Gynecomastia Surgery

The word Gynecomastia originates from the Greek words which literally refers to woman-like breasts. Gynecomastia is a very common health disorder seen in men. Gynaecomastia surgery is basically defined as an irregular or unexpected growth of glandular tissue of the male breast. This abnormality results in the breast enlargement. In public, the true excess glandular breast tissue in not observed to be normal. People often face teasing, embarrassment, and social trauma. Age is not an important factor for male gynecomastia condition to occur. It can physiologically affect neonates, adolescence or even the elderly people. In newborn, the passage of female hormones from the mother can result in this condition. However, in both adolescence and elderly, it is clearly stated as an abnormal condition directly related with disease or metabolic disorders.

In males, the prime cause of gynecomastia has been attributed to the increased level of sex hormone-binding globulin. This high-level results in the low-levels of free testosterone or the tissue responsiveness to them. However, in individual cases, the root cause is seldom discovered. Gynecomastia resulting from short-term hormonal changes during growth, usually disappears on its own. Persistent pubertal gynecomastia is a type of gynecomastia seen to develop in puberty and continues for more than two years. Malnutrition and failure to recover from malnutrition are considered to play an important role in creating the hormonal environment leading to gynecomastia.

The common causes associated with Gynecomastia include aging, steroid abuse or other estrogen enhancing medications, chronic liver disease, obesity, familial Gynecomastia or Klinefelter’s Syndrome. Hypertrophy of skin tissue, breast tissue and chest adipose tissue or a combination of all results in breast prominence. Certain medical conditions such as chronic kidney failure, hyperthyroidism, and cirrhosis of the liver are responsible for Gynecomastia. Some studies show human immunodeficiency virus (HIV) infection to be closely associated with bilateral gynecomastia.

Gynecomastia is totally distinguishable from muscle hypertrophy of the pectoralis muscles. During the surgery, to confirm the presence of gynecomastia, the gland is send to the lab. Under the microscope, in the lab, the gland is also checked for tumors.


  • The most common form of gynecomastia is a puffy nipple. Presence of a glandular tissue accumulation at the areola usually characterizes this condition. This gives a dome-shaped appearance to this part of the body.

  • Pure glandular type gynecomastia is seen to occur in bodybuilders. The anabolic steroid use, may thus be converted to estrogen.

  • Another type of gynecomastia is the unilateral/asymmetrical gynecomastia. In this condition, one breast appears larger while other is normal in size and shape.

  • Gynecomastia due to age: The elasticity of the skin is reduced and excess skin results in gynecomastia.

  • Congenital or hereditary gynecomastia: The symptoms of such gynecomastia appear evident from ages of 12 to 18.

  • Pseudogynecomastia: This condition of gynecomastia refers to excessive projection of areola. The cause is the malfunctioning of the adipose tissue instead of the glandular tissue. Although, it looks similar to a typical gynecomastia, but different treatment procedures are opted.

Enlargement of breast in male is the primary symptom of gynecomastia. This abnormality is symmetrical in location with respect to the nipple. When touched on the site, a firm or rubbery feeling is experienced. In some cases, unilateral gynecomastia is also seen. Even if both sides of the breast are involved, in most of the people, the enlargement varies in size. The condition is usually not characterized with severe pain. However, sensitivity and tenderness are often observed. A most important distinct factor between male breast cancer and gynecomastia is that cancer confines to one particular side. Cancer may not be necessarily centered around the nipple and often feels hard or firm. They are usually associated with skin dumpling, discharge from the nipple, nipple retraction, and underarm lymph nodes enlargement.

Treatment and Male Breast Reduction Surgery:

  • Chest deformity can be easily camouflaged along with stabilization of bouncing tissue using compression garments.

  • Mature gynecomastia which are larger than 1 inch in diameter are difficult to deal with medications.

  • The leading treatment option for the breast gland is the surgical incision. The outcomes are permanent and typically reliable. Breast reduction is the best suited method for men with exceptionally dense glandular breast tissue. A scapel followed by a stitch closure is used to remove the dense breast tissue. A combined treatment strategy of surgical excision and liposuction is chosen to correct a combined pseudogynecomastia and true gynecomastia. This provides a better breast contour to the men.

  • Liposuction is mainly used to remove the adipose tissue surrounding the breast instead of the breast gland. The main goal of the breast liposuction procedure is to improve the physical appearance of an individual. The method involves maximum removal of the fat deposited in the breast, without affecting the muscles or skin. Tumescent liposuction is significantly used as a treatment measure for male patients with excessive fat in their breasts. This is an effective method for treating pseudo-gynecomastia. Nowadays in India, power assisted or even routine wet liposuction followed by gland excision is greatly in practice and provide gratifying outcomes. Sometimes, this procedure is done in association with the abdomen liposuction. The combination of these two procedures is known as Body contouring. Following this procedure, it is necessary to wear pressure garments for a period of four to six weeks.

  • Patients suffering from prostate cancer before estrogen therapy can be protected from gynecomastia using radiation therapy.

  • Few modalities of treatment are available to treat severe Gynecomastia. Classical breast reduction with superior or inferior flaps, Periaureolar male breast reduction and vertical incision breast reduction.

Specific risks of male breast reduction surgery:In breast reduction surgery, complications are rarely observed when done by an experienced gynecomastia surgeon. Scarring can be avoided in procedures which makes use of proper incisions at correct locations. In some people, a post-surgery condition called Hypoesthesia is seen. Under this condition, there is a reduction in the areola sensation. However, this problem gets resolved in a few months. After the Gynecomastia treatment surgery, excessive breast swelling resulting from Hematoma and Seroma may occur. They usually requires proper intervention. In high BP patients or people who had an intake of blood thinners such as anabolic steroids or aspirin before surgery, the Hematoma condition is more common. Post excision and male liposuction, the breast tissue is seen to recur in some people. Adequate thinning of the large areola is done prior to the surgery. This is, sometimes, enough to reduce the man boob size.


Medications: In older men with low testosterone levels, testosterone replacement is recommended to be quite effective. However, it is not much effective in men with normal male hormone levels.

Surgical treatments: Severe gynecomastia or long-term gynecomastia is often corrected with reduction mammoplasty (breast reduction surgery). The treatment is highly considered for patients which fail to show improvement with medications.

The cost of Gynecomastia Surgery mainly depends upon the complexity of the problem. The variation in the price of the Gynecomastia surgery comes from the fact that the procedure encloses a variety of techniques. These techniques are usually performed to different extents as per the breast disorder. Other factors such as experience of the gynecomastia surgeons and the location also alter the treatment cost. The price of the surgery significantly changes with the experience of the gynecomastia surgeon. An extra skilled surgeon usually costs a larger. The delicacy and risks involved in the surgery prompts everyone to chose an experienced and proficient surgeon. The grade / size of male breast along with the room category and duration of surgery decides the cost for breast / Gynecomastia surgery.

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