A procedure that is growing in popularity is the male chest reduction. Many men are self-conscious of their chests. They feel like their chests are too big and resemble small breasts. This can be a significant source of anxiety for them, especially if they are young men or teens. It is not uncommon for men who suffer with enlarged chests to avoid taking their shirts off in public. This causes them to avoid situations like going to the beach or pools, or changing in a locker room. Men you suffer from enlarges chests often wear baggy shirts, or even multiple layers of shirts to cover themselves up.
What is Gynecomastia?
Gynecomastia, is the enlargement or swelling of breast tissue in males. It can occur in one side or both. Both males and females have breast tissue. Females, obviously have more, but in some males, the breast tissue can grow and can give the appearance of small breasts. In fact, reports indicate that it can be seen in up to 80% of young adolescent boys. This is likely the result of some hormonal changes and most of the time, the breast tissue shrinks as hormones continue to change during puberty and male hormones like testosterone increase.
Causes for Gynecomastia:
There are several causes for the enlargement of a male chest. The vast majority of cases are just simply normal hormonal changes of development and pose no physical danger. These hormonal changes are common during three phases of a male’s life: just after birth, during puberty, and later in life. Early in life, as a baby, there are high amounts of female hormones (estrogen) in the body, and this is from the mother. This is why newborn male babies often have puffy breast tissue. This shrinks as the mother’s estrogen is naturally removed from the body. Again, male chest enlargement can occur during puberty as the normal hormones are changing and regulating themselves. As males age, testosterone levels tend to drop. So men between the ages of 50-80 also commonly experience chest enlargement.
Normal hormonal changes are by far the most common reason for male chest enlargement, but some other less common causes include:
- liver or kidney disease
- tumors (testicular cancer, breast cancer)
- prescription medications (for hair loss, anxiety, depression, bipolar disorder, acid reflux)
What to do if you have Gynecomastia:
If you suffer with gynecomastia, the first thing you should do is visit your doctor. He or she will examine you and take a detailed history. They will also likely do some routine blood tests. This will help them determine the cause for your gynecomastia and help develop a treatment plan.
Treatment for Gynecomastia:
The treatment for your male chest enlargement will depend on what the cause is. If the cause is a medication or drug, then the treatment is to stop the offending thing and see what happens with your chest. If the cause is an underlying medical problem, then that problem should be addressed. If the cause is a hormonal issue, the treatment would be to adjust your hormone levels so that your testosterone increases and your estrogen decreases.
However, since the majority of cases of gynecomastia have no identifiable cause, the treatment would be surgical correction of the chest enlargement. This would also be true if the cause of the chest enlargement was treated, but the enlargement still remained.
Surgical Correction of Gynecomastia:
The first step is an evaluation by a Board Certified Plastic Surgeon, experienced in a male chest reduction procedure. During your evaluation, your surgeon will take your medical history and perform a physical examination. He or she will specifically examine your chest, looking carefully at the amount of excess skin, the quality of that skin, underlying breast tissue, and signs of asymmetry. Your surgeon will also review your medical evaluation to make sure there is no underlying cause that should be addressed before surgery. Your surgeon will also discuss the required incisions and resulting scars for your chest reduction. These incisions will depend on exactly what needs to be done for you and whether you require only breast tissue removal or also some skin removal. In general, if you are young, you likely only require removal of the underlying breast tissue that has enlarged. If you are older, or obese, you may also require some extra skin removal which would require additional incisions and scarring. Your plastic surgeon will be able to discuss with you which surgical approach is best.
· Breast Tissue Removal:
The removal of breast tissue can be done either using liposuction or making a small incision and directly removing the densest part of the breast gland. When liposuction is performed, it can be done through tiny hidden punctures on the chest. These puncture holes are very tiny and often require no more than a single stitch. This is a good technique for removing the majority of breast tissue. However, breast tissue can be very dense, especially directly under the nipple. This is why is is common to also make a small incision around the areola to directly pluck out the thick gland. If this incision needs to be made, it is small and well-hidden around the edge of the areola.
· Skin Removal:
In cases of excess skin, the skin would need to be removed as well, in order to get the best results. This is most common if you are overweight or have lost a lot of weight, or if you are older and have normal skin laxity that comes with aging. Sometimes the skin can be removed from just around the areola. Other times, more incisions need to be made down the chest or in the breast fold.
Where is the Procedure Performed?
A chest reduction is a surgical procedure that needs to be performed in an accredited surgery center or hospital. These are regulated facilities with the appropriate safety standards and appropriately trained staff. The procedure is usually performed using intravenous sedation or general anesthesia. It is usually an out-patient procedure, meaning you are able to go home the same day. In situations where other procedures are being done at the same time, you may be required to stay overnight for monitoring.
After a few hours in the recovery room, you will be discharged home. You will have pain medication and antibiotics. This procedure is very well tolerated and the pain is significantly less than with other procedures like a tummy tuck. You will wear a chest compression garment. After about a week, most people feel pretty good and you will be cleared to return to normal activities, including work and school. You will be restricted from heavy exercise for about 3-4 weeks while you are healing. It may take several months for swelling to go away and your appearance will improve during this time.
Recurrence of your chest enlargement
In general, this surgical procedure will permanently correct your chest enlargement. However, if your chest enlargement is due to things like recreational drug use or prescription medications, and you continue to use those things, then certainly your chest enlargement may recur. In some cases, chest enlargement may come back, simply because it is just way your body is programmed.
If you would like to learn more about reducing your male chest and correcting your gynecomastia, contact New York City Board Certified Plastic Surgeon, Dr. Matthew Schulman. During your consultation, you can find out if a male chest reduction is right for your and specifically which surgical technique is most appropriate.