Men who have gynecomastia have excess breast tissue.

The problem can develop during adolescence or adulthood.

Gynecomastia can negatively affect a man’s self-image, harming his quality of life for years.

Male breast reduction is common solution for gynecomastia.

A plastic surgeon can remove glandular tissue and fat, sculpting the chest into a more masculine shape.

Research on Male Breast Reduction

The Italian study evaluated 126 cases of gynecomastia during a six-year period. The average patient was a 28 year old male. Most patients had symptoms of gynecomastia on both sides of the chest, while a smaller number (11.9 percent) had the condition on one side.

During procedures, the surgeons employed different techniques as necessary. They frequently performed “adenomammectomy with periareolar inferior or inverted Omega incision,” while another alternative was “circumareolar or vertical scar incision and liposuction.”

The procedures effectively removed the excess glandular tissue and fat from the patient’s chest.

How Effective Was Your Procedure?

Before and after their male breast reduction surgery, patients filled out questionnaires for their experiences. They answered questions like:

• Why did you choose to undergo male breast reduction?
• How satisfied are you with your results?
• Has the quality of your life improved after surgery?

According to the study, patients had high satisfacton: “all patients reported an improvement in their quality of life with an average satisfaction score of 8.2 out of 10.” The complication rate was reportedly 17.72 percent.

“We suggest to the patients affected by gynecomastia to undergo surgery always and as soon as possible,” the authors conclude.

Learn more about male breast reduction in Northern Virginia.

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“I saw my stomach for the first time in the shower,” said Jeanne. She describes the discomfort she experienced with large breasts before surgery, and now the feeling of having a more manageable body shape. On the show, their plastic surgeon talks to Kathy Lee and Hoda about the cost of breast reduction, as well as some details about health insurance coverage.

Read more about breast reduction and  breast augmentation in Fairfax.

The use of mammography before breast reduction varies.  Some plastic surgeons may recommend it and some may not.  According to Dr. M.J. Campbell and the authors of this study, between 31% and 72% of patients do not undergo mammograms before breast reduction surgery.   They suggest that the role of mammography in breast reduction is “ill defined” and there are “no formal guidelines for surgeons.”

Of the 207 breast reconstruction patients studied, 32 of them presented abnormal mammographic results, and all were false positives.  While the authors say the reason for this unexpectedly high number is unknown, they do offer a theory:

“The high incidence of false-positive results may be the result of poor image clarity, as obese women, typically with larger breasts, might have a thicker volume of breast tissue compressed between the mammography plates, which can lead to more scattered radiation and decreased image contrast and quality.”

You can read the entire study, “The role of preoperative mammography in women considering reduction mammoplasty: a single institution review of 207 patients” in the May 2010 issue of The American Journal of Surgery.

To dispel the first and most common misunderstanding, the nipple/areola is not removed.  Although the incision scars give this impression.  The fact is that the nipple areolar complex remains attached to the “pedicle” or the breast tissue remaining after everything else has been removed.  The most common method of breast reduction has been the “inferior pedicle” technique.  This means that the breast tissue is removed from the lateral, superior and medial aspects of the breast.  Or if one thinks about it as a clock, from about 7:00 to 5:00.  The remaining pedicle is the tissue between 5:00 and 7:00 up to the center of the clock.  This center is where the nipple areolar complex is.

There are a few issues I take with this technique.  First, the blood supply is limited so large reductions cannot be done.  Second, it removes the breast tissue in the upper part, or superior pole, of the breast which can lead to a flattened area between the collar bone and the nipple.  And finally a breast reduction also lifts the breast but this technique tries to push the breast up.  Since breast tissue is like gelatin that doesn’t work that well.  Don’t get me wrong.  Most surgeons use this technique and get good outcomes but I think there is a better technique.

