Gynecomastia Surgery on the Rise

Most plastic surgery practices are noting an increase in male breast reduction surgery for gynecomastia as reported in a lead article in Plastic Surgery News, August 2006, published by the American Society of Plastic Surgeons.

The patient described kept his secret "under wraps" because of his embarrassment and fear of ridicule and is among the growing number of men who undergo gynecomastia procedures. "There were 16,275 gynecomastia procedures performed in 2005, a 17% increase over the 2004 level, according to the American Society of Plastic Surgeons procedural statistics." Plastic surgeons attribute the marked increase in procedures to correct the condition to the news media's interest in plastic surgery, the specialty's public education efforts, reality television shows that have elevated the visibility of procedures for males – all of which have led to a growing acceptance of plastic surgery among men. They also agree that the vast amount of related information available on the Internet has helped many men gain relief from the problem.

Front Left to Right: (1) Pre-op. Age 40, 5'11", 220 lbs. This patient had a history of weight gain and weight loss. He would not be seen at any time without a T-shirt.; (2) Pre-op Markings. Patient also disliked the fullness in front of the armpits above the breasts, and these areas were also liposuctioned. Often the breast needs to be opened and the tissue surgically removed ("subcutaneous mastectomy"); however, in this patient, the result was achieved with liposuction only.; (3) 6 week post-op. This patient's enlarged breasts were reduced considerably with liposuction only. 

Possible causes of gynecomastia include:

• Obesity (fatty gynecomastia)
• Medications such as Effexor, Motrin, Pepcid and digitalis
• Estrogen hormones in foods
• Testicular tumors
• Steroids, prohormone (body builders)
• Genetics

Gynecomastia can develop early in life – sometimes before age 13, and 65% of teenage boys may have gynecomastia according to some estimates. "Most conditions resolve themselves in this age group by age 17." For those that still have gynecomastia, surgery in the later teens is appropriate, so that boys can integrate better with their peer groups without the breasts being a source of embarrassment.

The internet has become a valuable tool for men who can do research in the privacy of their home.

The article continues: “Plastic surgeons who take on gynecomastia patients should keep several points in mind:

• Liposuction alone will not usually fully correct a significant proportion of gynecomastia cases.
• For men, scar location is very important. Therefore, the periareola is the best place for the incision because of the resulting scar.
• The recurrence rate is significantly higher when the breast gland is not resected.
• Bodybuilders usually bleed at a greater rate than non-bodybuilders, which is likely attributed to steroids and certain supplements."