Male Breast Reduction

Gynecomastia
Gynecomastia is the medical term for abnormal breast development in males. A fairly common condition affecting almost half of males during development, it can occur on one or both sides of the chest, and is the result of excessive breast tissue, fat, or both. In some cases, the condition is due to a normal or "physiological" phase of development. It can occur with the onset of puberty, but usually regresses by age 20. It can also occur with aging in otherwise healthy males. Other "pathological" causes of abnormal male breast growth can occur, either due to decreased production of testosterone (male hormone), increased production of estrogen (female hormone), or certain drugs. The use of anabolic steroids (used by body builders), and other drugs (marijuana, alcohol, cimetidine, spironolactone, some anti-depressants, for example) can be the cause of gynecomastia. Gynecomastia can be a sign of liver disease. But the majority of cases have no known cause. Certainly, most affected adolescent boys will "grow out of it" if no treatment is rendered. If this does not occur, treatment is available to reduce the size of the soft tissues, either by removal of fatty tissue using liposuction, or by open removal of breast gland tissue using a small incision around the areola, or pigmented area of the nipple. In more extensive cases with large amounts of excessive skin, larger skin incisions (and therefore larger scars) are necessary to remove the redundant skin.

The First Office Visit
Dr. Parson will take a thorough medical history, including any signs of abnormal secondary sexual development, history of alcohol or marijuana abuse, and a careful drug history. If other signs of either liver or endocrine malfunction seem evident, then a referral to a qualified medical specialist such as an endocrinologist may be warranted. In most cases involving adult males, either a history of anabolic steroid use or no cause at all can be identified. In most cases, surgery is the only effective form of therapy. The approach that Dr. Parson would advise will depend on the degree of breast enlargement, the ratio of fat to breast that exists, and the amount and elastic quality of the skin.

Risks of Breast Reduction for Gynecomastia
Complications from treatment of gynecomastia are infrequent and usually minor, though no surgical procedure is without some risk. These would include bleeding, infection, loss of sensation that may take up to a year to recover and could be permanent, visible irregularities in the skin, asymmetry, and fluid accumulations beneath the skin following the operation that may require drainage.

The Pre-Operative Period
It is imperative that patients refrain from ingesting any medications or other substances that could potentially be the cause of surgical complications. A list of medications should be reviewed and discontinued at least 2 weeks prior to operation. Patients are seen just prior to their surgery date for a general physical examination to ensure that no underlying medical problems exist that may interfere with the safety of their surgery. Prophylactic antibiotics are prescribed for a few days after surgery to reduce the risk of surgical wound infection. A prescription for pain medication is also written, so that you have your pain pills when you return home from the operation. Pre-operative photographs are taken so that you can see the improvement from your surgery afterwards. We generally take post-operative photographs at 3 - 6 months after your procedure.

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