I prefer a “superomedial” pedicle technique.  Although this was first introduced in the 1950′s it never caught on for unknown reasons.  However, around 10 years ago Dr. Elizabeth Hall-Findlay, of Canada, reintroduced the technique.  In this technique the breast tissue that is removed is the breast tissue that bothers women.  The tissue is removed from about the 4:00 position, around the bottom of the breast to the 11:00 position.

I think this is a better technique for several reasons.  First, as I said the tissue that bothers women with large breasts the most is removed.  Second, the pedicle or remaining breast tissue has fantastic blood supply so even the largest reduction is possible.  And finally the breast is supported from above like a suspension bridge-which works well for breast tissue.

So if you’re looking for a better breast reduction in the Washington DC area, call my assistant Katie to schedule your consultation.

In a November 1st interview with STV, Jeremy Piven commented briefly that he stopped drinking soy milk because he was afraid it might cause breast growth.  While talk show hosts and celebrity bloggers seem to think this is funny, they probably don’t know that 1) Piven might be right about soy milk and 2) for many men out there, male breasts are a major source of anxiety.

The purpose of this post is to direct readers to one article in an academic journal that may just validate his concern about soy milk.  Note that the article documents a single case – not a widespread scientific study. It should not be interpreted as conclusive.

This article in the May-June 2008 issue of Endocrine Practice documented an “unusual case of gynecomastia related to the consumption of soy products.”  According to the authors, a 60 year old male came in with 6 months duration of bilateral gynecomastia (male breasts) and no underlying conditions.  Because physical evaluations didn’t reveal a cause, they interviewed the man more thoroughly.

The patient “described a daily intake of 3 quarts of soy milk. After he discontinued drinking soy milk, his breast tenderness resolved.”

Gynecomastia is a hormonal and physical problem that may be caused by several different lifestyle factors.  Men who experience the condition should see a doctor to help resolve the underlying causes when possible.  If breast tissue persists after the cause is resolved, male breast reduction surgery is an option.

1. Better Breasts
Clearly the main goal of cosmetic breast surgery – participants of the study commented about improvements in breast shape and the clothing options that were now available to them as a result.  One patient with breast implants comments, “Some things are much more fun to put on, and the stuff that I used to wear looks way better–I am sure they looked good before, too–but I just fill in a bit more, look a bit more busty in them.”

2. Better Physical Well-Being
Breast reduction patients can get relief from back and neck pain, which often allows increased activity and better health.

3. Improved Psychosocial Well-Being
Patients in the study shared the positive changes in self perception and experiences in social settings. Increased confidence and feeling as if you fit the perceived “norm” of the female body are said to be a common benefits of breast surgery.

4. Improved Sexual Well Being
When people feel more attractive, they generally experience more sexual pleasure.  If breast implants or another surgery improve a woman’s perception of her self and her body, sexual well being can consequently improve.

5.  Great Surgeon-Patient Relationship
Women who experienced a good surgeon-patient relationship – with open, honest communication – expressed more satisfaction with breast surgery.  Patients who had an adverse relationship with the surgeon or staff reported being fearful, uncomfortable, and less satisfied.

6. Overall Satisfaction
Researchers also included the simple category of general satisfaction.  Would you undergo the surgery again?  One breast augmentation patient responds, “there is not one day that goes by that I am not so pleased that I did it.”

The article referenced is called “Satisfaction and quality of life in women who undergo breast surgery: A qualitative study” and you can find it here on BMC Women’s Health.

Here are two questions for our readers:

• Are there goals you have considered for breast surgery that aren’t listed above?
  
• If you have undergone a breast lift, breast reduction, reconstruction, or augmentation, were there additional benefits (or influencing factors) that these researchers haven’t identified?

The NBC Today Show recently featured Sculptra aesthetic on their “Today’s Health” segment. Along with a treatment demonstration and some patient testimonials, Dr. Roshini Raj of the NYU school of medicine appears on the show to explain the details regarding Sculptra treatment. She covers the advantages and disadvantages of Sculptra and of course, compares the filler to Botox.

