Learn More About Male Breast Reduction
When it comes to male breast reduction. Ann Arbor plastic surgeon Dr. Pramit Malhotra knows that asking questions may be difficult for those suffering from the condition known as gynecomastia. Men who develop breasts may struggle with knowing who to turn to, as well as with understanding the cause of the problem and their options to remedy it.
These answers to frequently asked questions can shed light on some of the biggest questions that may arise in relation to the development of male breasts and their reduction. Anyone who wants to know more can also contact our office.
What Are Male Breasts?
Everyone has breast tissue. Though it does not develop in males the same way it develops in females, boys and men still have breast tissue lobules, ducts, and fatty tissue. Hormone fluctuations that cause a drop in testosterone or increase in estrogen can prompt this tissue to grow. Some men have primarily fatty gynecomastia, where there is minimal glandular breast tissue. While obesity can create the appearance of breasts that are mostly made of fatty tissue, many men dealing with gynecomastia have glandular tissue as well.
What Causes Gynecomastia?
In the vast majority of patients, we are not able to identify a cause of the gynecomastia. Some of the most common causes and risk factors are:
- Pubertal: the most common cause
- Medications: diuretics like Spironolactone, Ketoconazole, acid reflux treatments, or prostate cancer drugs
- Marijuana or steroid use
- Herbal products like lavender and tea tree oil
Are Gynecomastia Cases On the Rise?
We are treating about 50 percent more patients every year. Some ethnicities, such as Indians, have a very high rate of gynecomastia. Most of our patients do not feel comfortable wearing a tight T-shirt or being by the pool. We do not have data yet to determine whether more patients are deciding to have treatment or if the gynecomastia numbers are actually on the rise. However, it is our suspicion that the problem is becoming much more common.
How Is Gynecomastia Classified?
There are four grades of gynecomastia:
- Grade 1: A localized disc of tissue under the areola (“puffy nipple”)
- Grade 2: Glandular tissue outside of the areola
- Grade 3: Glandular tissue outside of areola and loose skin
- Grade 4: Glandular tissue, loose skin, and often nipple hanging inferiorly
Can I Just Get Liposuction to Fix the Problem?
Surgical fat removal can reduce the volume of male breasts that have grown due to an increase in fatty tissue, but only gynecomastia surgery can remove the swollen gland and the fatty tissue. Often, using liposuction alone will leave the patient with a sculpted chest but a puffy, full nipple. A consultation can help a plastic surgeon determine the physical makeup of a man’s breasts, which will lead to a determination of the best course of action to create a more masculine chest. In some cases of revision gynecomastia surgery, liposuction plus the use of a special arthroscopic tissue-shaving device can be used without making a nipple incision.
Will I Have Visible Scars?
The overall goal of the surgery is to allow patients to be more comfortable in tight-fitting T-shirts and at the beach. The incisions are closed in three to four layers with very fine stitches to minimize the chance of a very visible scar. There is always a scar present, but often you would have to stretch the nipple out to see it, or be within 12 inches of the scar. Scar quality can vary, and the postoperative care of the scar with a specialized scar reduction protocol is important. If you have Grade 4 gynecomastia, you would need additional incisions than the peri-areaolar scar, and the incisions would be visible.
Is It Normal to Feel Pain in Enlarged Breasts?
Men may find that their unwanted breasts are tender, which is a common sensation felt as breast glands grow. Anyone experiencing swelling or pain should see his primary care physician to have the problem addressed. Nipple discharge, too, is something to discuss with a doctor. While gynecomastia is typically the result of natural hormone fluctuations—such as during puberty—or certain medications, shifts in testosterone and estrogen may also indicate a larger medical problem that should be diagnosed.
If you have asymmetric breast tissue, changing tissue on one side, or any pain or discharge, a visit with a general surgeon or surgical oncologist is required along with imaging of your chest. Approximately 1 percent of breast cancers are in male patients.
As a Man Developing Breasts, Am I Unusual?
Not at all. Gynecomastia is considered to be a common condition, impacting hundreds of thousands of men each year in the United States alone. In fact, many males experience some sort of breast swelling at some point in their lives, typically tied to times when their hormones are off balance. Newborn boys may have swollen breasts, adolescent boys may see them develop as they enter or leave puberty, and older men are prone to this physical change as testosterone levels go down from the levels more typical of youth.
There is nothing wrong with developing breasts, just as there is nothing wrong with seeking treatment to reduce them.