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Gynecomastia

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Gynecomastia is the medical term for over-developed male breasts and affects an estimated 50% of men, especially age 50 and higher. Although the problem is mostly genetic, it can be corrected easily with cosmetic surgery. In 1999, almost 11,000 males underwent surgery for gynecomastia. Dr. Rai uses ultrasonic liposuction to remove the excessive breast tissue with liposuction on an outpatient basis. This surgery has been particularly successful in boosting self-confidence in males with significant breast reduction. If you or someone you know is uncomfortable about their breast size, call Dr. Rai for a private Gynecomastia consultation.

Definition of Gynecomastia:

Presence of breasts on a man’s chest is called gynecomastia. For obvious reasons it leads to embarrassment and uncomfortable feeling by men who are affected by it. Gynecomastia becomes source of extreme self consciousness in, and out of clothes. Surgical treatment is the only effective treatment for gynecomastia.

What causes Gynecomastia?

Gynecomastia is either primary or secondary as detailed below:

  • Primary Gynecomastia:

    It can be part of spectrum of life that effects early, or late parts of life as detailed below:

    Early Life gynecomastia (Pubertal Breast development):
    It happens in pre-pubertal and pubertal age in young boys. It is caused by hormonal changes that happen in boys of this age group. It happens commonly. In most cases breast growth regresses by age 16 or so. However, in some cases regression does not take place. In such cases developed breast tissuepersists. Surgery will be required to correct this gynecomastia.

    Late life gynecomastia (Mid age breast development in men):
    It happens in 50s. It is related to hormonal changes since hormones are declining. Breast tissue may develop in men as result of hormonal changes, imbalance and aging.

  • Secondary Gynecomastia:

    Secondary refers to gynecomastia often caused by identifiable causes, mostly as result of side effect of therapeutic or recreational drugs. Some of these are:

    • Acid reducing drugs commonly used to treat acid reflux such as Cimetidine, Ranitidine, Omeprazole.
    • Antidepressants and tranquilizers
    • Hormones used to treat prostate cancer
    • Use of growth hormones
    • Propecia, used to treat prostate enlargement and baldness
    • Recreational drugs like Marijuana
    • Protein supplements have been blamed or at least associated with higher observed rate of gynecomastia.

Anatomy of Gynecomastia:

Anatomically male breast is comprised of inactive breast ducts, fatty tissue and stretched breast skin.

Treatment of Gynecomastia:

Surgery is the only effective treatment for gynecomastia.

Details of Gynecomastia Surgery:

In healthy individuals’ surgery is an outpatient procedure. However, hospital surgery may be required in presence of any medical issues. Surgery is best done under monitored general anesthesia.

Liposuction and Glandular Excision will Suffice when there is no Excess Skin

A number of incisional choices exist. In our practice we use periareolar skin incision. This is our choice because this incisionheals with an imperceptible scar.

Fatty tissue is removed with tumescent liposuction with or without ultrasound. Ultrasound assist is needed in cases of larger breasts. Fat removal is followed by removal of remaining ductal breast tissue. This is done with cautery and surgical dissection.

Fat is discarded. Ductal tissue is submitted for microscopic exam because of small incidence of breast cancer in breast tissue.

Some cases require use of drains at end of surgery. Most do not need drains. Incision is closed.

Compression vest is applied at end of operation to reduce swelling, give support and facilitate adherence of skin to underlying muscles. Duration of compression requirement depends on degree of initial gynecomastia, existing skin elasticity and individual patient factors. Compression garment may be required from 1-3 weeks.

Most patients can resume chest exercises in 3 weeks. It takes up to six months to get final results. Small percentage of patients will need some touchup to surgery after every thing has settled.

Mastectomy with Skin Excision will be needed when there is excess Breast Skin:

In cases of skin excess or skin inelasticity liposuction and gland excision will not work. In these situations, some sort of skin excision, mastectomy and nipple areola repositioning or even free nipple grafting will be required.

Recovery after gynecomastia surgery:

Regardless of surgical method used most patients will be fully recovered in 3-4 weeks

*Individual results may vary.

Long Term Success:

In most cases where there is no underlying cause for gynecomastia the results will be long-term. Rarely, for reasons not known or understood there can be recurrence of gynecomastia requiring another treatment.

Male gynecomastia is also a problem that can affect young boys in their teens. If excessive breast tissue continues to persist into the 20’s surgery should be considered. Gynecomastia surgery can result in a tremendous boost to a young man’s self esteem and confidence that will stay with him for years to come.

Gynecomastia Testimonials

  • “Everything has been excellent”


    Dr. Rai, I feel like I am healing faster than the timeline you gave me. Everything has been excellent. The swelling has gone down a fair amount, I can already feel the bumpiness as you described and when I flex my pectorals I can see them all the way to the sternum. Thank you so much Dr. Rai. I waited twenty years for this and I have waited too long.! I first found your website months ago and researched you as best I could and felt very comfortable with you before even meeting you. You did a great job marketing yourself on your website, and not only that, but you did so honestly; as your bedside manner, and your genuineness with how you handle the provider/patient relationship could be felt not only on your website but also in your office when I met you.

    We will be back next spring to visit my parents and we will contact you prior to flying over to set up a time for pictures. Also, if you desire a testimonial or anything of that nature, I’d be glad to help. I’ve been nothing but pleased.

    Thanks again for doing a great job and words cannot express how much of a difference this has already make to me, not only in appearance with how others see me, but in how I see myself. I can’t begin to explain how hard this was for me growing up and also as an adult, especially when I was younger, thinner and muscular, but always had the saggy area around each nipple. I noticed early on how people always tried to catch a quick glance downwards when talking with me face to face, or how sometimes people would turn their heads when walking by to get a longer look because it didn’t quite look right and just stood out a little bit. This has been something that was emotionally hard for me for years and now it is gone.

  • “I have better posture”


    I feel very confident. I realize I’m not a youngster but compared to what I looked like, I am very happy. I can wear any kind of shirt now. I have better posture, confident posture when standing around people. I would like to advise people to have gynecomastia done at an early age. Do not put it off. Parents should be made aware of the benefits of this surgery ex: self confidence in a child.

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Contact Cosmetic Surgical Center today at 972-566-6500 for your gynecomastia consultation with Dr. Rai serving Dallas, Texas.