Gynecomastia affects as many as 60 percent of men. It can be caused by hormones but also from diet, smoking marijuana, and steroid misuse. For Michael, he noticed his chest change at the age of 12 and since then, he has been covering his upper body with dark and heavy t-shirts and rash guards.
S. Larry Schlesinger, MD, FACS, a board-certified plastic surgeon in Honolulu, Hawaii (and also serving Kona and Maui) meets with Michael to talk about gynecomastia surgery (male breast reduction surgery) and what is involved in the process. Surgery typically includes liposuction, gland removal and sometimes skin removal.
Michael, good to see you.
Michael – good to see you.
For most people, they get them (male breasts) at puberty. They go away. By the time they’re 17 or 18 and yours didn’t.
There’s two elements to what we’re going to do first. We’re going to liposuction your chest. And then we’re going to go to your areola because the main part of the gland, almost all the gland is underneath the nipple. We make a little incision below the areola, kind of a half-moon shaped incision and then we get into this open space where above it is skin and below it is muscle and it’s kind of an area that got evacuated by sucking the fat out. So most of the gland is going to be stuck to the nipple. What we do is take it out in pieces. Bit by bit by bit and that way you don’t make any dents that you’ve got to fix at a later time.
Breasts, to have indented nipples after going through this whole thing would not be good. So I leave a little button of that tissue there and sew that up and we bring some tissue from the side underneath so there’s no dents and we sew in layers and then sew around the edge of the areola and then we put you into a vest.
You wear that (vest) for one month. Five days after surgery, we’ll start with ultrasound. Not the kind that finds the baby in the uterus but the kind that the physical therapist uses on sore muscles. That will break up the scar tissue, everything will flatten down very nicely.
At about six to eight weeks, you are going to get like a little lump under the nipple. What it is is scar tissue. And that, I stick a little corticosteroid in. It’s not the kind that makes big muscles, this is the kind that shrinks scar tissue. And it will shrink it up, one or two times and then you’re pow. By the way, pow means finished in Hawaii. And then you’re pow and then that’s that and we shake hands and say good bye and you go swimming.
So we’re going to release a tiger when we get rid of all this.
Michael – oh definitely (laughter)
S. Larry Schlesinger, MD, FACS – That’s a good thing!
All – yeah.