Male breast development is known as gynecomastia. Gynecomastia is commonly due to hormonal changes during puberty. In most men, breast development in puberty is temporary, but for a small minority, it may be permanent. Weight gain may also be a contributing factor in breast development; many patients have breast enlargement due to fatty tissue accumulation (lipomastia). Many patients have a combination of both lipomastia and gynecomastia.
Whatever the cause, patients are often embarrassed by their appearance. They choose to avoid situations such as swimming, changing in a public change room, or going to the beach. A male breast reduction is a procedure performed by plastic surgeon Lawrence Tong, MD that can make the chest look normal by reversing the changes associated with male breast development.
What Gynecomastia (Male Breast) Reduction Does
Gynecomastia surgery improves the contour of the male chest by removing the breast tissue and associated soft tissues that contribute to the unwanted appearance. This is accomplished by:
- Removing glandular breast tissue (gynecomastia)
- Removing fatty breast tissue (lipomastia)
- Removing the stretched excess skin (when required)
- Elevating and or reducing the nipple-areolar (when required)
Dr. Tong will carefully evaluate your situation to determine which surgical techniques are needed to accomplish your optimal appearance.
Who is a Candidate for Male Breast Reduction?
If you are a male patient with breast enlargement, whether caused by growth of glandular tissue or fat accumulation, you may be interested in surgery for Gynecomastia. Toronto male patients with any of the following conditions could benefit:
- Men who have a small, firm ‘dome’ of breast tissue just underneath the nipple
- Men who have a small or moderate mound of breast tissue (gland and/or fat), with no significant skin excess
- Men who have a large mound of breast tissue (gland and/or fat) with significant skin excess / possible drooping
Issues to Consider with Male Breast Reduction Surgery
Correction of male breast enlargement by removal of the offending tissues does not equate to total removal of tissues from the area. The most common complication from male breast reduction surgery is removing too much tissue and causing a depression. This problem is difficult to fix and may look worse than the original concern. Dr. Tong exercises extremely careful judgment during surgery to prevent this from happening.
Certain disease processes, or side effects from particular drugs, can cause male breast enlargement. These factors must be identified and dealt with before considering male breast reduction surgery. During your consultation, Dr. Tong will evaluate you to make certain that surgery is an appropriate treatment for you.
Incisions for Male Breast Reduction
Any surgical procedure will leave some type of scar. Dr. Tong specializes in obtaining the least visible scars and putting them in the least visible places. The specific type and degree of enlargement is determined by the method of male breast reduction surgery.
If the breast is composed of mainly fatty tissue, then Liposuction— consisting of a tiny (2-3mm) incision— would be all that is required.
If glandular tissue (firm, fibrous true breast tissue) is present as well, a small incision along the edge of the lower areola is added.
If excess skin is present, removal is required; incisions may vary from a single incision around the areola to longer incisions.
A table outlining the types of surgery for different forms of male breast enlargement and their incisions is below.
Wearing any type of clothing will cover any of these scars. The peri-areolar scar sits at a normal border between the darker and lighter skin of the areola edge. With your shirt off, the Liposuction and peri-areolar scars tend not to be visible to other people. Chest hair will also help hide any scars.
Which Type of Gynecomastia (Male Breast) Reduction Incision Will You Need?
In male breast reduction surgery, the severity and composition of the breast enlargement dictates which type of surgery is required and which incisions will be used.
Types of Surgery for Different Forms of Male Breast Enlargement
|Composition/severity||Type of procedure||Incisions|
Fatty breast tissue
Small (2-3 mm) incision in chest skin
Glandular breast tissue
Around the lower areola
Excess skin the areolar area (puffy looking nipples)
Peri-areaolar skin removal
Around the entire areola
Significant excess skin
Removal and lifting of hanging chest skin
Around the areola and in the breast fold
A combined approach may be utilized, depending on the particular anatomy; for example, Liposuction plus glandular removal is a frequent combination.
Details of the Male Breast Reduction Procedure
Dr. Tong performs your procedure under local anesthesia, general anesthesia, or IV sedation. He treats mild forms of breast enlargement while you are awake, with local anesthesia only. If you undergo IV sedation or general anesthesia, you will be asleep and completely unaware during the procedure. Dr. Tong conducts your surgery in downtown Yorkville, within his medical complex at 199 Avenue Road, Toronto.
Gynecomastia correction is carried out by removing the unwanted tissues as dictated by the particular anatomy: fat tissue, glandular tissue, or excess skin. Dr. Tong carefully reshapes your chest so that it looks flat, but not scooped, with techniques that include Liposuction, glandular tissue removal, excess skin removal, and lifting of the soft tissues (see table of techniques of male breast reduction).
Near the end of surgery, Dr. Tong positions the operating bed so you are sitting upright. This allows your chest to be assessed in the most accurate manner while Dr. Tong makes surgical adjustments to achieve the best possible result for you. Once completed, he uses plastic surgical techniques to sew the incisions closed. After the last stitches are placed, you will be placed in a surgical chest compression garment and gently awakened from anesthesia.
Recovery after Gynecomastia Correction in Toronto
Following your male breast reduction surgery, the anesthetic effects gradually subside as you recover in the post-anesthetic unit, monitored by our registered nurses. After the anesthesia has worn off, you will go home, accompanied by your friend(s) or family member(s). Patients who have surgery performed with local anesthetic only, can drive themselves home immediately.
At home you should rest. You may perform non-strenuous activities such as watching television, making meals, and reading, but nothing more vigorous. The chest may be swollen and have visible bruising during the first 1-3 weeks. You should expect the chest to feel sore for 7-10 days; your pain medication should be used during this time. A majority of patients return to (non-strenuous) work after 5-7 days.
At one week after surgery, you will see Dr. Tong to have stitches removed and your progress assessed. You will likely be allowed to start light exercise (e.g. walking) at 1-2 weeks after surgery. Avoid strenuous activity (jogging, martial arts, weight lifting) until 4-6 weeks after surgery.
The chest may initially look fuller than before your procedure. This is entirely normal and it takes between 1-3 months for the swelling to fully settle. As the swelling subsides, you will notice that the chest has a more natural look, feel, and shape.
In addition to the first post-operative visit, you will see Dr. Tong at 6 weeks and 6 months after surgery. Post-op photos will also be taken at these visits to document your progress.
Risks and Complications Associated with Gynecomastia Correction Surgery
Any surgery carries certain risks and potential complications. Gynecomastia surgery is considered a low risk procedure. General risks include bleeding, infection, scars, and anesthetic risks. Dr. Tong will go over the pertinent risks associated with the procedure at the time of your consultation.
Get Educated about Gynecomastia Correction in Toronto
There is a good deal of information to take in during your initial Gynecomastia consultation, and Dr. Tong will make sure that you understand all the important aspects of male breast reduction. He will take the time to answer all of your questions and concerns. You will never be rushed or pressured into making a decision about surgery. Our goal is to make you an educated patient. We know that an educated patient will make smarter choices about their surgery and their surgeon.
To learn more about how Toronto Gynecomastia surgeon Lawrence Tong, MD can help with male breast enlargement, set up a consultation with Dr. Tong by giving us a call at (416) 972-0999, or let us give you a call. Just fill out our contact form and we will call you on the same or the next business day. No physician’s referral is needed.
Male Breast Reduction (Gynecomastia Surgery) at a Glance
- Over-resection of breast tissue leading to an inverted nipple region