American Society of Plastic Surgeons
For Medical Professionals
3 years ago

Gynecomastia with incision under nipple only(no liposuction)

I weigh 212 lbs as of now. Last year I had reduced my weight to 155lbs but yet I had a female like appearance to my chest. It was puffy and just didn’t look right. I weigh a lot now and gynecomastia has increased in appearance. The surgery hospital I consulted will be operating using nipple incision I believe it was. My question is, with future exercise will my chest look flat with just incision?

Procedure: Breast Reduction
Location: Chicago, IL

Replies 6

Barry Citron
ASPS Surgeon

If the surgery corrects the gynecomastia and your weight remains stable, exercise will help to enhance your result. Best wishes

Elliot Jacobs
ASPS Surgeon

The scenario you describe (residual gynecomastia after weight loss) is not unusual. Treatment will require an incision around the edge of the areola and usually some additional skin undermining surrouding the areola to allow the skin to re-distribute. This is most often done with liposuction instruments, sometimes to remove any residual surrounding fat or sometimes merely to loosen the skin (with no suction utlized). Good luck! Elliot W. Jacobs, MD, FACS, New York City

Nelson Castillo

Thank you for sharing your excellent question. For most gynecomastia patients the best result comes from a combination of liposuction and direct glandular excision. The liposuction helps reduce pseudogynecomastia (excess chess fat) while the incision allows removal of the gland the causes areolar herniation and the female like appearance to the chest. Hope this helps.

Jeremy White
ASPS Surgeon

I can't say for sure without photos and a physical exam, but exercise and a healthy diet will help to maintain and optimize your results.

Rahul Vemula
ASPS Surgeon
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Thanks for this great question. If you will be flat depends on the quality of your skin, if you have skin that is sagging, stretch marks, and the nipple areola complex is hanging low below the fold (ptosis) you may need a skin excision procedure as well. This is my experience with weight loss patients . Many of my weight loss patients main concern is that they no longer have a female appearance to the breast but have a sagging and deflated skin that does not go away with diet and exercise

Please consult with a board certified plastic surgeon to determine which procedures are best to achieve your goals.

Best wishes!

Michael Law
ASPS Surgeon

Congratulations on your weight loss. Being at or near your ideal weight is a great place to start for gynecomastia surgery. Certainly there are some men with excess glandular tissue only who do not require liposuction. if you are avoiding liposuction due to a concern of scarring, you should not let that worry you. The scars related to gynecomastia surgery often fade to being virtually imperceptible. Most of my gynecomastia patients are comfortable being shirtless during outdoor and sporting events and in intimate moments. Be careful too about the way in which glandular tissue is removed. I often perform gynecomastia revision surgery for patients who had surgery performed elsewhere. The most common correction is for men who experience divots and irregular contours after surgery.


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