Sculptra was recently FDA approved for cosmetic use. While the wrinkle filler has been used off-label in cosmetic applications for a long time, the recent FDA clearance has spawned a renewed interest of the drug in the cosmetic surgery industry and in the media.

Questions like the ones above were asked by researchers during the Beauty for Life survey, a collaborative effort by the American Society for Aesthetic Plastic Surgery and the American Society of Plastic Surgeons.  ASAPS President Renato Saltz says the survey was intended to help surgeons “understand what patients are most concerned about at different stages of their lives.”

Participants were grouped according to age so researchers could determine how members of each generation approach physical appearance of the self and physical appearance of ones partner or potential partner.

Respondents in their 20s, 30s, and 40s reported that a “fit, well proportioned body” was what they found most appealing in another person.  When it came to their own physical characteristics, the same group was apparently more concerned about their own faces.  The abdomen and hips were said to be areas of significant concern (especially in the 30s), but across the board, patients said they were most conscious of their facial appearance.

Reasons given for maintaining an attractive physical appearance included the following:

1. Boost self confidence
2. Make friends
3. Attract partners
4. Increase job prospects

In all age groups, cosmetic procedures ranked fairly high, alongside diet, exercise, and skin care.  Through the link listed below you can easily view the results (in a pdf file) of the Beauty for Life survey.

• http://www.surgery.org/private/download/BFLUserSurvey.pdf

According to news sources in the UK, Ms. Halep complained that her large (34 DD) breasts have slowed her reaction time on the court and caused discomfort. “It’s the weight that troubles me – my ability to react quickly”, she told The Sun.

In 2008, Halep won the junior French Open. She is now ranked 317th in the world.

Women pursue breast reduction surgery for a several reasons, increased mobility being just one of them. One breast reduction patient stated, “Before I didn’t want to run anywhere, [not] even across the street. If something happened, I would not run.  It was painful and embarrassing” (Klassen 2009).

Beside issues with physical activity, many women hope to alleviate irritation around their bra strap and underneath the breast, pain in the back and neck, and discomfort during sleeping.

The procedure can be described as a ‘normalizing’ experience for women. Once the surgery is complete, patients often say they are less self-conscious, they fit into more ‘regular’ sized clothes, and that they typify what is perceived as ‘the norm’ of the female body.

For more information on breast reduction surgery in Virginia, see this part of our homepage.

The breast reduction procedure involves designing a skin incision, removing breast tissue from around the pedicle, or remaining breast tissue that contains the nipple/areolar complex, then closing the reduced skin and breast.  The more modern technique that I use, a pedicle from the top rather than the bottom of the breast, gives outstanding long lasting results. (See breast reduction photos.)

So when I saw a young woman recently in consultation with large sagging breasts who told me that other plastic surgeons had suggested liposuctioning the breasts instead of a formal reduction I had to discuss it.

First, usually one of the significant problems with large breasts is that the nipple is too low or rather the breast is ptotic (sagging).  This is an unappealing appearance for the patients.  Formal breast reduction surgery not only reduces the breast size but also returns the nipple to its proper position, on a level just above the breast fold or crease.

Liposuction can reduce fatty tissue in the breast but does nothing to elevate the nipple.  Second, liposuction will remove fat and little else.  So in young patients who tend to have fibrous glandular tissue mixed with fat the fat will be removed leaving the fibrous tissue.  Unfortunately, these tissues aren’t evenly distributed and the breast will end up with a lumpy bumpy empty sack appearance.  Not my idea of artistic surgery.

So for the most part liposuction breast reduction doesn’t work with young sagging breasts.  However, in patients where there is significantly less fibrous or glandular tissue, the nipple is in the correct location and the skin has great tone liposuction may have a role.  But these patients are few and far between.  My advice to this patient was get the correct surgery that will give the best, aesthetically pleasing and predictable results.

If you’d like to discuss breast reduction, liposuction or any cosmetic issue contact our office at 703.752.6608 or click here to arrange a complementary consultation.