Gynecomastia is the enlargement of a male’s breasts secondary to various factors. It occurs in the Adolescence years because of temporary hormonal imbalance of testosterone (male hormone) andestrogen (female hormone). It affects 30 percent to 60 percent of all males reaching puberty, and subsides by age 18 in 80 percent of the cases. Medically, usually a benign temporary condition, psychologically, it can negatively affect self-esteem and other areas of mental and emotional health in adolescent males.
I have been performing Gynecomastia surgery in New York City for over 20 years.
Teenagers and young men with gynecomastia often endure significant teasing and embarrassment. Due to the emasculating nature of this condition, many of those afflicted find it difficult to discuss. Unrelenting criticism and taunting by peers may cause development of serious body-image issues such as avoidance of exposing the body (especially at the beach or locker room), withdrawal from peers and depression. A complete understanding of the condition will assist in dealing with the issue.
Gynecomastia is characterized by some or all of the following:
- Excess localized fat
- Excess glandular tissue development
- A combination of both excess fat and glandular tissue
- Sometimes excess breast skin
- Presence unilaterally (one breast) or bilaterally (both breasts)
True Gynecomastia means that the enlarged breasts are all breast tissue and Pseudogynecomastia means that the enlarged breasts are mostly fatty tissue. Most cases of adolescent Gynecomastia are mixed, a combination of enlarged breast tissue and increased fatty tissue.
Causes of Gynecomastia
Other than hormonal changes during puberty, Gynecomastia can be caused by certain types of adrenal, pituitary or testicular tumors. Drugs or medications such as anabolic steroids, valium, antidepressants, some antibiotics, ulcer medications like Tagamet, amphetamines, heroin and alcohol can also cause Gynecomastia.
The consultation process (plan to spend at least one hour), includes an in-depth discussion about your desires and concerns regarding Gynecomastia Surgery. It is the surgeon’s task to explain all aspects of the operation, the pros and cons, and most importantly, the concept of realistic expectations with regard to your postoperative result. I prefer to meet a second time with each patient prior to surgery to assure complete understanding of the his desires from his Gynecomastia operation.
Gynecomastia Surgery Candidates
The best candidates for Gynecomastia surgery are healthy males who are realistic about what the Surgery can afford after a complete consultation. Plastic surgical intervention should be considered in boys whose condition does not improve by their 18th birthday (if it bothers them), or less commonly at age 16 or 17, if peer taunting or psychological issues escalate. Young men with this condition (18 and older) may consider surgical intervention at any time, as long as they are healthy, nonsmokers and have reasonable expectations.
A vigorous diet and exercise program should be encouraged first to possibly obviate the need for surgery. The best results are usually achieved in patients with smaller breasts, but excellent results are achievable in all cases.
The Gynecomastia Procedure
There are various techniques employed for Gynecomastia Surgery, and I am adept at all of them. I try to choose the best procedure to match your particular needs, anatomy and skin type.
The most common procedures are those involving liposuction alone. Sometimes firm glandular tissue must be directly excised, usually through a small incision around the nipple. Larger breasts with redundant skin require more extensive surgery, trimming excess skin.
The Gynecomastia Surgery is performed in my state of the art, fully certified operative suite in my office located on the Upper East Side in New York. Depending on the procedure, the operation lasts 1-2 hours. I utilize either general anesthesia, or local anesthesia with sedation, administered by one of our experienced, board certified anesthesiologists. Recovery after surgery takes 1-2 hours, with my RN at your side at all times. For your safety, I require that a friend, family member or private duty nurse accompany you home and spend at least one night with you.
Scars on or near the breast are an inevitable consequence of this type of surgery, but I close the skin with great care and offer advice and support regarding scar care after surgery.
You will be discharged with a binder placed around your chest, which should be worn at all times. After 1-2 weeks, I will ask you to replace the binder with a snug, elastic T-shirt to speed reduction of swelling and skin contraction. You will be given a follow-up appointment with me in 1-3 days.
Most of my patients return to work or school within 4-7 days postoperatively, and pain after surgery is well controlled with pain medication. My staff and I will counsel you regarding all aspects of scar care to achieve the best possible, least noticeable scars.
I have a great deal of experience with all aspects of Gynecomastia Surgery, and comfortably possess the required expertise to allow me to achieve the best possible results for you.
When will my final result from Gynecomastia Surgery be noticeable?
The type and extent of surgery dictates healing time and when the final result is achieved. It may take as long as 6 months for all swelling to resolve and skin to contract, but obvious improvement is appreciated as early as one month postop.
How long do the results from Gynecomastia Surgery last?
Various factors can affect the longevity of your result, but extreme weight gain can cause a recurrence of your condition. Stable body weight, and regular exercise and a healthy diet goes a long way towards a permanent result.
At what age can my son safely have Gynecomastia Surgery?
Plastic surgical intervention should be considered in boys whose condition does not improve by their 18th birthday (if it bothers them), or less commonly at age 16 or 17, if peer taunting or psychological issues escalate.
Your son’s pediatrician should be involved in the process.
What can I do to try to avoid Gynecomastia Surgery?
Try adopting a vigorous diet and exercise routine, employing cardio exercises and weight training targeting the chest pectoral muscles. The diet is as important as the exercise regimen, and you may consider consulting a nutritionist for help. If that fails, then Gynecomastia Surgery is your best option.
Will Gynecomastia Surgery affect nipple sensation?
Nipple sensation and nipple erection should not be affected, but you may experience greater or less sensation for a brief time after surgery while recovering, but sensation should return to normal shortly thereafter.