodulators. If you’re interested in combining something with your gynecomastia surgery, discuss this with us during your consultation.

Gynecomastia surgery is performed on an outpatient basis using appropriate anesthesia. Whether a surgeon performs liposuction using injections of local anesthetic or excision surgery using general anesthesia, patients are completely comfortable during their procedure. After gynecomastia surgery, soreness and tenderness are managed with prescription pain medication at first. This is typically needed only for a few days, after which an over-the-counter medication like Extra Strength Tylenol is sufficient. The compression garment applied after surgery also helps control comfort.

These are outpatient procedures performed by our four surgeons in our offices on St. Peters Centre Boulevard. The length of the surgery depends upon the method used. Removing glandular tissue will involve more time than simply removing fatty tissue with liposuction. These surgeries usually run from one to two hours.

If surgery proves necessary, your Renaissance Plastic Surgery surgeon will discuss the procedure in detail with you. To avoid obvious scarring, we usually will make incisions either in the armpits or around the areolae. We will then remove the glandular tissue, along with excess skin and fat. Liposuction may be included if you have an abundance of fat in the breasts in addition to the glandular tissue. The procedure usually lasts around one hour.

One of the more unfortunate aspects of gynecomastia is that, while it can really impact a man’s self-confidence, most men don’t choose to do anything to address the condition. Estimates are hard to fully verify, but it’s thought that from 40 to 60 percent of men are affected by enlarged breasts. But in 2019, only 20,955 men chose to have surgery to correct their condition. That’s a shame because these procedures with a board-certified plastic surgeon such as our team at Renaissance are not complicated, don’t involve much of a recovery, and don’t leave any noticeable scarring.

Patients may be advised to do a few things before gynecomastia surgery. General guidelines include:

• Have health records sent to the surgeon’s office.
• Complete any necessary lab work well in advance of surgery.
• Stop taking medications and supplements as directed by the surgeon. Some medications may need to be switched, not stopped. This is discussed in detail during the consultation visit.
• Stop all tobacco and nicotine use at least two weeks before surgery.
• Arrange at least a few days off work.
• Arrange for someone to drive to the surgery center. This person or another loved one will need to drive the patient home after the procedure.
• Arrange around-the-clock care for the first 48 hours after surgery.
• Complete any pressing work or home projects in advance of surgery so the recovery period is calmer and more relaxing.

Surgery to correct gynecomastia does not involve a difficult recovery. There will be some swelling and discomfort that may last up to two weeks (and can linger longer at times), but it will begin to resolve relatively quickly. You will need to wear a compression shirt or vest to reduce swelling and to help your chest conform to its new contour. You should be able to resume most of your normal activities within one week after surgery, but any exercise, such as weightlifting, that directly involves the chest will need to wait for up to six weeks. Your Renaissance surgeon will discuss this with you during your follow-up appointments.

There is a stigma attached to having enlarged breasts when you’re a man. It can make a man avoid situations when he would need to take his shirt off, such as turning down an invitation to a pool party or a waterskiing outing. With true gynecomastia, the enlarged breasts are due to hormone fluctuations that are a part of normal aging. Having a few extra pounds can only exacerbate the problem by adding a little fatty tissue. When our surgeons perform these procedures, we hear feedback from patients saying it’s the first time in years they’ve felt comfortable taking their shirt off. It seems like a small thing but reducing enlarged breasts can really improve a man’s self-esteem. These procedures will slim the contour of your breasts to normal proportions. Scars are very small and virtually invisible. These are satisfying procedures for our patients from across the St. Peters, St. Charles, St. Louis area.

It is unfortunate that more men who suffer from enlarged breasts don’t have surgery to correct the problem. After the first week or two at most, patients can return to light exercise, such as walking. Strenuous exercise needs to wait for a month or so. But you’ll quickly be able to return to work and regular activities.

Recurrence of gynecomastia is very rare after excision surgery. True gynecomastia, versus enlarged breasts due to weight gain, is caused mainly by excess glandular tissue. This causes the protrusion of the nipple-areola complex. In male breast reduction surgery, we remove the majority of the mammary gland, leaving enough to support the nipple-areola. With this tissue gone, the chances of recurrence are very low. However, if the gynecomastia was due to the use of steroids, marijuana, or other medications, it is possible for a patient’s breasts to become enlarged again if usage is continued.

Scarring after gynecomastia is inevitable. The question is how much scarring will one have. When a surgeon corrects gynecomastia using liposuction alone, scarring is limited to tiny areas generally measuring no more than a millimeter or two long. When excision is needed, incisions (and scars) may be slightly larger. Men who need tissue lifting along with excisional surgery might incur scars that are similar to those of a woman’s breast lift. We understand that scarring is a concern for many patients because, unlike women who have breast surgery, men cannot hide their scars. Strategies for promoting optimal scar reduction include:

• Do not smoke after surgery. Smokers undergoing plastic surgery are advised to stop smoking weeks before their procedure. Additionally, patients should avoid all tobacco use after surgery. Nicotine, a vasoconstrictor, inhibits the body’s healing capacity, so should be avoided for at least six weeks.
• Avoid certain medications and supplements. Before surgery, a surgeon may advise a patient to avoid various medications and supplements that can increase the risk of bleeding. Where there is bleeding, there is bruising. Where there is bruising, the risk of more noticeable scarring may be higher.
• Follow post-operative instructions. One of the steps that can significantly reduce the risk of visible scarring is to keep incisions clean while the skin is healing. After gently cleaning incisions, patients should pat the skin dry and maintain that dryness throughout the day.
• Do not resume exercise too soon. Most men who undergo gynecomastia surgery are motivated to resume their normal exercise routine. We understand and support this. Ongoing exercise once healing is complete can help maintain the results of surgery. However, exercising too soon can cause irritation to the skin that is still healing, resulting in more visible scarring.

Gynecomastia can have significant social and emotional impacts on a man’s life. Regardless, treatment for enlarged male breasts is not deemed medically necessary by most insurance companies. Verbiage within one insurance plan states that surgical treatment for gynecomastia is “considered cosmetic in nature and not medically necessary: 1. when performed solely to improve appearance of the male breast or to alter contours of the breast wall and 2. when performed solely to treat psychological or psychosocial complaints.” Men interested in restoring their shape and sense of self can explore alternative methods of covering the costs of gynecomastia surgery and usually find payment plans relatively easy to secure.