Gynecomastia Surgery

Male Breast Reduction Surgery

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Gynecomastia surgery (also called gyno surgery) improves the male chest contour. The procedure may use liposuction alone or with surgery to remove excess fat, tissue, and skin from male breasts. Duke Health plastic surgeons may recommend gyno surgery to improve your physical appearance, boost your self-esteem and confidence, and enrich your quality of life.

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What to Know About Gynecomastia and Gyno Surgery

Gynecomastia Causes
Gynecomastia refers to enlarged breasts in men. While large male breasts can be inherited, gynecomastia often results from a hormonal imbalance caused by an endocrine disorder or medications like testosterone replacement therapy and anabolic steroids, weight loss, or weight gain.

Good Candidates for Gynecomastia Surgery
You may be a candidate for gyno surgery if you have enlarged, swollen, or overdeveloped breasts that cause embarrassment or discomfort, and prevent you from participating in activities or affect your psychological well-being. Candidates for gyno surgery have conditions that can’t be corrected through medications or by stopping certain medications. You must also be healthy and not have any illness or condition that could increase your risk of surgical complications. Importantly, your body weight should be at a healthy level to maximize your results and prevent issues with healing after surgery.

Gynecomastia Surgery Cost
Gynecomastia surgery may be covered by your insurance in certain severe cases with extra skin and breast tissue. However, insurance does not cover surgery performed for purely cosmetic reasons and if your gynecomastia is less severe it may not be a covered benefit. After a comprehensive consultation with our plastic surgery, you can meet with our financial counselor. They will give you an estimated cost to help you determine if this is the right approach for you.

You May Have Scars
Your surgeon will use the natural contours of your breasts to minimize scarring as much as possible. Gynecomastia surgery may be performed through tiny incisions if done with liposuction alone but may require larger incisions depending on the severity of your gynecomastia. Your surgeon will discuss the best approach to your case during your consultation.

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Gyno Surgery Risks
Gynecomastia surgery carries the same risks as any other standard surgery. These include the risk of bleeding and infection and risks associated with general anesthesia. Your doctor will discuss these risks with you if surgery is recommended.

The Risk that Gynecomastia Will Return
The risk of gynecomastia returning is relatively low if we identify what caused gynecomastia and steps are taken to avoid them following the procedure. The effects of the surgery are permanent, but it is possible for breasts to re-enlarge following excess weight loss or weight gain, hormonal imbalances, and the use of certain drugs (including anabolic steroids).

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Your Initial Consultation and Tests

An initial visit with your plastic surgeon may take place via telehealth or in person. We will discuss your reasons for pursuing gyno surgery and your goals. To determine if you are a candidate for male breast reduction surgery, your surgeon will review your family history, general health status, lifestyle habits such as smoking, previous operations, any medications you may be taking, and conditions that can put you at risk for surgery.

During an additional in-person visit, your breasts will be measured and assessed for size and shape, and photographs may be taken for your medical record. Before treatment is recommended, you will also undergo one or more of the following tests.

  • Blood tests may be necessary to evaluate your hormone levels. Pre-surgical testing also requires several blood tests to assess your liver and kidney function and to determine if you have an infection, a blood disorder, or anemia, that may have gone previously undetected.
  • A mammogram may be performed to detect any underlying breast abnormalities. Gynecomastia can increase your risk for male breast cancer. Additional imaging, including ultrasound and MRI, may also be requested.

Gynecomastia Treatment Options

We will recommend a treatment that may include nonsurgical options or surgery.

Non-Surgical Treatment
If gynecomastia is caused by a hormonal imbalance, medication may be prescribed. These are best discussed with your primary care provider or an endocrinologist. Plastic surgeons do not prescribe these medications. Options include testosterone replacement therapy, an estrogen receptor modulator such as tamoxifen, which has been shown to reduce breast volume; or clomiphene, which stimulates hormone production.

Alternatively, your surgeon may recommend that you lose weight, quit smoking, or discontinue medication before surgery to ensure you experience the best possible outcome.

Surgical Options
If surgery is recommended, we will discuss your options, the expected outcome, potential risks and complications, and your post-operation recovery.

Gynecomastia Procedure and Recovery

Gyno surgery typically includes one or more of the following procedures.

Liposuction
If your main concern is having prominent nipples and you do not need a lot of breast tissue removed, we may only perform liposuction. You will be sedated, and a small thin tube called a cannula is inserted through tiny incisions in the breast. Excess fat is loosened and sucked out through the tube to recontour the chest.

Surgical Removal
Most often, liposuction is combined with surgical removal of excess fat and tissue. The most common technique involves an incision that encircles the dark area around the nipple (areola). Another incision follows the natural curve of the crease beneath the breasts. Excess fat and glandular tissue are removed.

Breast Lift
If the weight of excess breast tissue causes the breasts to sag and stretch the areola, your plastic surgeon will perform a breast lift, and then reposition and resize the areola at the same time.

The procedure is performed under general anesthesia and typically takes about one to two hours. It may be performed in an outpatient ambulatory surgery center or may require an overnight stay. Sometimes a second procedure is required to tighten the skin and achieve optimal cosmetic results.

Gyno Surgery Recovery

Your chest will be wrapped in bandages.

A compression chest vest will be applied after the surgery and worn for six weeks to three months to help with your recovery and ensure you experience optimal results.

You will be sore for the first two weeks and your chest will be swollen and bruised.

Your pain can be controlled with a prescription or over-the-counter pain medication.

You can return to work in about one week.

You can return to physical activity in four to six weeks.

Gynecomastia can often require patience on your part because swelling can persist for months after surgery and make your chest appear more prominent. It often takes 6 months to a year of healing to see your true final result.

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Duke University Hospital is proud of our team and the exceptional care they provide. They are why we are once again recognized as the best hospital in North Carolina, and nationally ranked in 11 adult and 9 pediatric specialties by U.S. News & World Report for 2023–2024.

This page was medically reviewed on 12/13/2023 by