Male Breast Reduction – Gynecomastia Surgery

Serving New York City, Manhattan

 

Gynecomastia is the treatment of the prominent male chest that is commonly due to excess fatty deposits and sometimes even breast tissue development. New York City patients will have variable amounts of excess skin and have to be assessed for individualized treatment. Sometimes patients can be treated by liposuction alone, or liposuction can be combined with direct excision of the underlying fatty or breast tissue. Direct excision of tissue can be performed through a small incision along the areola-skin border on the chest. For patients that have had massive weight loss ( i.e post-bariatric surgery patients), excision techniques removing skin and subcutaneous fatty tissue is sometimes performed. There are several different techniques that can be used to accomplish this for Dr. Wallach’s Manhattan NY Plastic Surgery patients. The surgical procedure usually takes between two and three hours with a recuperation time of one to two weeks.

Techniques:

Listed from moderate to severe deformities.

Liposuction

Liposuction is used for the treatment of gynecomastia in men that have good skin tone and a moderate fatty component. This can be performed using a tumescent technique. One or two small incisions are made to gain access for the procedure. Commonly the cannula is also used to disrupt the chest fold to allow for adequate re-draping. Patients will wear a compression garment after the procedure to help minimize the risk of seroma (fluid) collection. Recovery from chest liposuction is similar to other treated areas, and patients can usually go back to work in a few days.  For more information regarding Liposuction and Gynecomastia, visit our blog.

Periareola Incision Technique and Liposuction

For male patients in New York with moderately good skin tone, a moderate amount of subcutaneous fat, but who also may have breast tissue under the areola, then liposuction performed along with a periareola incision is a good technique. A periareola incision usually involves an incision along the border of the darker areola skin and the chest skin from the three o’clock position to the nine o’clock position. This incision is used sometimes when patients have a component of breast tissue under their areola. Liposuction does not remove breast tissue well, and therefore the open technique is usually necessary. Sometimes this is staged when the patient is not sure they want an incision along the border of the areola, or it is unclear if there is sub-areola component of breast tissue. The liposuction compliments the procedure to treat the subcutaneous fat.

Male Breast Reduction Techniques

In general, formal breast reduction techniques similar to those performed for women and are used for men in one of two situations: 1) where there is actually a breast gland similar to a woman, or 2) where a man has undergone massive weight loss and has significantly redundant skin and soft tissue with ptotic (sagging) chest skin.

Pedicle-Based Breast Reduction

A technique for breast reduction similar to what is done for females is performed for men. The nipple areola complex is usually made smaller in diameter and “carried” on a pedicle of tissue, commonly inferiorly based. This pedicle, unlike what is performed for women, is thinned so that when it is placed into the appropriate position, it does not look like a female breast. An ellipse of skin is removed and the subcutaneous fatty and breast tissue is removed. The resulting scar is usually transverse with a small scar around the areola. For some thinner men with hanging loose skin, this may not be the ideal procedure, because even with the thin pedicle it still may look like a female breast. The benefit to this technique is that sensation to the nipple may be preserved.


“As an expert in the field of plastic surgery, one of the most rewarding aspects of my career has been listening to my patients stories about how having plastic surgery has changed their lives.”


 

Free Nipple Graft Technique

This technique uses similar incisions as used in the pedicle-based breast reduction technique, but the nipple-areola complex is replaced as a free graft. There is no actual pedicle of tissue so there is less of a chance of having a chest look like a female breast. This is good for thinner men with mainly loose skin. The remaining scars are similar to the pedicle-based technique in that there is a final transverse lower chest scar and a scar around the border of the areola. The main disadvantage to this technique is that the nipple-areola complex will be insensate and may suffer from hypopigmentation (lighter skin) or even partial loss.

If you would like more information about New York Plastic Surgeon Dr. Wallach and his success with New York City Gynecomastia procedures, we hope that you will not hesitate to contact our Manhattan offices at (212) 257-3263 or by mail at 1049 5th Avenue, Suite 2D in New York, NY 10028; or using our contact form to request additional details.

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