Date July 19, 2015
Categories Cosmetic Surgery
Weightlifters may call it “gyno,” while others use terms such as “man boobs.” The medical term is gynecomastia, a common condition that causes enlarged glandular breast tissue in boys and men. It may affect one or both sides of the chest and can cause tenderness, embarrassment, and self-consciousness.
Gynecomastia is different from pseudogynecomastia, which is chest enlargement caused primarily by excess fat. Some men have a combination of glandular breast tissue and fat. Identifying the type of tissue present helps determine the most appropriate treatment.
What Causes Gynecomastia?
Gynecomastia often develops when the balance between testosterone and estrogen changes. Although men produce mostly testosterone, they also produce small amounts of estrogen. Factors that alter the relationship between these hormones can stimulate male breast tissue.
Common causes and contributing factors include:
- Hormonal changes during puberty
- Aging
- Weight gain or obesity
- Anabolic steroids and certain bodybuilding supplements
- Prescription and nonprescription medications
- Alcohol and recreational drug use
- Thyroid, liver, kidney, or testosterone-related conditions
Certain medications—including some treatments for prostate conditions, heart disease, anxiety, ulcers, and other medical problems—may contribute to gynecomastia. Patients should speak with their medical provider before stopping or changing any medication.
Gynecomastia in Teenagers
Temporary breast development is common during puberty. Adolescent gynecomastia often begins as a tender, firm area beneath the nipple and usually improves without treatment within several months to two years.
When enlarged breast tissue persists, a pediatrician or primary care provider may recommend further evaluation. This may include a medical history, physical examination, medication review, and laboratory testing to rule out an underlying hormonal or health condition.
Persistent gynecomastia can significantly affect a teenager’s confidence. Some teens wear multiple shirts or compression garments to conceal their chest, avoid swimming, or feel uncomfortable participating in sports.
Gynecomastia in Weightlifters and Older Men
Weightlifters who use anabolic steroids or hormone-altering supplements may develop gynecomastia. Increasing testosterone does not always prevent breast development because some testosterone can be converted into estrogen.
Gynecomastia also becomes more common with age. Hormonal changes, medications, medical conditions, and increased body fat can all contribute to male breast enlargement in older adults.
When Should You Consider Gynecomastia Surgery?
Gynecomastia surgery, also known as male breast reduction surgery, may be appropriate when:
- Breast size has remained stable
- Glandular tissue has persisted despite observation or medical evaluation
- Weight loss has not sufficiently improved the chest contour
- Enlarged breasts cause physical discomfort or emotional distress
- You avoid swimming, exercise, sports, or fitted clothing because of your chest
- You have realistic expectations and are healthy enough for surgery
Patients should undergo an appropriate medical evaluation before cosmetic surgery, particularly when breast enlargement is new, painful, one-sided, or associated with nipple discharge, a hard lump, or skin changes.
How Is Male Breast Reduction Performed?
The surgical technique depends on whether the enlarged chest contains glandular tissue, excess fat, loose skin, or a combination of these.
For glandular gynecomastia, the surgeon commonly makes an incision along the lower border of the areola, where the darker areolar skin meets the surrounding chest skin. Through this incision, the surgeon removes the firm breast tissue beneath the nipple. An appropriate layer of tissue is preserved beneath the nipple and areola to help prevent a depressed or sunken appearance.
Men with excess fatty tissue may also need chest liposuction. Before liposuction, the treatment area is infused with tumescent solution containing diluted local anesthetic. Thin patients and some weightlifters may need glandular tissue removal without extensive liposuction.
Depending on the extent of treatment and the patient’s individual needs, gynecomastia surgery may be performed as an office-based procedure or in an operating room.
Recovery After Gynecomastia Surgery
After surgery, the incisions are typically closed with sutures, and patients wear a compression vest to control swelling and support the new chest contour. Bruising, swelling, and temporary tenderness are common during the early stages of recovery.
Bleeding or a collection of blood beneath the skin, known as a hematoma, is an important potential complication. Patients should carefully follow their surgeon’s postoperative instructions and report unusual swelling, increasing pain, or other concerns promptly.
The timing for returning to work, exercise, and weightlifting depends on the extent of surgery and how healing progresses. Your plastic surgeon will provide personalized activity restrictions during follow-up appointments.
Does Insurance Cover Gynecomastia Surgery?
Most health insurance plans consider male breast reduction a cosmetic procedure. Coverage may occasionally be available in severe cases involving documented symptoms or medical necessity. Requirements vary by insurance company, so patients should contact their insurer directly to confirm their benefits and prior-authorization requirements.
Schedule a Gynecomastia Consultation
Gynecomastia can affect much more than physical appearance. It may influence clothing choices, social activities, athletic participation, and self-confidence. Male breast reduction surgery can remove excess glandular tissue and fat to create a flatter, more masculine chest contour.
If you are considering gynecomastia surgery in Wisconsin, contact Fox Valley Plastic Surgery to schedule a consultation. Our team serves patients from Oshkosh, Appleton, and communities throughout the Fox Valley.