Gynecomastia Treatment

Are you a healthy man with abnormally large breasts? Do you envy men with chiseled and defined pecs that confidently wear tight shirts or even go shirtless at the gym or pool? If so, you may have a medical condition known as gynecomastia (excessive male breast tissue).

Unfortunately, no matter how much you diet or exercise like those men you envy at the gym, you won’t be able to eliminate the pesky, excess breast tissue and loose skin on your chest. The only solution for a flatter, firmer chest is male breast reduction surgery. Board-certified plastic surgeon Dr. Ronald Schuster can help determine whether gynecomastia surgery will help you achieve your goals.

To learn more about male breast reduction, call 410-902-9800 today to schedule a confidential consultation with Dr. Schuster. Our office in Baltimore helps men from throughout Maryland, including Owings Mills and Townson.

Because of his unique approach to gynecomastia surgery, which produces a natural and masculine appearance with the least amount of noticeable scarring, men travel from across the country seeking Dr. Schuster’s care. Virtual consultations are available for out-of-town patients.

Gynecomastia Surgery Before & After Photos

What Is Gynecomastia?

Gynecomastia is the abnormal enlargement of the male breast. There are many theories as to what causes gynecomastia. Abnormal levels of estrogen and testosterone, abnormal hormone receptor activity and/or quantity have all been postulated. In the majority of cases (called idiopathic gynecomastia), there is not any identifiable cause. Idiopathic gynecomastia develops during puberty. It has been written in the pediatric literature that up to one third of all boys develop some degree of gynecomastia, and that 80-90 percent of cases will resolve on their own. Even if true, at face value, this still leaves many men with gynecomastia.

There are other known causes of gynecomastia which can result from:

  • Medications
  • Marijuana
  • Anabolic steroids
  • Medical conditions such as:
    • Hyperthyroidism
    • Pituitary tumors (prolactin secreting and growth hormone adenomas)
    • Chronic kidney disease
    • Liver failure
    • Steroid secreting tumors (involving the testicles, adrenal glands and lung)

Gynecomastia is not associated with an increased risk of breast cancer. It primarily causes psychological distress, embarrassment, and other emotional side effects. This can be very severe at times and results in the avoidance of activities which require a boy or man to be seen without his shirt on. If not addressed as a youth, uneasy feelings often linger and can become an issue for men as they marry and have children. They will often have difficulty spending time with their children at the pool or beach. It is unfortunate that this problem is not spoken about more often, because gynecomastia treatment is actually very easy.

Do I Have Gynecomastia?

Patients who have gynecomastia will either develop symptoms before or during puberty, though some men can develop excess breast tissue later in life. The most noticeable symptom of the condition is enlarged male breasts, which are not related to excessive weight. Symptoms of gynecomastia include hypersensitivity of the nipples, breast tenderness, and visibly enlarged breasts or puffy nipples.

Men who have a high body mass index (over 25) are more likely to develop enlarged chests. Being clinically overweight or obese can lead to an increase in estrogen, a primary female sex hormone, which can lead to gynecomastia. For some people, losing weight can reduce the appearance of enlarged male breasts, but others will require surgical revision after weight loss.

If you are wondering whether you have gynecomastia, ask yourself:

  • Could my enlarged breasts be due to excess weight?
  • Do my breasts change in response to diet or exercise?
  • When did I develop noticeable breasts?

If you believe that you have gynecomastia, the next step is to seek out a board-certified plastic surgeon to receive a proper diagnosis and discuss a gynecomastia procedure.

Do I Have Pseudogynecomastia?

Pseudogynecomastia is a condition in which excess fat tissue develops behind the nipples, creating a protrusion that resembles the enlarged appearance of gynecomastia. The primary cause of pseudogynecomastia is excess body weight. Therefore, the first line of treatment is not to discuss gynecomastia surgery but instead develop a diet and exercise plan.

