Age: 31 Gynecomastia/Breast Reduction
This is a case that I am very proud of. It reminds me of why I perform so many gynecomastia cases and the real benefits of treatment. It illustrates the potential power of a simple procedure over a persons life.
This is a 31 year old male who told me that he had gynecomastia since adolescence. He says he suffers a 10 out of 10 on my “gynecomastia scale.” It had affected his personality, his social relationships and his self-esteem. The condition had negatively affected almost every aspect of his life.
He is 5’10” and 218 pounds. He is seen here after treatment of his chest fullness with liposuction alone. I had originally anticipated that he would require both liposuction and tissue removal, but at the end of his liposuction, I wasn’t able to appreciate any actual breast tissue. I removed 2100cc of fat from his anterior chest, as well as under his arms. This is a large amount of fat to be removed only from the upper chest and breast area.
He is seen here 8 months after his procedure. He has lost 18 pounds, is eating healthy and is doing P90X. This procedure has revolutionized him—
- “It has catapulted my spirit.”
- “I feel like I have been liberated.”
- “I don’t dwell on what I used to have.”
- “The burden has been lifted.”
- “Life goes on.”
This man is in the midst of a big transition. He plans on losing a lot more weight (“I’m concentrating on my abdomen now”). He says he has adjusted to his new chest without him feeling that he has “scars” from living with chest fullness for so long. It’s important to note that I did not offer him liposuction of his abdomen as I knew that this was an issue with carrying too much weight, whereas his chest fullness would not change that much with weight loss alone.
Age: 43 Gynecomastia/Breast Reduction
This patient says he has had gynecomastia since he was young. He complaines of general fullness in the breast area as well as puffiness to the areolas. Through an incision on the lower half of the areola I was able to remove a significant amount of fibrofatty tissue. I also performed liposuction of the lateral breast and underarm area to make sure that the results are smooth and natural. I removed 94 grams of tissue on the right and 135 grams of tissue on the left as well as 1,115 cc of fat with liposuction.
He is seen here at four months. There is a big difference in the appearance of his chest. His areolas are smaller and less puffy, and his chest is much flatter and less breast like than before. As is typical, there is firm scar tissue beneath the areola as well as an indent at the incision. He is massaging his chest area daily. It takes about 15 months for the healing to be complete and for the tissues to soften. The most common post operative issue that patients must deal with is seroma formation. This is watery fluid that accumulates under the chest skin after removal of the fibrofatty tissue. Although drains are used in many larger gynecomastia cases, it is common to have to have periodic aspiration of fluid with a syringe and needle. Eventually this process of fluid accumulation will stop. Complications from gynecomastia surgery is generally related to the amount of tissue removed–the greater the tissue removed the greater the chance for fluid accumulation, hematoma and skin contour irregularities.
Age: 15 Gynecomastia/Breast Reduction
This young man was unhappy with the fullness of his chest, especially when wearing T shirts. He limited activities that involved not wearing a shirt. We removed the excessive tissue beneath his nipple-areola complexes. Now he feels like a new man and hopes to become a lifeguard next summer!
Age: 36 Gynecomastia/ Breast Reduction
This is a 36 year old male, 6’4″ and 235 pounds who presented to me for treatment of gynecomastia. He told me that he had used a “testosterone precursor” some years prior and that this caused his gynecomastia. He is seen here after treatment of his gynecomastia with surgical removal of about 70 grams of dense breast tissue from each side. I have included a photograph of the tissue specimen immediately after removal.
It’s interesting to note that after examining his pre and post-operative photos, there is a similarity between gynecomastia and Rhinoplasty (nose job) in that the frontal, straight on view may not reveal much of a difference, but the lateral view reveals all. You can clearly see the projection of his chest area on the lateral view and how much it has been flattened by the tissue removal. I recall that he has some minor healing irregularities in the early months after his procedure, but these areas are resolved with time and massage, as well as the use of a “roller” over the chest.
Prohormones are substances that can be precursors to a naturally occurring hormones produced by the body. Body builders and athletes consider talking prohormones because they are converted into anabolic steroids (like testosterone) and they are looking to benefit from an increase in muscle mass, endurance and strength. Prohormones are perfectly legal in most cases, so people feel they can use these compounds without any legal risk.
One side effect of these hormones is gynecomastia. It does not occur in all those who use these compounds, but when it does, it can be very distressing. Why would taking a male hormone precursor cause breast development? This can happen to some men who convert the testosterone to estrogen. It’s the female hormone estrogen that causes breast development.
Age: 46 Gynecomastia/Breast Reduction
Age: 36 Gynecomastia/Breast Reduction
