Posted on August - 06 - 2011

Men with Breast tissue — Gynecomastia

Part I: Men and Plastic Surgery

Gynecomastia: Getting It Off Their Chest

 Most people think cosmetic surgery is reserved for women.  And, while most procedures are performed on women, men are becoming more open about their desire to look good, too.

 We’re accustomed to hearing about breast surgery in women, but men? In men, there is a phenomenon that occurs in which men develop enlarged breasts during puberty or later in life called gynecomastia.

 According to the American Society of Aesthetic Plastic Surgery, Gynocmastia was the fourth most popular procedures for men, with nearly 19,000 surgeries performed last year.

 Gynecomastia occurs most often at puberty but fortunately, it usually goes away during the late teen years. As you can imagine, it can be devastating for a young man’s self-esteem.

 As well, many men in their 50’s or 60’s will develop gynecomastia, even in the absence of weight gain. What happens is that a certain amount of testosterone is converted (or aromatized) into estrogen, and the estrogen causes breast enlargement. When body builders take “anabolic steroids,” testosterone or one of its various forms to build more muscle mass, they often develop gynecomastia for the same reason. In these cases, taking a prescription medication to reduce this aromatization into estrogen can easily prevent gynecomastia. I do not endorse the taking of anabolic steroids for this purpose, however. Those taken by mouth can destroy one’s liver and other side effects are acne, stretch marks, and hair loss. Steroids should be prescribed and monitored by one’s physician.

 Removing excess breast tissue requires plastic surgery through a small incision between the areolar around the nipple and the skin. A scar placed in the area of color difference is usually barely perceptible. Sometimes liposuction is also necessary. Gynecomastia surgery can be performed either under local or general anesthesia, and it is one of the most gratifying procedures performed on men.

 Check back in next week where we’ll discuss more about the latest innovations and most popular procedures for men.

E. Ronald Finger, MD, FACS

Plastic Surgeon

Savannah, GA


Website: Finger & Associates
Phone: 912-354-4411

Posted on May - 09 - 2010

Cosmetic Surgery for the Guys

For many years, cosmetic surgery has been a very private affair, especially in men.  Some people would even wear disguises when visiting their plastic surgeon.  Now it is very open, and even common in the male population.

The most common procedures in males are liposuction of the “love-handles,” followed by face lifts and eyelid lift  procedures.  Results are uniformly satisfactory.  Of course, other procedures, such as nose jobs, chin implants, liposuction of the neck and elsewhere are also commonly performed. 

Unknown to most people is the problem of over-sized breast, called gynecomastia.  Men truly hate having excess breast tissue.  They can’t wear T-shirts and are often embarrassed, and the fact that it is treatable is unknown to most people.  Typically, this problem usually begins around puberty but usually goes away in the late teens.  It also develops with weight gain and during andropause, the male menopause.  This is because the enzyme that converts testosterone into estrogen is more abundant.  This is also why body builders who take large doses of anabolic steroids, forms of testosterone, get large breasts.  Excess testosterone makes more estrogen, which stimulates formation of breasts tissue.

Regardless of the cause, the treatment is to remove the breast tissue.  This is usually through a small incision at the bottom end of the nipple-areola complex, where there is a skin color change.  In addition, liposuction is usually performed.  These procedures must be individualized according to the gland/fat ratio, as the surgical excision removes the “core” breast tissue and the liposuction removes the fat.  If a patient is significantly overweight, some skin may have to be removed as well, leaving scars which must be discussed with your plastic surgeon.

Recovery usually takes a few days requiring an Ace bandage around the chest.  This procedure can be performed under general or local anesthesia.

E. Ronald Finger, M.D.

Savannah, GA

Website: Finger & Associates
Phone: 912-354-4411

Posted on October - 28 - 2009

Treatment of men’s large breast

Male Breast Reduction (Gynecomastia)

Gynecomastia, a medical word from the Greek words for “women-like beasts” affects one out of every ten men.  Enlarged breasts on young boys last only a few years and are

generally resolved by age 18.  Enlarged breasts on a man; however, can be uncomfortable, as well as socially and psychologically embarrassing.  They often won’t ware T-shirts of go swimming because of exposure to their deformity.  Gynecomastia may be associated with obesity, hormonal imbalance, liver disease or certain medications may cause the problem.  The most common medicines are anabolic steroids which elevate testosterone or testosterone itself, which is being prescribed more frequently, as it should be.  Some of the testosterone converts to estrogen and that is what causes the enlarged breasts.  Other medications causing gynecomastia are Avodart, Pepsid, Tagomet, Lanoxin, Prozac and others found on Google.  For those on testosterone, Arimidex may be taken, which reduces the conversion of testosterone to estrogen.  Blood tests are necessary by your physician to determine your estrogen levels.

Male breast reduction can be performed as an outpatient surgical procedure under local or general anesthesia.  If the gynecomastia is primarily caused by fatty tissue, liposuction is usually the procedure of choice.  However, if gynecomastia is the result of a glandular disorder and consists of an actual breast gland, liposuction alone is not likely to be adequate.  This can be identified by feeling a firm core just under the nipple.  If this is the case, and it often is, surgical excision of the core will be needed.  Usually, liposuction is also needed to remove any excess fat surrounding the core. 

If the patient’s breast is very large and sagging, then an entirely different procedure is necessary, removing both breast and skin.  This is a much more involved procedure and can be discussed in another blog.

E. Ronald Finger, M.D., FACS

912-354-4411/ 800-868-9301

Savannah, GA

Website: Finger & Associates
Phone: 912-354-4411