Men may have breast enlargement secondary to breast gland hypertrophy (growth) versus weight gain. Gland hypertrophy (gynecomastia) often occurs in puberty, and then resolves on its own.
If it does not, a medical work up may be necessary to rule out a more serious underlying medical condition causing the problem. Insurance plans do not cover treatment of gynecomastia in adults, but may rarely in teens. Apart from possible related medical issues, breast enlargement may cause the male patient to feel subconscious about his appearance. Treatment is aimed towards reducing the breast size while minimizing scarring.
Some gynecomastia patients may be treated by liposuction only. Small incisions are made around the nipple and in the armpit to allow access for the suction cannulas (tubes). Tissue is then removed centrally and feathered out to the edges of the chest. If there is a particularly large amount of breast tissue underneath the nipple, or if there is an excessive amount of skin, larger excisions for surgical removal may be necessary. The chest is then wrapped in a compression garment.
The compression garment is like a vest and should be worn for several months after the operation for best results. Sutures are usually removed one week after operation and activity should be limited for 2 weeks.
The chest may feel hard or uneven at first, but this will improve with time. The chest is naturally asymmetric and asymmetries often persist after the operation. Sometimes, a limited amount of improvement is accepted to avoid making larger incisions. These incisions are better hidden on a woman’s breast, but tend to make a man’s chest appear more feminine. Accordingly, these incisions are not made unless absolutely unavoidable. In large breasts, liposuction may be performed first and then skin excision at a later date in an effort to reduce scar length.
Complications include, but are not limited to, infection, bleeding, seroma, nipple loss or insensitivity, and recurrence. Most men are very happy with their choice to have surgery and feel more comfortable with their bodies both with and without their shirts on.