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Dr. Levens' Parkland Life Magazine Articles
Oversized Male Breasts: Not an Uncommon Problem
By David J. Levens, MD, PA, FACS
Gynecomastia is a medical term that originates from the Greek
words for "women-like breasts." The condition
often results in embarrassment, teasing, and social trauma,
especially for teens and younger men, leading many to wear
heavy, loose-fitting shirts and avoid sports and bare-chested
activities.
Sufferers
may find some comfort in the fact that they are not alone. Gynecomastia is present
in an estimated 40 to 60 percent of the male population. It may affect only one
breast or both. Certain drugs, such as anabolic steroids, medications containing
estrogen, alcohol and marijuana, may cause or contribute to enlarged male breasts. So
might some medical conditions including cancer and impaired liver function. However,
it is widely accepted in the medical community that a large percentage of cases
occur for unknown reasons.
Excess fat
or glandular tissue, especially along the lower breast, are the culprits, creating
a "female" contour. Diet and exercise can help with generalized
fat, but cannot be directed to the specific shape of the chest fat. Neither
diet nor exercise will help reduce excess glandular tissue. Indeed, as
muscle beneath the breast is built up as with chest exercises, the overlying
fat and glandular tissue is pushed further forward and may become more noticeable.
The best candidates
for male breast reduction are those who have firm, elastic skin that will reshape
to the body’s new contours. The procedure is appropriate for men
of any age who are otherwise healthy. In the case of teens, surgery should
be postponed until the individual is past puberty and mature enough physically
and emotionally to handle it, usually by 16 or 17. Even then, the condition often
resolves itself without surgical treatment by age 18 or 19, so patients are well
advised to wait until then, unless the gynecomastia is causing major emotional
trauma. A free consultation with a plastic surgeon can give both the patient
and his parents the guidance they need to make an informed decision.
Depending
on the nature and extent of the gynecomastia, enlarged male breasts can be reduced
by liposuction and/or by cutting out excess glandular tissue and/or skin. The
procedure typically takes an average of two hours, usually on an outpatient basis,
using general or local anesthesia.
If deposits
of excess fatty tissue, and are causing the enlargement not by excess skin and
glandular tissue, liposuction alone may resolve the problem. Tiny incisions
are made near the nipple, fat is suctioned out through a very narrow canula (tube). In
such cases, scars will be small and barely visible. Results are permanent,
although subsequent obesity can recreate a gynecomastia-like effect.
If the problem
is being caused not just by fatty deposits but by excess glandular mass as well,
the excess tissue is removed through an incision at the lower edge of the areola.
This sometimes causes a crater effect and must be contoured carefully, usually
along with liposuction of the surrounding fat. In rare cases of excess
skin, incisions are made beneath around and beneath the areola as with a female
breast lift or reduction.
There is little
downtime after this procedure and patients typically return to work within one
week, unless the work is extremely strenuous. There will be scarring around
the nipple but it will fade over time. There will be some post-operative bruising,
swelling, and burning sensation. To assist with the healing process, the patient
will wear an elastic pressure garment for 3-6 weeks and must avoid exposing scarred
areas to the sun for at least 6 months.
Some patients
also experience temporary numbness or lack of sensation in the breast area that
can last up to a year. Infrequent complications, associated with many surgical
procedures, include possible infection, skin damage, fluid accumulation, bleeding,
scarring or pigment changes. Post-operative asymmetry, while rare, is possible.
When that occurs, a second procedure may be needed to remove additional tissue
and create better balance.
Post-recovery,
the patient enjoys a firmer, flatter, more contoured chest which fits the standard “male
profile”. Subsequent exercise to tone the breast muscles will produce
even greater improvement.
Interested in seeing past articles?
See our archived Parkland
Life Articles page.
David Levens, MD, PA, FACS has been
practicing cosmetic surgery in Coral Springs since 1989. In addition to his private practice
at 1725 University Drive, Dr. Levens has served as Vice
Chief of Staff and Chief of Surgery at the Coral Springs
Medical Center. He is Certified by the American Board of Plastic Surgery
and is a member of the American Society for Aesthetic Plastic Surgery
and the American Society of Plastic Surgeons. Dr. Levens has
been cited repeatedly in Miami Metro Magazine’s annual lists
of “Best Doctors in South Florida”. He
earned his medical degree at Columbia University, New
York, and served residencies in general surgery and
plastic surgery at Montefiore Hospital & Medical
Center, New York. He
lives in Coral Springs with his wife,
Linda, and their two children, Danielle and Ben. He can be
reached at 954-752-1020 or www.DrLevens.com |
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