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Correction of Gynecomastia
Male Breast Reduction
Gynecomastia is Very Common
Gynecomastia (“Man Boobs”) is extremely common and affects an estimated 40 to 60 percent of all men – rich, famous and ordinary alike. As you can see below, many Hollywood stars, Senator Kennedy as well as several world leaders such as Russian President Vladimir Putin and former British PM Tony Blair appear to have gynecomastia.
WHY do Boys and Men Develop Breasts?
Men and women produce both male (testosterone) and female (estrogens) hormones. Our breasts are very sensitive to the balance and ratio between estrogen and testosterone levels in our blood. If there is either a fall in the testosterone level and, or a rise in the estrogen level, breasts are stimulated to grow. The ratio of male to female hormone in our bodies may be reduced by obesity, old age, taking certain drugs or medications that simulate female hormones and by certain diseases. Gynecomastia has many potential causes. Male breast over-development may be divided into two large groups: Physiologic or normal gynecomastia and Pathologic (or Abnormal) gynecomastia. Normal (Physiologic) Gynecomastia affects up to 60% of men at some point in their lives. It is commonly seen with newborn boys (due to maternal circulating estrogens) and may last for a few weeks, as well as in obese boys and men and in older men. Normal Gynecomastia has two large peaks. The first peak begins and most often ends during the teen years. (Its incidence rises from about 2% of 11-years-old boys to a peak of about 60% of 15-year-olds and then falls to around 20% per cent of 17-year-old boys). This common occurrence of Physiologic gynecomastia in puberty may be related to transient rise in female hormones with a rise in the ratio of female-to-male hormones. At puberty, the testosterone level does not rise steadily. Over the first few teenage years, it continually fluctuates wildly. These dips in testosterone allow the small amount of estrogen (female hormone) in the circulation to stimulate the breasts resulting
in enlarging and/or tender breasts. As a higher level of testosterone is produced inthe latter teen years, breast growth regresses and most affected boys outgrow it. The second peak occurs in around the age of 60, when gynecomastia rises slowly and affects over 40% of healthy aging men. Fat cells preferentially produce more female hormones. As a result, male obesity is commonly associated with breast development. In addition, aging is often associated with some degree of gynecomastia. A combination of decreased production of testosterone with an increased amount of body fat (which produces estrogens) cause breast stimulation and growth.
Gynecomastia is also seen in men who lost weight. Many of them often come to our office with residual stubborn pockets of fat on their chests despite working out in the gym all the time. Pathologic Gynecomastia is caused by one or a combination of three processes : 1) Deficiency in Testosterone production or action (including androgen receptor defects) with or without a related increase in Estrogen production, 2) Increase in Estrogen production and, or Hypersensitivity of Breast tissue to Estrogens 3) In 10-20% of cases, man breasts may be also seen with long term use of certain medications, including taking either body-building steroids or estrogens, taking some drugs which have an estrogen-like effect on the breast or others which act by blocking the effect of testosterone. The body always strives for balance. When it senses a higher level of
The body always strives for balance. When it senses a higher level of testosterone or testosterone-like compounds, it will actively change them, by a process called aromatization, into an estrogen like hormone. As a result, the intake of such anabolic steroids (especially, Anadrol, Dianabol and Sustanon) is associated with rapid development of men breasts. The prolonged use of certain tricyclic antidepressants or valium, of certain Calcium-channel blockers (anti-hypertension or heart problems medications) (such as nifedipine, verapamil, diltiazem), ACE inhibitors (such as captopril, enalapril), Digoxin, Amiodarone or, Spironolactone, such as Drugs for duodenal ulcer (i.e. Omeprazole, Ranitidine, Cimetidine, Zantac or Tagamet), certain Antibiotics and antifungal drugs (i.e. Isoniazid, Metronidazole (Flagyl) or Ketoconazole) , Proscar and Propecia are associated with gynecomastia. Some of the anti-AIDS drugs known as Retroviral Therapies are associated with gynecomastia. In addition, the abuse of alcohol and the use of illegal drugs such Marijuana, Heroin,
methadone or Amphetamines result in breast development. Although stopping these medications may lead to regression of the gynecomastia, in some cases, surgery may still be needed to eliminate the condition. Gynecomastia (man breasts) may also be seen with pituitary gland failure, chronic kidney disease, chronic liver disease, HIV, adrenal disease or with thyroid disease or certain congenital disorders (such as Kleinfelter’s syndrome). It may also be seen with some hormone producing tumors of the adrenal, testis or lung. In summary, the vast majority of gynecomastia cases are either due to anabolic steroid use or are harmless cases related due to
obesity and, or to an increased sensitivity of the male breast tissue to circulating estrogen hormone. In the latter cases, there is no detectable hormonal imbalance and complete hormonal work ups are frequently negative.
