Enlargement of the male breast is called Gynecomastia and is a fairly frequent finding. Over 50% of adolescents developed some degree of breast enlargement during puberty,but, for the majority of men this resolves. When breast enlargement does not disappear with maturation, enlargement of the male breast can occur and results in feeling self-conscious and embarrassed with breasts that appear somewhat feminine In many cases this can resemble fully formed female breasts. Sometimes, weight gain early in life can result in larger male breasts even after the majority of the weight is lost. Older men also suffer from fatty replacement of normal breast tissue and enlargement. While there are several underlying medical conditions and medications that can cause Gynecomastia, the majority of patients suffer from idiopathic Gynecomastia, which means that there is no definitive underlying cause. Patients who suffer from this condition seek a more masculine appearing chest. Unfortunately, insurance carriers rarely cover the removal of the men’s breast tissue unless it is causing symptoms or a result of an underlying pathology.
The type of surgery for male breast reduction necessary depends on the severity of skin excess that accompanies breast enlargement, the composition of the breast, or whether or not it is primarily fatty or primarily glandular. Liposuction alone is frequently the only necessary surgical means to remove it and this occurs when the tissue is primarily fatty or mixed glandular and fatty. This procedure would involve just a few small incisions and the use of ultrasonic-assisted liposuction to remove the excess fat. Sometimes additional breast tissue has to be removed after completion of the fat removal through an incision or small opening. More complicated procedures are necessary when excess skin is present and removal of excess gland or fat would result in significant excess skin giving the appearance of the very saggy breast envelope. In these cases, a mastectomy-type technique which involves some degree of scarring to remove the excess skin will be necessary. Decisions about incision location and type of removal have to be made during the Gynecomastia surgery consultation with a plastic surgeon.