Male chest surgery (also called male breast reduction) is generally a combination of liposuction to remove excess fat over the lower chest, skin tightening and removal of male breast tissue. All men have breast tissue, but in some, it is more prominent and can distort the shape of the chest as well as make the areola appear larger. This enlarged breast tissue is called gynecomastia. Often, treatment requires all three of these steps to achieve a more contoured, natural appearance to the male chest.
Ideal candidates:
Initially, you will meet with Dr. Aimé at a consultation appointment where your medical history will be reviewed and your areas of concern and goals will be discussed. A physical exam will be performed to determine if your gynecomastia is due to excess fat only or there is also enlarged male breast gland present. Dr. Aimé will then discuss your options for treatment, whether that be liposuction alone, gland removal only or a combination of the two. Prior to your procedure, you will have a preoperative appointment to review the surgical plan, consent forms, measure your chest for your compression garment and answer any questions you have. Depending on your medical history, you may need to have labs done or see your primary care physician prior to surgery. Some medications or supplements may be adjusted in the weeks leading up to surgery to decrease the risk of bleeding. Smoking should be stopped 4 weeks prior to and following surgery as it can impair wound healing and increase the risk of infection.
Male chest and gynecomastia surgery is performed by making an incision along the lower half of the areola and removing the excess breast tissue. The incision is then closed with dissolvable suture and generally results in a near inconspicuous scar. The chest is contoured using liposuction through a small incision on the outer side of the chest. If there is skin redundancy, skin tightening can also be performed. In some cases where there is significant skin excess with droopiness, a wedge of skin may need to be excised to reduce the skin envelope to better fit the chest. In this case, the nipple and areola are often repositioned. The procedure can be performed awake under local anesthesia or asleep under general anesthesia depending on patient preference.
Swelling and bruising over the chest is common following male chest and gynecomastia surgery. Generally, drains are not used. Liposuction incisions are usually left open to allow any excess fluid from liposuction to drain out on its own. The incision around the areola is closed with sutures during surgery and small surgical tape may be in place to cover the incisions. A compression vest is typically worn for up to 4 weeks to reduce swelling and help the skin contour over the chest.
Post-procedure pain is mild to moderate and well generally tolerated with just Tylenol and ibuprofen. Sutures along the areola are dissolvable and do not need to be removed. Most patients are able to return to normal daily activities within several days of the procedure. Many patients feel ready to return to work several days to a week after the procedure. Strenuous activity is restricted for 2 to 4 weeks after which you may resume light exercise. Moderate exercise is allowed at 4 weeks and activity restrictions are lifted 6 weeks after surgery.
The following are reputable organizations that provide information specifically for plastic surgery patients on this and other procedures.
American Society of Plastic Surgery
https://www.plasticsurgery.org/cosmetic-procedures/gynecomastia-surgery
American Society of Aesthetic Plastic Surgeons
https://www.theaestheticsociety.org/procedures/breast/gynecomastia
