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Male Breast Reduction

Tighten and Tone Your Chest

Gynecomastia refers to a male’s excess breast tissue and currently affects 40-60% of all men. Men who suffer from gynecomastia are often self-conscious about the appearance of their chest and may not be able to improve their condition with diet and exercise alone.

Doctor plastic surgeon with scalpel near male patient's chest. Male Breast and Nipple Reduction Concept, background

True gynecomastia can be seen in men whose breast tissue enlarges. Pseudo-gynecomastia occurs more often and is distinguished as the fatty male breast. While this develops during puberty, most men grow out of this by their twenties, but some still deal with this issue well into adulthood and throughout the aging process.

Gynecomastia is not commonly talked about, so men are often unaware of treatment options and instead try to hide or cover up their condition. While diet and exercise will help to achieve a healthier and well-balanced overall physique, gynecomastia cannot be corrected by a healthy lifestyle alone and often requires surgery.

What is gynecomastia?

True gynecomastia is triggered by a decrease in the amount of the hormone testosterone compared with estrogen. This causes an increase in the amount of breast gland tissue in both teenage boys and men. Gynecomastia can affect one or both breasts and it can affect them unevenly.

This breast enlargement isn’t a serious health issue, but it can be embarrassing for a man. It can make a man avoid scenarios where he would be required to take his shirt off, a water-skiing invitation over to Lake Saint Louis, for instance.

Gynecomastia can go away on its own, and it typically does in adolescents at the conclusion of puberty. This can also happen with adults if the changes in the aging have created variations in testosterone levels. But in adults, the condition is often combined with some fatty tissue and glandular enlargement, so it may not fully resolve.

What causes gynecomastia?

What’s behind adult gynecomastia is somewhat of an unknown. This is apropos, as the available common knowledge in the public is abysmal, as well. 

The condition is common in pubescent boys. It is estimated that up to 70 percent of boys have gynecomastia to some degree. In pubescent boys, the cause is the changing levels of estrogen and testosterone. Teenage gynecomastia usually resolves as hormone levels stabilize. 

With adults, causation isn’t clear-cut. Middle-aged and older men also are experiencing shifts in hormone levels, and that could be triggering gynecomastia. Certain medications can also cause gynecomastia:

  • Steroids
  • Anti-anxiety drugs
  • Antibiotics
  • AIDS treatment drugs
  • Heartburn treatment drugs
  • Tricyclic antidepressants

Other causes:

  • Marijuana use
  • Heroin use
  • Excessive alcohol consumption
  • Herbal products with tree oil and lavender oil (each contain natural estrogen)

Is male breast enlargement typically caused by fat?

While it is true that many men have enlarged breasts due to the accumulation of fat, this isn’t necessarily the “usual” cause. Many more men have true gynecomastia, where elevated hormones have caused the breast gland tissue to become enlarged, than people know. They assume it’s the extra weight, but that’s often not the case.

That said, carrying more than a healthy amount of weight is asking for fat to accumulate around your breasts. This is true of both male and female breasts. In men who are obese, this could definitely be a possibility, or it could be a mixture of fatty tissue and glandular tissue. That’s why in these procedures our Renaissance Plastic Surgery surgeons usually combine some amount of liposuction even if they are removing glandular tissue.

How do I know if I have gynecomastia or fat?

There are two terms commonly used to describe gynecomastia. They are “true gynecomastia” and “pseudogynecomastia.” The latter occurs when excess weight causes fat cells in the chest to enlarge. At first glance, true gynecomastia and pseudogynecomastia look the same. However, a surgeon can tell the difference by observing which part of the chest has become enlarged.

Glandular gynecomastia generally involves the enlargement of breast tissue. Pseudogynecomastia, on the other hand, involves the enlargement of fat cells. Therefore, one might see the shape of the chest improve with weight loss and exercise. However, it is not guaranteed that diet and exercise will achieve the desired outcome. The vast majority of men who undergo a medical assessment for enlarged breasts are found to have true gynecomastia.

