Gynecomastia or male breast enlargement is a condition that affects a significant number of men. The majority of cases of gynecomastia begin during adolescence, during which up to two thirds of young men experience some breast development. This is usually a transient phenomenon and the abnormal contour corrects itself spontaneously. However, experience shows that if breast enlargement persists beyond two years, it is unlikely to resolve on its own.

Some patients may be sufficiently bothered by their chest contour to seek remedy during their teen years. Many other men present to the plastic surgeon during their twenties, thirties or even forties.

In most patients gynecomastia is caused by a combination of dense breast tissue behind the nipple and fatty tissue over the pectoralis major muscle. Liposuction alone in these patients will often lead to disappointing results. In these cases, minimal incision surgery is used to remove the firm breast tissue through an incision that hides nicely at the edge of the areola. This type of direct excision is combined with liposuction for feathering and tapering of peripheral contour. This approach produces the most gratifying and lasting results.

Gynecomastia surgery is performed on an outpatient basis. Most patients report that the surgery produces only modest discomfort. An elastic vest-like garment is worn for the first two weeks following surgery. Lower body exercise can resume in two weeks with return to upper body workouts a month after surgery. The improved chest contour is apparent by two to three weeks, as swelling subsides. Results continue to improve for 3 to 4 months following surgery as the skin continues to tighten.