American Society of Plastic Surgeons
For Medical Professionals
 
MArizona
4 months ago
Answered

Gynecomastia Question

I read surgical methods to reduce Gynecomastia; they seem radical. Mine are not horrible, but noticeable, and at 67, I'm fit. Here's the thing, if I just simply pull up my skin above my breasts' tissue, a common term might be "breasts lift", they look great. In fact, I'm on the skinny side so get an appearance of a nice muscular chest. Yet, I don't see this anywhere as an option. Is it?

Procedure: Male Breast Reduction
Location: PRESCOTT, AZ

Replies 5

Mark Boschert
ASPS Surgeon

Yes, that is an option. The problem is the scarring. Most men don’t want any scars on their chest and to try to remove skin from above the nipple would leave a large scar. That is why the best treatments including hidden scar around the areola to remove the excess tissue and allow the skin to reset in the appropriate position.

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Debra Johnson
ASPS Surgeon
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You likely have loose skin, due to aging and genetics. There might be some "non-invasive" treatments that could improve things without surgical scars. Radiofrequency devices such as BodyTite or Velashape might work. "Threadlifting" wherein barbed sutures are threaded under the skin to elevate it (often used the face) might work, at least in the short term. Seek a board-certified ASPS member through the Find-a-Surgeon tool on this website, and ask about alternatives to surgery.

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Rahul Vemula
ASPS Surgeon
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Thanks for your question. There are several “grades” of gynecomastia that we use to classify its severity. It also depends on if the gynecomastia is mostly comprised of fat or glandular breast tissue. Depending on your specific anatomy, the severity of the gynecomastia and your goals there are several options. These range from doing liposuction only, to liposuction with removal of some of the glandular tissue. Most people fall into the category of needing liposuction and removal of the gland. If there is ptosis (sagging) of the nipples then a more radical procedure is needed where excess skin is removed as well.

When Liposuction is performed, many of us also use an ultrasound liposuction such as VASER.

Your first step should be to see a board certified plastic surgeon to see which category you fall into and what the best treatment would be for you.

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Elliot Jacobs

Yes, pulling the chest skin up would seem to be a logical answer. More than likely, your lax skin is due, in part, to gradual aging and possibly sun exposure. In order to really lift the breast, a sizable amount of skin would have to be removed -- most likely leaving you with a scar at the upper edge of the areola or perhaps even a horizontal scar across the chest above the areola. Unfortunately, all the non-invasive skin tightening machines can only tighten the skin a little bit -- not sufficient for your needs. Furthermore, you will not have addressed the remaining fat/breast tissue, which will continue to exert a downward pull on your chest skin.

In my experience in doing many thousands of gynecomastia procedures, and many on men in their 60's, the best treatment would still be traditional liposuction and possibly gland excision if needed. The skin will usually tighten up by itself. If one adds an energy device such as Body-Tite, it could provide you with a sculpted chest.

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Michelle Copeland
ASPS Surgeon
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Fortunately, the condition can often be reversed with liposuction just by making a small incision under the nipple. It is now possible to reduce the size of the breast using virtually scarless technique. Through a small incision around the nipple liposuction with ultrasound and fine laser beams liquefy the fat and glandular tissue recontouring the breast around the areola and from the sides and bottom of the breasts. Because liposuction stimulates the skin to tighten, a smooth contour after fat is removed is possible. I recommend making an appointment with a board-certified plastic surgeon who can go over your surgical options with you.

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