Determining the Cause of Gynecomastia

Patients who develop either pre-pubertal or delayed gynecomastia (after age 30) should have a complete medical work up to rule out any other cause for their gynecomastia. Laboratory tests that can be useful during this work-up include:

  • Blood work — serum levels of LH, FSH, testosterone, estradiol, and human chorionic gonadotropin (hCG), prolactin, thyroid panel (recommended)
  • Ultrasound of testicles, if there is any suspicion of a mass
  • CT scan – brain/skull to rule out pituitary adenoma

Goals of Gynecomastia Surgery

While there are a number of potential causes of gynecomastia, the goals of male breast reduction surgery remain consistent:

  • To treat gynecomastia, a condition that causes enlarged male breasts
  • To reduce breast size and decrease sagging or excess skin
  • To create a flatter, firmer chest
  • To reduce psychological distress or embarrassment

Dr. Schuster understands the personal impact excess breast tissue can have on a man’s sense of masculinity, and is committed to helping his patients restore their confidence and self-esteem.

If you are embarrassed to remove your shirt while swimming or in intimate situations, contact our Baltimore office today to schedule a private consultation.

How is Gynecomastia Surgery Performed?

  • Step 1 – The elimination of fat within and surrounding the breast gland: This can usually be done easily with standard liposuction techniques. Liposuction isused to create a smooth contour. Removing the breast gland without using liposuction can increase the risks of irregularities, over resection and crater deformities.Standard liposuction, however, does not work well for the thicker fibrous tissue that is also mixed in with the fat and breast tissue. For this second step, Dr. Schuster uses Ultrasonic-Assisted Liposuction (UAL).
Baltimore Magazine Top Doctor 2018 Award
    UAL produces a sound wave energy that helps to break down the thicker tissue. In reality, the UAL is performed first during the operation, followed by traditional liposuction. Finally, the third step involves the removal of the most dense, true glandular tissue. This tissue lies directly beneath the nipple area and needs to be directly cut out, or excised.

  • Step 2 – Direct excision:  This has traditionally been performed through an incision placed at the lower border of the areola. While there is nothing “wrong” with this approach, there is always the risk of being left with a noticeable scar. Having matching scars on the areola can sometimes be conspicuous and leave the patient feeling a bit self-conscious. For many years, Dr. Schuster has been able to perform all three essential steps through a small incision (1/2”) on the side of the chest. The incision is needed anyway for the liposuction and UAL, so by making it just a little larger, Dr. Schuster is able to successfully perform all three steps without the additional areolar scar. The scar generally heals very well and is “off” the breast. This has been called the Pull Through, or Lateral Pull Through technique.
  • Step 3 – Removal of Excess Skin: Finally, after performing the removal of the breast tissue the final result depends on the ability of the skin to shrink. In most cases, the skin will be able to shrink on its own. Dr. Schuster believes that using a compression vest helps to encourage the skin to shrink and reduce early swelling. In more advanced cases, there is too much skin, or the skin does not have the elasticity to shrink well enough on its own. In these cases, skin has to be removed. In the moderately advanced patients, the extra skin can be removed in a donut pattern around the areola, leaving a thin scar that goes around the border of the areola. This is called the Peri Areolar excision. In the most severe cases the excess skin is removed at the bottom of the breast, leaving a scar that extends along the inframammary crease. The nipple is actually removed and placed back onto the breast in the right position as a Nipple Graft. A thorough examination is needed to determine which type of correction is right for the individual patient.

Male breast reduction is performed as a short outpatient procedure under a twilight type of anesthesia. It is not at all painful since a great deal of numbing medicine is used. Patients are very comfortable for the entire day and night after surgery. The following day the discomfort is mild, generally feeling similar to the soreness that one feels the day after a hard workout.

How Is Recovery From Male Breast Reduction Surgery?

Recovery from male breast reduction is usually easy and discomfort is generally mild. Dr. Schuster typically recommends that male breast reduction patients take a week off work or school to recover. However, if you do not have a physically demanding job, you may likely be able to have surgery performed on a Friday, and return to work on Monday.

You will wear a compression vest beneath your clothes for three weeks. The vest helps to control the swelling and helps to shrink the skin quickly. You may resume exercise in two weeks. You will see results within the first two weeks but they will continue to improve for about three months.

Non-Surgical Gynecomastia Treatment Alternatives

Not every patient is able or willing to undergo a plastic surgery procedure. If you are interested in pursuing a non-surgical alternative to gynecomastia surgery, consider:

  • Compression undergarments
  • Weight reduction with diet and exercise — effective in cases of pseudo-gynecomastia, where breast enlargement is surplus fat

During your initial consultation with Dr. Schuster, he will determine your candidacy for male breast reduction and explain all of your treatment options, including non-surgical options.

