Question: My husband is a 43-year-old man who exercises regularly but is still very self conscious about his appearance because he has breasts. (if you call them that on a man?) He won’t even go to the pool in the summer because he’s uncomfortable being shirtless in public. No matter how much he works out, he’s unable to lose the fat or tighten the skin in this area. Is there a surgery that could help him?
Answer: Your husband’s problem is not uncommon and definitely makes a man very uncomfortable in many situations. He has a condition called gynecomastia (male breasts). True gynecomastia is caused by abnormally enlarged breast tissue whereas pseudo-gynecomastia is the result of an excessive amount of fatty tissue in the male breast area. The most common deformity is a combination of both, where there is a larger than normal amount of breast (fibrous) tissue in the chest, along with an abnormal amount of fatty tissue. True gynecomastia can be a normal finding in a healthy male, but there are some medical conditions that can cause pathologic (disease related) gynecomastia. There are also a number of medications which can cause the development of male breasts. Men are also susceptible to breast cancer and this must be evaluated. If your husband has the type of gynecomastia that is not related to disease or medications, then he would be a good candidate for surgery. Surgery is performed on an outpatient basis and requires an anesthetic. The excess fatty tissue is removed around the chest area with liposuction, and then the breast tissue is removed surgically through an incision just under the nipple. This keeps scarring to a minimum. When the breasts are extremely large, the skin may not shrink completely after the chest area is flattened with surgery. In that case, additional surgery may be required. I believe that this surgery gives excellent results and certainly improves the patient’s self esteem and self image. I would recommend that you make a consultation with an experienced board-certified plastic surgeon who can evaluate your husband and discuss his options and the risks and complications associated with the procedures.