This article is for informational purposes only and should not be considered medical advice. Please consult a qualified healthcare professional for personalized guidance and treatment.

What is gynecomastia and what causes it?

Gynecomastia refers to benign enlargement of male breast tissue and is a common reason men seek chest contouring. It can result from hormonal imbalance (relative increase in estrogen or reduced androgens), certain medications, underlying health conditions, or age-related changes. Obesity can cause pseudo-gynecomastia due to excess fatty breast tissue, while true gynecomastia involves glandular proliferation. A clinical exam, history of medications or substance use, and sometimes blood tests or imaging help distinguish causes and inform whether surgery or medical management is appropriate.

How does breast reduction (mammoplasty) work?

Mammoplasty is an umbrella term for operations that alter breast size or shape; breast reduction specifically removes excess breast tissue, skin, and sometimes fat to achieve a smaller profile. Surgeons commonly combine direct excision of glandular tissue with liposuction to refine contours. Incision patterns vary—periareolar, vertical, or inverted-T—depending on reduction amount and skin laxity. The procedure aims to relieve physical symptoms (back or shoulder pain) and produce a proportionate aesthetic outcome while preserving nipple-areola viability and, when possible, sensation.

When is surgery considered for male patients?

Surgery for male breast enlargement is often considered when gynecomastia persists despite conservative measures (weight loss, addressing medication causes, or hormonal treatment) and when it causes pain, recurrent inflammation, or significant psychosocial distress. Candidates should ideally have stable body weight and realistic expectations. Preoperative assessment typically includes evaluation of medical history, physical exam, and discussion of goals. In younger males, observation or medical therapy may be attempted first if the condition is recent and likely to resolve.

How does surgery change chest contour?

Surgical approaches focus on flattening the chest and restoring a masculine contour. For predominantly fatty enlargement, liposuction sculpts the chest by removing fat through small incisions. For glandular or mixed enlargement, direct excision of breast tissue under the nipple or via a circumareolar incision is often required. When excess skin remains after tissue removal, skin resection and redraping may be necessary to tighten the chest. Outcomes aim for symmetry and a natural chest slope; however, scars, contour irregularities, and asymmetry are possible and discussed before surgery.

What happens to excess tissue during surgery?

Surgeons tailor removal techniques to the type of tissue involved. Fatty tissue is frequently addressed with liposuction, which provides smoother contours through suction-assisted removal. Glandular tissue is firmer and typically requires sharp excision. When both are present, a combined technique is used. Removed tissue is sent for pathology in some cases to confirm benign findings if there are atypical features. Preservation of nipple-areola blood supply is a priority; in large reductions, the nipple may be relocated using a pedicled or free graft technique, with implications for sensation and breastfeeding.

Recovery and considerations

Recovery protocols vary, but common elements include short-term swelling and bruising, wearing a compression garment for several weeks, and activity restrictions to allow healing. Pain is generally manageable with prescribed or over-the-counter analgesics. Follow-up visits monitor wound healing and detect complications such as hematoma, infection, seroma, delayed healing, or changes in nipple sensation. Smoking cessation before and after surgery, control of chronic conditions (like diabetes), and adherence to the surgeon’s instructions reduce complication risk. Realistic expectations and understanding potential scarring are important parts of preoperative counseling.

Conclusion

Breast reduction and mammoplasty encompass a range of procedures that address symptomatic or aesthetic breast and chest concerns in both women and men. Careful evaluation of the underlying cause—especially distinguishing fatty from glandular tissue in gynecomastia—guides technique selection. Prospective patients should discuss goals, risks, and recovery timelines with a qualified surgeon to determine whether surgery or non-surgical management best suits their situation.