GYNECOMASTIA - Orange County, CA
What is Gynecomastia and How is It Caused?
Although all males have some remnants of breast tissue, gynecomastia is the enlargement (or hypertrophy) of this tissue. This creates female-looking breasts that can often make guys self-conscious as well as make them the subject of teasing, bullying, or harassment.
Gynecomastia can be caused by a number of difference factors, including testicular tumors, thyroid issues, medications, drug abuse, hormone imbalance, and steroid use, among others.
Who is a Good Candidate to Get Their Gynecomastia Fixed?
Gynecomastia can happen at all ages, but not patients will need treatment. It can first occur in babies due to high levels of estrogen from the mom still floating in the baby's bloodstream. This will usually resolve on its own after a few weeks to months as the estrogen levels decrease.
Gynecomastia commonly occurs around puberty. During this period of growth, teens will have an elevated estradiol/estrogen ratio, which stimulates the formation of breast tissue. Although this may cause some anxiety, it is actually fairly common and can occur in over 2/3 of the population.
As your hormone balance improves, the gynecomastia should start to resolve on its own. This can take up to 2 years to resolve. However, patients with gynecomastia that is present for longer than 1 year will be more likely to not have full resolution and may eventually need surgery.
Gynecomastia can also commonly occur in the elderly population or in overweight patients. As people age, they will generally gain more fat, which contains an enzyme called aromatase. This enzyme converts testosterone to estrogen, leading to breast formation if there is an abundance of fat. This breast tissue can occasionally be treated with weight loss, but it often requires surgical intervention.
Bodybuilders or athletes who use or abuse steroids can also form gynecomastia. The increased levels of testosterone supplementation in the body will be converted to estradiol and estrogen, leading to breast formation. Stopping the steroids may help resolve the issue, but the longer the breast tissue persists, the more likely surgery will be required to treat it.
Gynecomastia can also be caused by a slew of other factors including cirrhosis, kidney failure, testicular tumors, adrenal tumors, pituitary tumors, thyroid problems, hypogonadism, cancer, chemotherapy, ACE inhibitors, calcium channel blockers, digitalis, and other drugs. Treating the underlying cause may help resolve the gynecomastia. In up to 25% of cases, no cause may be identified.
How Do I Prepare for Gynecomastia Surgery?
Patients should be healthy overall and able to tolerate general anesthesia. Depending on your history and the course of your disease you may be asked to get labs including a basic metabolic panel (BMP), complete blood cell count (CBC), coagulation factors, EKG, TSH/thyroxine levels, follicle-stimulating hormone (FSH), chorionic gonadotropin, luteinizing hormone (LH), testosterone levels, and estradiol levels.
You may also be asked to get some imaging of your body including a testicular ultrasound to check for possible tumors. Your doctor should perform a full physical examination on you to look for any other abnormal findings.
What Does Gynecomastia Surgery Entail?
Treatment for gynecomastia usually involves getting put to sleep completely. Depending on the thickness of your breast tissue, your surgeon may opt for a few different ways to treat it.
If you have mainly fatty breast tissue, your surgeon may treat it with liposuction only. A few small incisions are made on your chest and numbing fluid is infiltrated. The fatty tissue is then sucked out to help contour your chest.
If you have mainly fibrous (thicker and harder) breast tissue, your surgeon may opt to cut it out directly with or without liposuction. An incision is usually made around the areola with a possible small extension to the side. The breast tissue is then cut out directly, leaving some tissue under the skin and nipple for padding and contouring. You may or may not have drains at the end of the procedure.
Very rarely will a larger incision need to be made across the entire lower chest to remove the breast tissue. The total procedure time usually varies between 2-3 hours.
What is the Recovery After Gynecomastia Surgery?
Recovery usually takes several weeks total. You will be given a compression garment or a compression wrap after surgery to help reduce swelling and to help your skin heal down to your chest. If drains were placed, they will usually be removed at 1 week after surgery.
We recommend taking a week off of work, but some patients will return to light duty work after only several days. Any heavy lifting or strenuous exercise can be resumed at 6 weeks. Light cardio can be resumed at 3 weeks.
Your results are immediate! The swelling and bruising will take several weeks to resolve. Some numbness of the area, including the nipples, may persist for several weeks or months.
What are the Risks of Gynecomastia Treatment?
Risks of general anesthesia will be discussed with the anesthesiologist. Bleeding and infection risks are similar to those of any surgery that involves an incision. Other risks related to Gynecomastia Surgery include:
- Contour irregularities, including under-resection or over-resection of tissue
- Persistent numbness
- Blood or fluid collections under the skin (hematoma or seroma)
- Poor scarring
- Need for revisions
Always be sure to consult with a Board Eligible or a Board Certified Plastic Surgeon to determine if getting a gynecomastia surgery is right for you! Dr. David Nguyen would be happy to see you in consultation to walk you through the process and discuss your results. Call 657-900-5055 for a free consultation today!
Gynecomastia Removal Cost: $5,075 for both sides, $3,700 for one side
See More Gynecomastia Before & After Photos