Something to keep in mind about the two types of gynecomastia is that treatment may be the same in each situation. Some men benefit from liposuction alone, which shapes the chest by removing excess fat. Others achieve the best results through breast gland removal.

Who would be a good candidate for male breast reduction?

During your consultation with Dr. Boschert, Dr. Craig, or Dr. Mills, the first thing we need to do is to decide if surgery is the right choice for your enlarged breasts. To decide that, we first need to rule some things out. If a man’s enlarged breasts are due to weight gain, the first step is to lose the weight and see if the condition persists. Heavy drinkers and marijuana users also aren’t candidates for surgery, as their breast enlargement comes from their lifestyle choices. 

close up of a mans chest, he is a prime candidate for a male breast reduction.

Your Renaissance Plastic Surgery surgeon will examine your chest to diagnose if true gynecomastia is to blame. He will feel for a firm, rubbery mass underneath the nipple area. The size of this mass is usually less than two inches in diameter. It will often be sensitive to applied pressure. Before opting for surgery, we will likely begin treatment by prescribing medication that reduces the amount of estrogen the patient’s body is producing. It is important that the patient still has good elasticity in his chest skin so that it can tighten down over his slimmer contour after surgery.

What are the benefits of having male breast reduction surgery?

What’s the benefit of being able to take your shirt off and not wonder if people are snickering about your “man boobs?” What’s the benefit of accepting those offers for pool parties or simply being comfortable taking your shirt off when mowing the lawn on a hot Missouri summer day? Truth is — when a man has enlarged breasts it’s something that can make him very self-conscious about being seen without a shirt. 

Unfortunately, misperception and misunderstanding surround the issue of enlarged male breasts, and this keeps many men from looking into the problem. Correcting it with the team at Renaissance Plastic Surgery is not difficult, and it can really give your self-confidence a boost. 

Patient Testimonial

"Dr. Craig and his team are amazing! Everyone was extremely nice, helpful, and laid back. No pressure to move forward quickly and they were always happy to answer your questions. I worked with Amy (nurse), Christine (scheduling), and Dr. Craig- I wouldn't hesitate to visit them again. Super happy with my results! Thank you, Dr. Craig!"

Can enlarged male breasts be reduced without surgery?

Male Breast reduction 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.

Can I combine gynecomastia surgery with another procedure?

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.

Is male breast reduction surgery painful?

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.

How long does breast reduction surgery take?

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.

Male Breast Reduction Options in St. Louis

During your consultation, our surgeons will speak with you and analyze your condition to determine what is causing your gynecomastia. It is important that you are currently at a stable weight and living a healthy lifestyle, as the appearance of male breasts can also be associated with being overweight.

At Renaissance, our surgeons will generally remove fat from your breast tissue using liposuction; however, in certain situations, liposuction may not be enough. Our surgeons may need to excise the excess tissue, surgically removing it through an incision made around part or all of the areola. If you have a glandular disorder, Dr. BoschertDr. Craig or Dr. Mills may recommend other alternatives to help you achieve the taut and masculine physique you desire.

What is the procedure for male breast reduction?

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. 

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.

How common is surgery to correct gynecomastia?

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. 

How should I prepare for male breast reduction surgery?

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.

How will recovery be after male breast reduction surgery?

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. 

Cropped image of a muscular man with a towel on the shoulder

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.

What kind of results can I expect from male breast reduction?

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.

How soon after breast reduction surgery can I get back to normal activities?

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. 

Is male breast reduction permanent?

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. 

Will there be visible scarring from male breast reduction surgery?

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.

Is gynecomastia surgery covered by insurance?

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.

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If you're interested in learning more about male breast reduction please contact us for a consultation at 636-535-2933 or fill out our contact us form. We will discuss your needs and concerns, and determine your best course of action.

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St. Peters, MO 63376

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145 St. Peters Centre Blvd
St. Peters, MO 63376

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Hours: Monday – Friday 8 am – 5 pm

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