You might be surprised to learn that one of the fastest growing plastic surgery procedures performed on men in America is… the breast reduction. In 2016, almost 30,000 surgeries of this type were performed on men for a condition called gynecomastia or it’s relative pseudogynecomastia.
Gynecomastia comes from a combination of the Greek words for woman (gynae) and breast (mastos), and it is a term used to describe enlarged breast tissue in men. True gynecomastia is characterized by an overgrowth of glandular tissue. This usually manifests as a small tender lump of glandular breast tissue beneath the nipple/areola. It is not uncommon to see this problem in adolescent males, but in most it will resolve as they get older. Pseudo– (Greek for false) gynecomastia is characterized by increased fat deposits in the breast area.
Both conditions (which for convenience are often both referred to as gynecomastia) are common, affecting up to a third of all men. The problem is benign but can cause social and psychological discomfort.
According to the American Society of Plastic Surgeons, gynecomastia is characterized by the following signs:
- Excess localized fat
- Excess glandular tissue development
- Sometimes excess breast skin
- Presence unilaterally (one breast) or bilaterally (both breasts)
Though for most cases of gynecomastia there is no identifiable reason for its occurrence, it can be the result of a hormone imbalance: either the presence of too much estrogen or too little testosterone. Drugs including anabolic steroids, certain antidepressants, and alcohol have been linked to this condition as have certain medical conditions, a few of which are listed below:
- Kidney disease and dialysis
- Extreme stress
- Liver disease
Depending on the level of physical or social discomfort that accompanies the condition, with the help of a qualified plastic surgeon, the problem can be fixed. Excess skin, fat, and glandular tissue can be removed with a breast reduction, also called reduction mammaplasty.
In many cases this surgery involves a small incision at the border of the areola to remove the offending glandular tissue with any excess fat addressed as needed with liposuction. When the condition is more advanced, it can be corrected with a chest lift, or mastopexy, similar to a breast lift in women.
The severity of the condition, the elasticity of the skin, and the amount of sagging all help to determine the type of mastopexy needed to restore a firmer and more masculine appearance to the chest. The location and extent of the incision depend on the amount of tissue removed and include the following types of mastopexy:
Periareolar or doughnut mastopexy
An incision is made around the areola. Excess skin, fat and glandular tissue are removed. With this technique the areola can be made smaller.
A keyhole incision is made around the areola and down to the crease of the breast in order to remove more excess skin, fat and glandular tissue. The areola can be reduced in size as well.
Extended circumvertical mastopexy
An inverted “T” incision pattern allows the removal of more skin, fat, and glandular tissue and relocation of the areola. In some cases, the vertical scar below the areola is extended out toward the armpit.
To learn how plastic surgeons like Dr. Slack minimize the appearance of scars see our post: Best Practices for Minimizing Scars. You can also look through this male breast reduction before and after photo gallery to see how discrete the scarring can be.
In addition to years of experience, Dr. Slack has completed a fellowship and extensive training in cosmetic and reconstructive surgery of the breast. He says the best candidate for the surgery:
- is in good physical health,
- is at a stable weight,
- has realistic expectations, and
- does not smoke, or is prepared to quit smoking at least two weeks before the surgery.
If you are a man suffering from a sagging chest or gynecomastia and want to know if you are a candidate for surgery, contact us today and schedule a free consultation.