Gynecomastia treatment, or male breast reduction, seeks to address a condition that exists, in varying degrees, in almost half of all men. While the surgery may be performed on men of any age, it is discouraged for those who suffer from obesity, as well as for men who drink alcohol excessively and/or smoke marijuana. Gynecomastia surgery removes excess fat and breast tissue from the chest wall to produce a flatter, more masculine chest.
In the consultation, Dr. Cherup will examine your chest and your overall body size and shape. She will determine by the looseness of the skin, the amount of breast and fat tissue behind the nipple areolar complex, and your overall body shape and size whether the breast tissue that exists there is significant or not. The reduction surgery can be performed if there is a likely possibility that after removing the tissue, it will not re-accumulate. Persistent weight gain and/or use of too much alcohol or marijuana can cause the breast tissue to recur after the surgery. Under these circumstances, Dr. Cherup will not perform the surgery. It also may be necessary to obtain an endocrinology consult prior to surgery. If there is a likelihood that a pituitary tumor, an adrenal gland tumor, or testicular tumor is causing abnormalities in your hormone levels and increasing the likelihood of gynecomastia, this condition needs to be addressed before gynecomastia surgery can be performed.
Many patients during the consultation express a desire to have the surgery paid for by their health insurance. Dr. Cherup’s experience, which encompasses the current state of insurance compensation, is that insurance only compensates for this surgery when the deformity is significant, and usually when it is seen in a young teen. It is highly unlikely that this surgery will be paid for by insurance when you are an adult male, in school or with a job, and have no endocrinologic abnormality to be the causative factor of the gynecomastia. In other words, 90 percent of grown men have to consider this a cosmetic surgery, for which payment outside of insurance will be necessary.
Male Breast Reduction Surgical Procedure
Dr. Cherup will perform the surgery under general anesthesia utilizing liposuction and direct excision. Surgery is initiated by making a small incision in the armpit, and through that incision liposuctioning the excess fat that is on the chest wall and the surrounding areas. Dr. Cherup will then make an incision one-third of the way around the areola. Through that incision, she will remove a significant mass of fatty tissue, which will probably also include some breast tissue.
Once she is confident that all the tissue that is necessary to be removed is done so in a smooth, even way, Dr. Cherup will close the incision with stitches underneath the skin. In general, this procedure usually lasts between one to two hours and is always done on an outpatient basis. Two small drain tubes will be introduced through the incisions in your armpit and will drain the excess fluid that might accumulate under the skin. Steri-Strips, gauze dressings, and a compression will finalize the procedure. You will go home with only a pressure type of discomfort and instructions on how to manage the drains.
Post Operative Care and Potential Complications
Dr. Cherup will see you back two days after the surgery. At that visit, your incisions will be inspected and the drain tubes likely removed. Remember to bring your drainage record with you to that visit. You will be returned to your compression vest, and be ready for a shower that afternoon.
As with any cosmetic surgical procedure, complications that need to be addressed are rare. Patients frequently experience some bruising and swelling, although this subsides fairly quickly over two weeks. In certain cases, decreased sensation to the nipple and the chest wall skin may occur.
An indentation on the chest wall where most of the breast tissue was removed can occur in some cases. Dr. Cherup tries very hard to remove the tissue evenly, but thoroughly. Extra scarring internally can cause tethering of the skin to the muscle. Usually massage and time will resolve this problem. Rarely, Dr. Cherup may need to inject your own fat into that indentation to elevate it and make it look smooth.
A hematoma (collection of blood) can occur under the skin if you were too active after the surgery, or if the garment is not snug enough. Small hematomas will resolve on their own. A large one will necessitate a return to the operating room to remove it. This is why it is extremely important for you to stop all medications that could cause bleeding (i.e., fish oil, vitamin E, glucosamine, aspirin, and Advil) two weeks before surgery.
Schedule a Consultation
For more information on the cosmetic surgery risks, postoperative instruction or healing information for male breast reduction surgery in Pittsburgh, PA, contact surgeon Lori L. Cherup M.D. at her main office in Pittsburgh, Pennsylvania.
Call Dr. Cherup at (412) 220-8181 or (877) 441-0639 or use our online form below.
From Our Patients…
“I hate going to any doctor EXCEPT Dr. Cherup – she actually makes the visit a real experience and pleasure. A true professional who instills trust. Thank you!” -Joseph C.