frequently asked questions

Below you will find the most Frequently Asked Questions, or FAQ, in the field of Gynecomastia. Should you have additional questions or concerns, please sign-up in our forum.

It is usually a consequence of a hormonal imbalance between androgens, with resulting increase in the amount of breast glandular tissue. In about 25% of the cases, no underlying cause for gynecomastia is found. In the other cases, the condition can be a sign of liver or renal disease, endocrinologic problems, or excessive drinking. Gynecomastia is also a side effect for several medications, including anabolic androgenic steroids, or AAS, or due to more common drugs such as cimetidine or omeprazole. For more information, please click here
Many cases of Gynecomastia do not require treatment, as the condition improves spontaneously. In persistent cases, however, treatment is determined on an individual basis. Treatment can be medical and/or surgical, depending on your specific issues and goals.
In general, treatment is indicated if the Gynecomastia causes you pain in your breasts or psychological distress. Other medical conditions must be ruled out to verify the correct diagnosis of Gynecomastia, then a personal treatment plan can be set up.
Gynecomastia can be a sign of other medical conditions, and the underlying condition must be diagnosed and treated first. Gynecomastia may regress once the offending disease is controlled, or it may persist. The presence of pain in the breasts after treatment of the underlying condition could indicate medical treatment is necessary for Gynecomastia, for instance. So, if you experience pain in your breasts, please contact your physician for advice and treatment first. The medical treatment may be sufficient for your case.
Once Gynecomastia has been diagnosed, and the medical treatment failed or not indicated in your case, surgery becomes a cosmetic consideration. Surgery is intended to remove Gynecomastia tissue and reshaping of the breast close to its previous size, form, and shape. You need to ask your surgeon about the treatment options, benefits, risks and complications for your specific case.
On the average, pubertal Gynecomastia tends to resolve itself within three years of onset, but it may take longer to regress in some cases. Therefore, it is prudent to wait until puberty is over before considering surgery, as a general rule. You should discuss your individual case with your surgeon.
In most instances, Gynecomastia surgery can be done under local tumescent anesthesia with or without oral sedation. Patients may drive after the procedure as long as no sedation took place. Intramuscular sedation may be used, as well as deep intravenous sedation, but it’s rarely needed if the surgeon uses local tumescent anesthesia. General anesthesia may also be used for some cases. Ask your consulting surgeons about your best options.
Ask to see photographs or testimonials of his/her work. Gynecomastia surgery is an artistic surgery in many ways; artistic talent cannot be taught, cannot be placed on a certificate on the walls, and cannot be copied. It’s important you trust your surgeon, see the final results of his/her work, and feel comfortable with the treatment plan offered. You may consult more than one surgeon, for a second or third opinion.
The medical treatment for Gynecomastia should be covered by your health insurance. The surgical treatment is considered elective or cosmetic, and it is not usually covered by most insurances. Your pre-operative laboratory testing, oral antibiotics and analgesics should be covered by your insurance. We recommend you check with your health insurance company directly regarding your plan coverage prior to scheduling your surgery.
The costs will encompass the surgeon, the anesthesia, and the facility fees. The total cost averages $5,000-8,000 USD. Other costs to consider, include: the cost of oral medications such as antibiotics and analgesics; preoperative lab work and mammogram; the cost of a compression garment; revision surgery, if needed. Ask your provider about all of these costs. These are general numbers, and the values do vary demographically.
The most common complications include hematomas, seromas, sub-optimal tissue excision, superficial skin infections, scarring, and asymmetry. Hematomas and seromas are usually drained under local anesthesia in-office, and additional drainage procedures may be required. Sub-optimal tissue excision may require additional revision surgery to correct asymmetries, shape, and contour. Infections are treated with antibiotics, or abscess drainage. Scarring may occur as a result of individual scarring tendencies, or as a result of the surgery itself. As in any surgical procedure, minor to fatal complications are possible. You need to discuss your individual condition with your surgeon.
You may have a circumareolar incision on your areola, or a criss-cross nipple incision, or a infra-mammary fold incision; a 2-incision technique, on the areola and laterally to your breast, also known as pull-through technique; or a single port incision technique (SPOT technique) in the axilla in order to remove the tissue, less visible then most. In more extensive cases, a complete mastectomy may be needed, with nipple-areolar grafting procedures, and a more complex surgery is indicated. You need to discuss your individual condition with your surgeon.
As a rule, Gynecomastia surgery is not considered to be a major surgical procedure, and therefore the downtime is not long. It varies with the extent of your condition, and with the type of surgery needed. In most instances, you may return to work in 1-7 days, or longer, depending on your occupation. Exercise and weight-lifting is usually avoided in the first few weeks after surgery. You need to discuss your individual expectations with your surgeon.
It depends on the type of procedure performed, and on your surgeons preference. Drains are not a bad thing in surgery.
It is almost always outpatient, you go home 1-2 hours after your surgery. You need to discuss your individual condition with your surgeon.
It varies from person to person, and depending on the duration of the usage of the offending factor. It is generally accepted that a certain degree of irreversible tissue changes do occur after one year from the onset of the drug use, and stopping the offender will likely not cause spontaneous resolution of the condition.
If your breast enlargement is due to weight gain only, yes. Being overweight or obese is a contributing factor to developing breasts or "man boobs". This is called Pseudogynecomastia: pseudo means false. Weight loss will eliminate pseudogynecomastia, but if have true gynecomastia it will not work, and yuo will need surgical excision of the gynecomastia tissue.
It is the reduction in the volume of the male breast. It can be done with liposuction, surgical removal of breast tissue, or a combination of both. Please click here for more information (link to the page Gynecomastia Surgery).
It depends on the extent of you. Typically, no weight lifting and no upper body exercise for at least two weeks after surgery is the norm.
There is usually minimal scarring where the incisions were made. There might be some contour irregularity and scarring in cases with redundant skin. If liposuction is performed, there will be some typical liposuction post-surgical tissue changes that usually resolve completely over time. You need to discuss the surgical incisions location with your surgeon, as every case has its particularities and individual healing varies.
Typically, right after surgery. However, postoperative changes do occur as a normal healing process and the final results are usually seen in weeks or months, depending on the extent of your procedure.
gynecomastia faq

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