Breasts have Deformed Men throughout Recorded History
Gynecomastia predates history and there are many examples of historical statues demonstrating gynecomastia. A famous example is that of the controversial 18th Dynasty pharaoh Akhenaten (Amenhotep IV) (1351–1334 B.C.), husband to Nefertiti and father of King Tut, who appears to have suffered from gynecomastia (Please, see Right, where he worships the sun god, Aten). Gynecomastia is also obvious in two of his predecessors. The two statues below (Left and center) are well over 4,000 years old. They date to the 4th Dynasty of Egyptian Pharaohs (2,575 to 2,465 BC) which is mostly known for its enormous building projects. Its second king, the Pharaoh Kheops (Khufu), built the largest pyramid on the plateau of Giza, which is the only
remaining structure of the original Seven Wonders of the Ancient World. His son, the Pharaoh Chephren, built the great Sphinx. The statue below on the left is of a royal scribe from the 4th dynasty and the one in the middle is of the Pharaoh Kheops (Khufu). Both men clearly have gynecomastia.
In the Far East, many sculptures of Buddha (aprox. 560 - 483BC) depict him with man breasts (on far Right). One must therefore assume that gynecomastia was and remains common there as well.
While we do not know how socially acceptable man breasts were in antiquity, we do know that in today’s society they are a source of great concern and embarrassment. Despite affecting between a third to one half of all men, gynecomastia remains a source of ridicule and alienation. In the age of perfect chiseled chests, the entertainment industry repeatedly points out those who are no longer perfect and ridicules men with gynecomastia.
In 1995, on the Seinfeld episode “The Doorman”, to help Frank Constanza with his gynecomastia, the ever enterprising Kramer introduced “The Bro”. After all, “A bra is for ladies. Meet The Bro”. An invention Constanza preferred to call “The Manssiere “. Four years later, the Austin Powers series introduced Fat Bastard. Fat Bastard was Dr. Evil’s morbidly obese, flatulent, gluttonous and vulgar Scottish killer who incidentally also had significant gynecomastia.
As its many pejorative descriptions (i.e. “Bitch Tits”, “B.T.’s”, “Man Boobs”, “Moobs”, “Moobies” etc.) readily attest, gynecomastia is associated with significant social and psychosocial hardships. Many of the boys and men who have it feel greatly ashamed. Commonly, they wear baggy clothing, withdraw from sports and avoid everyday activities which involve exposing their chests (including playing shirts and skins), such as avoiding changing in locker rooms, avoiding PE classes or going to the gym, stalling getting into the shower till the other men were gone, avoiding the beach or swimming in public and never going without a shirt or at least a t-shirt. Some flatten their chests with compressions garments or ace bandages.
Correction of Gynecomastia
Surgery is the only effective treatment for persistent gynecomastia. Despite what you may have read in the back of fitness magazine or seen on late night TV, gynecomastia cannot be improved or reversed by any creams, lotions, special massage devices, injections, dietary supplements or other “magic” pills nor by exercise. Men who choose not to have surgery may camouflage their chest deformity and obtain some emotional relief by using compression garments.
Treatment of Teen Gynecomastia
Because 95% of teen gynecomastia cases resolve on their own, the vast majority of teens who gather the courage to confide in the pediatricians just how much they suffer are uniformly told to wait. Most end up waiting for years while subjected to ridicule, teasing and self-imposed exile. But, because we live in a culture which idolizes the perfect figure and puts a premium on chiseled pecs, many teens are not willing of putting up with ridicule until their gynecomastia resolves. Therefore, in some, a better approach would be to agree on a plan of action in 2-3 years. If the gynecomastia had stabilized and had not resolved by then, those teens should then be offered surgical treatment.
