This male patient had breast reduction with liposuction to remove breast like fat deposits for a flatter chest.

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What is Gynecomastia Surgery?

Gynecomastia, also commonly referred to as "man boobs", is an enlargement of breast tissue in men. Gynecomastia Surgery, also referred to as "male breast reduction," is one of the most popular cosmetic procedures requested by men. While some men requesting this surgery are overweight, many are not.

The development of gynecomastia often begins in puberty, although it can also first present as an adult. Gynecomastia can be precipitated with certain medications, and in particular, the use of steroids. The condition is often associated with increased ratios of estrogens/androgens that circulate in the bloodstream.

Gynecomastia severity is characterized with a grading system based on the amount of excess tissue and the presence of excess skin. The scale is as follows:

  • Grade 1: minor enlargement, no skin excess
  • Grade 2: moderate enlargement, no skin excess
  • Grade 3: moderate englargement with skin excess
  • Grade 4: marked enlargement with skin excess

I'm embarrassed to take my shirt off, even in front of my wife

-a Pennsylvania patient

What problems does Gynecomastia surgery solve?

Common symptoms include:

  • enlarged glandular breast tissue
  • tenderness of the breasts and/or nipples
  • impaired self-confidence

Can the male breast lumps be cancer?

Breast cancer in men is rare. Only 1% of breast cancer occurs in men. Most breast masses in males are benign. Typically, a man notices a lump on one side growing over a period of a few months. It is usually not painful. There may be some bleeding through the nipple. See your doctor if you have any of these signs.

How is Gynecomastia performed?

gynecomastia before and after patient illustrationThe technique used to eliminate male breasts depends on the amount of fat and breast tissue, as well as the quality of the skin and position of the nipple complex. If the skin tone is good and the nipple position is not excessively hanging, then liposuction will yield a good result. It is possible to remove over a pound (half a kilogram) per side in some cases. We operate on male breasts of all sizes and shapes. Some men just have a small mound the size of a grape directly behind the nipple. In addition, the excess tissue may be only on one side.

The technique most commonly used is a combination of liposuction and some amount of tissue/gland removal. For those men with larger breasts and hanging nipples, they may additionally need skin excision/mastopexy in combination with fat extraction and tissue removal.

Many surgeons use the same breast techniques they use on women. However, I feel that this is not the correct approach since those techniques aim to give a projecting conical breast mound where the objective with male breast reduction is just the opposite -- to produce a flat, non-projecting breast. Therefore, a different technique is used for men.

If only a small amount of tissue is being removed, the procedure can be performed under Local anesthesia . However, if more than 300cc of tissue needs to be removed from either side, it is best to use IV Anesthesia so that you are in a light sleep during the procedure. If any amount of skin needs to be excised I usually use IV sedation to keep the patient comfortable.

What are the Pre-Operative requirements?

Local cases do not require pre-operative clearance, but cases performed under IV sedation do. Patients with procedures under IV sedation are required to get a medical clearance two weeks prior to surgery. A CBC blood test and an H&P (history and physical) are the minimum requirements if you are a healthy adult.

No matter which anesthesia you receive, you should stop smoking 2 weeks prior to surgery, as well as stop aspirin products 2 weeks prior to surgery. With IV Sedation, you may not eat or drink anything after midnight on the night before surgery. However, cases under Local anesthesia can come to the case after eating a light breakfast.

What is Gynecomastia Post-Op recovery like?

Most men want to know when they can resume full activity and most are capable of doing so after two weeks. By that time all the sutures have been removed. You will be asked to wear a tight vest for 6 weeks to help control the swelling. There is usually very little bruising. Those that need open surgery (liposuction plus excision) will have scars on the chest, which will remain pink for months, before finally fading to the color of the surrounding skin.

What are the risks and possible complications?

Depending on techniques employed (liposuction and/or excision) there will are risks and complications associated, as with any surgery. Possible complications with gynecomastia surgery include, but are not limited to:

  • hematoma
  • seroma
  • fat necrosis
  • infection
  • nipple or breast sensitivity changes
  • asymmetry
  • unfavorable scarring

How much does Gynecomastia Surgery cost?

The main factor for the cost is whether the procedure is performed under Local or IV sedation. If the amount of tissue being removed is minor, it can be performed under Local anesthesia. This is similar to going to the dentist as the surgical area will be locally anesthetized so that you do not feel anything during the procedure.

However, if there are >300 cc of breast tissue to be removed from either or both sides, you will likely need to have the procedure performed under IV anesthesia. Total estimated costs for removal of fat and tissue are as follows:

Gynecomastia  2017 Price
with Local Anesthesia (lipo only)
$3,400
with IV Sedation (lipo + gland excision)
$5,225

These prices include the surgeon's fee, the board certified anesthesiologist's fee, the surgery center fee, garment, and follow-up office visits.

Can I finance my Gynecomastia surgery?

Yes, we work with a number of finance companies so that you can have a low, affordable, monthly payment. Please call the office at 410-494-8100 or see our financing section for more information.

Gynecomastia Before and After Photos*

before and after male chest contouringSee our patient gallery of Gynecomastia Before and After Photos, all performed by Dr. Ricardo Rodriguez, a Board Certified Plastic Surgeon with over 20 years experience. Please note that all of these patients have given written consent to use their photos at our web site. We are very grateful for their participation in patient education!

Having your Gynecomastia surgery in Baltimore, Maryland?

Contact UsOur office and surgery center is only 30 miles from BWI airport and 20 minutes from the downtown Amtrak train station. Give us a call at +1-410-494-8100 or Contact Us online to set up a consult.

We'll be happy to schedule a time for you to visit our offices or participate in a virtual consultation, after which I'll be able to explain your options fully to help you decide if surgery can help you achieve your desired outcome.

doctor's signatureUpdated October 16, 2017
Ricardo L Rodriguez MD
Board Certified Plastic Surgery

*Note: Patients depicted in photos and videos have provided written consent to display their photos online. Every patient is unique, and surgical results may vary. Please contact us if you have any questions.