Gynecomastia (Male Breast Reduction) FAQs

General FAQs
  • Q1 :

    Can I go right back to the gym after surgery?

  • No. I recommend that patients avoid training chest for four weeks. They should start that third week with light weights, maybe machines, even, just to get the blood flowing and so on. Gradually, heavier weights can be used. By not training chest for three or four weeks, they can avoid development of a fluid collection or other problem in the are of the surgery. After that, they should start back in slowly to avoid injury. Most patients are back to normal six weeks after their surgery, but their sanity has been maintained since they've been training all along.
  • Q2 :

    Could it be cancer?

  • A lump in the breast should always cause some concern, though breast cancer in men is very unusual--less than 1%, and this is generally in older men. Gynecomastia often occurs on both sides, so if a breast mass occurs on only one side, it may be more suspicious for cancer. It would be extremely unusual to see male breast cancer on both sides at the same time. Sometimes a patient's history may give a clue as to whether or not the lump could be cancer. In other cases, a mammogram or ultrasound may be required. Sometimes a biopsy of the tissue must be done to be sure it isn't cancer.
  • Q3 :

    How long does the surgery last?

  • The surgery takes about one and a half hours.
  • Q4 :

    How visible are the scars after excision

  • Usually, they're barely perceptible.
  • Q5 :

    If this is caused by estrogens, does the tissue actually look like women's breast tissue?

  • It does to a certain extent, in that it is made up of ducts and fat and other elements which are found in women's breasts. At the same time, it looks different to a pathologist who is looking at the tissue under a microscope--it doesn't really form glands to make milk as it does in women.
  • Q6 :

    Is gynecomastia common?

  • A number of studies have looked at the frequency of gynecomastia in the general population, and the incidence may be as high as 60 - 70%. What is found is that it occurs most commonly in three age groups: Newborns, adolescents, and older men.
  • Q7 :

    Is there any way to predict who will get gynecomastia and who won't?

  • Unfortunately, no.
  • Q8 :

    Is this a dangerous condition?

  • No, not really. But if the gynecomastia is really significant, teens will sometimes try to avoid situations where they have to take their shirts off. They may come off as being shy, they may be socially isolated--avoid sports and girls--just because they're embarrassed about the appearance of their chest.
  • Q9 :

    Now, why would a pathologist look at the tissue--is this a type of cancer?

  • No, gynecomastia is not cancer. It is a benign disease, even though its quite depressing for men who get it.
  • Q10 :

    What are other risks of the surgery?

  • Problems which can occur include bleeding or hematoma formation, which can require a second operation for drainage of the collection of blood. This is more common in steroid users due to the high degree of vascularity of the chest wall. Infections are very unusual. The nipple sensation is usually altered after the operation, and in rare instances the nipple loses it's blood supply and dies. In this case, it has to be removed and replaced as a skin graft, but it doesn't look great when this is done. Depressions or contour irregularities can also occur.
  • Q11 :

    What is gynecomastia?

  • Literally, the term "gynecomastia" refers to female-like breasts. Of course, this is in guys--female-like breasts in women are desirable. But in guys they're not welcome.
  • Q12 :

    What's gynecomastia look like? Does it really look like women's breasts?

  • It can, but of course that would be an extreme case. More typically, it starts as a little lump under the nipple, usually during puberty. The lump usually goes away with time, but not in all cases. Sometimes it gets bigger, causing the nipple to stick out. In a boy who is a little overweight, the chest might really start to look more like his sister's chest with early breast development. Some kids can even squeeze a little fluid out of the nipple. It's a pretty frightening experience for an adolescent, so lots of guys just ignore it, hoping it will go away--unless their parents push them into seeing their doctor.
  • Q13 :

    Which is better--excision or liposuction?

  • Liposuction is a great tool when the condition is mostly caused by fatty tissue, because this is easily removed this way. In steroid related gynecomastia, the tissue under the nipple can be very dense, and I find that this must be cut out.
  • Q14 :

    Which is better--excision or liposuction?

  • Liposuction is a great tool when the condition is mostly caused by fatty tissue, because this is easily removed this way. In steroid related gynecomastia, the tissue under the nipple can be very dense, and I find that this must be cut out.
  • Q15 :

    Why does gynecomastia happen only to males at certain age groups?

  • The bottom line with gynecomastia is that it occurs due to an abnormality in the ratio of testosterone to estrogens in the body. When this ratio is low, the estrogen effect is stronger and stimulates the growth of the tissue around the breast. The testosterone which is most important is that which is not bound to protein in the blood, in other words, the free serum testosterone. This has been found to be lower in boys with gynecomastia compared to those without, while all the other hormone levels were about the same.