Gynecomastia

Gynecomastia is the medical term for enlarged male breasts.    This is a fairly common problem and usually involves both breasts.  It is important to distinguish this common condition from male breast cancer which can also enlarge a male breast.  Usually cancer involves one breast and, fortunately, is very rare.  Gynecomastia is occasionally tender and the breasts are diffusely enlarged rather than an isolated lump.  Commonly fatty tissue is present in the peripheral areas of the breast and breast tissue, which is firmer, is felt deep to the nipple and areola (the circle around the nipple).  Thus gynecomastia involves both excess breast tissue and fatty tissue in most cases.

The most common cause for gynecomastia is actually unknown.  The less common causes involve an imbalance of hormones, liver disease, marijuana use, and the use of anabolic steroids used by body builders.  Occasionally your doctor or Dr. Topol will recommend certain blood tests or even a mammogram to evaluate the gynecomastia.

Assuming that you have no specific cause for your gynecomastia, the treatment is usually surgical to resolve the problem.  The best results are obtained in men with good skin tone and smaller breasts.  Larger breasts and poor stretched skin will improve with surgery but not to the extent of the smaller breast. 

Surgical treatment depends on how much of the breast is fat and how much is actual breast tissue.  If mostly fat then liposuction alone can remove the fat and, depending on the quality of your skin, allow the skin to re-drape and tighten over the newly contoured chest.  Liposuction is usually done under anesthesia and involves making two very small incisions on the chest to insert the tubes to suction out the fat.  If there is an excess of breast tissue as well, (the most common situation), then an incision is also made around part of the edge of the areola (where the scar will be hidden) to surgically remove the breast tissue that is usually directly under the nipple and areola.  After surgery a drain is often placed to suction out tissue fluid over a period of a few days.  Patients wear a tight fitting vest-like garment to further assist the breast skin in re-draping and tightening over the chest.  Pain medication is given which may be needed for a few days.  Surgery is done as an outpatient and follow-up visits will be scheduled in the office.

As with all liposuction, there will be swelling after surgery which actually takes several weeks to fully resolve but the improvement will be seen immediately.  Occasionally, but not very often, insurance will cover this surgery.  Most of the time, however, this is not covered and payment is thus self-pay.  If you have further questions or would like to schedule an appointment to see Dr.Topol, give our office a call or send us an e-mail.