Before seeking surgery, you must remember that adult gynecomastia may also rarely be a manifestation of a more complicated underlying disease process. Therefore, before any case of persistent gynecomastia is treated surgically, you may want to have a full investigation to eliminate a treatable underlying cause. You should see either an Endocrinologist (hormone doctor) or your Internal Medicine doctor for a work-up to detect the underlying cause, if any, of your gynecomastia before seeking surgical correction. Doctors Aldea and Eby do not do such medical work-ups but would be glad to hear from and interact with your doctor in coordinating your subsequent surgical care. If everything is normal, which is usually
the case, Doctors Aldea and Eby can remove your excess breast tissue and correct your gynecomastia. Gynecomastia varies in its severity and its various breasts display the entire wide spectrum of breast shapes and sizes; from small breast prominences, to full breasts to droopy, deflated breasts. The gynecomastia correction surgical technique that Dr. Aldea and, or Dr. Eby would suggest will depend on the size of your breasts and their content (fat, glandular breast tissue), the ratio of breast fat to breast skin envelope and the amount and elasticity of the breast skin. Depending on your particular extent of breast enlargement, Dr. Aldea or Dr. Eby will pick the least-invasive gynecomastia surgery technique which may provide you with the best chest contour.
Gynecomastia Surgery Techniques
use of ultrasound-assisted liposuction (UAL), especially VASER Liposelection (see our Liposuction page), has greatly improved the evenness and symmetry of liposuction and makes the removal of male breast tissue a much less traumatic experience.
As you can see above, in minimal gynecomastia cases, VASER Liposelection done through a tiny incision, hidden at the edge of the areola, is used to vacuum off the breast fat and flatten the chest. In moderate cases of gynecomastia, in addition to liposuction of the breast, the excess breast gland fibrous and fatty tissues which sit under the nipple are surgically removed. (Please, see photos from the VASER website on the Right). Lastly, as you can see above, liposuction alone could not produce acceptable results in the most extreme gynecomastia cases. When correcting gynecomastia involving either large breasts (which would require removal of larger amounts of fat and glandular tissue) and, or in men with poor breast skin elasticity, the excess and or damaged skin would not adjust well to the new smaller breasts and would badly sag. For this reason, it has to be surgically removed to achieve a flatter chest. Such breast reductions are unavoidingly associated with more conspicuous scars. But many men with large droopy man breasts prefer these scars over having large breasts. Gynecomastia correction operations greatly reduce and flatten the enlarged male breasts and are usually done under general anesthesia as outpatient procedures.
Recovery - Postoperatively, there may be temporary bruising, tenderness or numbness. You will feel some discomfort for a few days after surgery. However, the discomfort will be controlled with medications prescribed by Dr. Aldea or Dr. Eby. There will be some swelling for about 4 weeks. To help reduce swelling and help contour your chest, you will need to wear an elastic compression garment continuously for two weeks and then for a few weeks longer only at night. On the average, depending on the nature of your occupation, you may be back to work: average 1 week. More strenuous activity (including gym): average 3-4 weeks. The operation is extremely safe. Some of the rare potential risks associated with it may be bleeding, infection, fluid accumulation, asymmetry, skin sagging or pigmentation changes.
Male Breast Reduction is among the most common cosmetic procedures performed on men and the number of males seeking treatment for it is on the rise. According to the American Society of Plastic Surgeons, 14,000 boys between the ages of 13 and 19 had surgery to reduce the size of their breasts in 2006.
COST of Man Breast (Gynecomastia) Surgery
The vast majority of US medical insurance companies regard these gynecomastia surgery procedures as cosmetic in nature and will not pay for them.
You can get a good idea of the current professional fees charged for Male Breast Reduction (Gynecomastia Correction) by other ABPS board-certified Plastic surgeons across the country, by checking the latest (2008) fee survey by the American Society of Plastic Surgeons of the professional fees charges by its members. Our fees are extremely competitive, not only within our own metropolitan Memphis area, but ESPECIALLY in comparison with fees charged by plastic surgeons elsewhere in the United States. This remains applicable even when travel and lodging expenses are added. (In other words, cheaper than these surgical fees). As was discussed above, gynecomastia patients differ significantly in the size and consistency of their breasts and in their individual cosmetic goals. As a result, the procedures and their durations will differ, resulting in correspondingly different costs. The cost of YOUR gynecomastia treatment surgery will depend on the procedure used in YOUR particular case. Read more about it on our Fees and Costs page (Click HERE).