What Are The Risks Of Gynecomastia Surgery?

For most sufferers of enlarged male breasts, clinically known as gynecomastia, the benefits of treatment are self-evident: a dramatic decrease in self-consciousness about their appearance accompanied by an increased sense of masculinity. While the procedure is extremely safe and time-tested, Dr. Ronald H. Schuster wants his gynecomastia patients to understand all of the possible male breast reduction risks prior to surgery at his Baltimore, Maryland area practice.

While serious male breast reduction risks are rare, the procedure, as with any surgical procedure no matter how minimally invasive, is not risk-free. These risks include:

  • Excessive bleeding
  • Infection at the incision points
  • Extreme loss of fluids
  • Adverse reaction to anesthesia

These risks are particularly rare when the surgery is performed by an experienced, board-certified plastic surgeon such as Dr. Schuster. Most patients do experience temporary side effects such as swelling and bruising; however, these generally subside within weeks of the procedure, especially when patients carefully follow Dr. Schuster’s post-operative instructions. Scarring is inevitable, although Dr. Schuster uses minimally invasive liposuction techniques to remove excess fat from the breast area, ensuring the smallest, most discreet scars possible.

Dr. Schuster carefully screens patients to ensure that they are suitable candidates for male breast reduction, thereby minimizing risks. At his Baltimore area practice, the safety of the patient is the paramount concern.

Is Gynecomastia Reversible?

Some cases of pubertal gynecomastia will resolve on their own, and teenage boys will go on to develop a naturally masculine chest. If symptoms do not resolve within two years after they appear during puberty, then the patient will likely need to speak with a plastic surgeon for a gynecomastia surgery consultation.

As for whether or not gynecomastia can return after surgery, the only likelihood of that is due to age or extreme weight gain. Generally, the results are permanent. As long as a patient follows a healthy lifestyle, their breasts will not enlarge on their own.

For younger patients, it is possible that they may notice enlargement or loose skin when they reach middle age.

Why Choose Dr. Schuster For Your Male Breast Reduction?

Men suffering from excess breast tissue (man boobs or puffy nipples) travel from across the country to receive care from Dr. Schuster. Over the course of his 30-year career, Dr. Schuster has refined his technique for gynecomastia surgery to leave the least amount of visible scarring. This is incredibly important for patients who already live with the embarrassment of overly large breasts.

Read: Should I Be Worried About Male Breast Reduction Scars?

Gynecomastia Surgery Testimonials

"I saw Dr. Schuster for Gynecomastia. From the consultation to the final checkup, the experience was comfortable and customized. Dr. Schuster and his team worked with me every step of the way. In the first meeting with him I was made comfortable with [my] condition and how common it was. By the second meeting, I was scheduling a surgery date. The results were amazing. I recommend Dr. Schuster and his office to anyone seeking the change they desire."

- RealSelf

Dr. Schuster is a fellowship-trained, board-certified plastic surgeon with nearly three decades of plastic surgery experience. He is Chief of Plastic Surgery at Baltimore’s Northwest Hospital Center and belongs to the American Society of Plastic Surgeons and the American Society for Aesthetic Plastic Surgery. He has been recognized as a “Top Doctor” by Baltimore Magazine.

During your initial consultation, Dr. Schuster will carefully evaluate your unique needs and customize a treatment plan that is tailored to your personal goals.

Please visit our before-and-after gallery to see examples of Dr. Schuster’s exceptional results.

Does Insurance Cover Gynecomastia Surgery?

Insurance companies rarely cover gynecomastia surgery. During your consultation, Dr. Schuster will be able to better determine if your insurance company will reimburse your procedure. Whenever possible, our staff will write to your insurance company before your gynecomastia surgery is performed so that you will know in advance what kind of coverage to expect.

Schedule Your Male Breast Reduction Consultation Today

You don’t have to live with overly large breasts. Call 410-902-9800 today to schedule a gynecomastia surgery consultation with board-certified plastic surgeon Dr. Ronald Schuster. In addition to our patients from Baltimore, Owings Mills and Townson, Maryland, we proudly welcome men from across the United States. Virtual consultations are available for out-of-town patients.



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Location Map: 10807 Falls Rd #101 Lutherville-Timonium, MD 21093
10807 Falls Rd #101
Lutherville-Timonium, MD 21093

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