Regardless of its cost, as a procedure which often enhances appearance greatly boosts self-confidence, it is hard to put a price on the real value of gynecomastia correction. Our office works with several financing companies which would make your gynecomastia surgery very affordable. Please, consult our SPECIAL OFFERS page for details on our time-limited Plastic Surgery savings.
NO REASON to Suffer Any Longer - Men Breasts are Correctable
Gynecomastia surgery transforms lives. It transforms introverts into extroverts. It often liberates men from being ashamed of their chests, transforming them into outgoing and active individuals.
Can Gynecomastia Surgery answer your particular needs?
Dr. Aldea is an expert in gynecomastia correction surgery. Using innovative surgical techniques and a customized, analytic artistic approach, Dr. Aldea is able to offer his patients dynamic flatter chests with natural results. If you would like to learn more about gynecomastia correction surgery and see what it can do for you, please, call (901) 752-1412 to schedule your consultation.
This web site has been prepared to give you a basic understanding of this type of cosmetic procedure. If you want to learn more or have any further questions, please call us at (901) 752-1412 to arrange a consultation with one of our doctors. You will be under no obligation to undergo surgery by attending a consultation with either Dr. Aldea or Dr. Eby.
Please, call 752-1412 for your appointment today!
Cosmetic surgery is an investment in yourself. An investment which could make a world of difference in your outlook.
Peter A. Aldea, M.D. Patricia L. Eby, M.D. Certified and Re-Certified by The American Board of Plastic Surgery Members of the American Society of Plastic Surgeons Fellows of The American College of Surgeons
Cosmetic Surgery Specialists of Memphis, PLLC 6401 Poplar Avenue, Suite 360, Memphis, Tennessee 38119
Plastic surgery specialists Dr. Peter Aldea and Dr. Patricia Eby could be your best source for Breast Enlargement, Short Scar Breast Lift surgery, Male Breast reduction surgery, Body contouring surgery, Butt Lift - Brazilian Butt Lift, Mommy Makeover, Figure Restoration after Massive Weight Loss, Tummy Tuck and Abdominoplasty, VASER Liposelection, Liposuclpture. They are experienced cosmetic surgeons who would like to help you with your Eyelid Lift, Blepharoplasty, Facelift – Rhytidectomy, neck lift, Forehead Lift, Nose Surgery – Rhinoplasty, Botox, Juvederm, Restylane, Latisse and Lip Augmentation needs.
Let Dr. Peter Aldea and Dr. Patricia Eby of Cosmetic Surgery Specialists of Memphis, PLLC help unlock and bring out your beauty!
Dr. Peter Aldea and Dr. Patricia Eby have performed Plastic Surgery procedures on satisfied patients from across Tennessee, Arkansas, Mississippi, Missouri and the Mid-South as well as several foreign countries. Their Cosmetic Surgery patients come from Memphis, Germantown, Collierville, Cordova, Bartlett, Arlington, Batesville, Blytheville, Brentwood, Bolivar, Brownsville, Byhalia, Cleveland, Columbia, Covington, Dyersburg, Franklin, Kingston, Smyrna, Jonesboro, Lebanon, Lexington, Columbus, Clarksville, Clarksdale, Cookeville, Crossville, Grenada, Greenville, Henderson, Hendersonville, Hernando, Holly Springs, Lakeland, Lawrenceburg, Martin, Marion, Maryville, Millington, Moscow, Murfreesboro, Nashville, Helena, Munford, Oakland, Olive Branch, Osceola, Forrest City, Paris, Paragould, Pine Bluff, Rossville, Southaven, Savannah, Tupelo, Little Rock, Horn Lake, Huntsville, Jackson, Corinth, Florence, Ripley, Oxford, Senatobia, Union City, West Memphis and Wynne.
Cosmetic Surgery Specialists of Memphis, PLLC is a comprehensive center for plastic surgery and cosmetic surgery excellence. On this website you can learn what makes our practice so unique.