Male Breast Reduction New York City

Choosing Male Breast Reduction

Enlarged breasts in males (technically known as “gynecomastia”) is a condition that many men find psychologically painful. Having enlarged breasts can make men the target of teasing. It can also make them self-conscious about removing their shirts, so they are reluctant to participate in sports or romantic relationships. Gynecomastia surgery reduces the breast size and flattens the chest, which creates a more masculine contour of the upper body.

Am I a Good Candidate for Male Breast Reduction?

You are a good candidate for male breast reduction if you have gynecomastia and are unhappy with the size of your breasts. You must also be in good health, live in New York City (or be willing to travel), and be motivated to follow Dr. Cangello’s pre-operative and post-operative instructions. This includes wearing a compression garment for several weeks after surgery.

There are many causes of gynecomastia, including an imbalance of hormones and medication side-effects. For this reason, it is essential that you are honest with Dr. Cangello about your use of alcohol, medication, supplements and illicit drugs (including performance enhancers such as anabolic steroids). Identifying the cause of your gynecomastia will allow Dr. Cangello to determine the safest way to reach your aesthetic goals.

Good candidates must also have realistic expectations for the surgery. Dr. Cangello will explain the results that you can expect from your male breast reduction surgery and how to best achieve your desired look. In most cases, candidates are at least 18-years-old.

Your weight should be stable and you should be within 10 to 15 pounds of your ideal weight. If you were to lose more weight than this following your surgery, it may have a negative effect on the aesthetics of your result.


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The Consultation: Creating Your Plastic Surgery Plan

Your male breast reduction surgery begins with a consultation with Dr. David Cangello in our New York City office. Dr. Cangello will discuss your medical history and the results that you want from your male breast reduction surgery. For your surgery to proceed safely, you need to be honest about your allergies, medications, personal habits, and previous surgical procedures. Dr. Cangello will need to understand the cause of your gynecomastia before he can proceed with surgery. This means that you may need to be referred to see an endocrinologist to see if there is any hormonal cause for your breast enlargement.

Dr. Cangello will conduct a physical examination. He will be looking at the size and shape of your breast tissue, the placement of your nipples, the size of your areolas, and the quality of your skin. After the exam, Dr. Cangello will recommend a surgical plan to create a more masculine appearing breast for you.

Gynecomastia Severity Grading:

Type I: A localized protrusion (excess) of tissue that is concentrated around the area of the areola only. This is the least severe form of gynecomastia.

Type II: Moderate breast enlargement exceeding areola boundaries with edges that are indistinct from the chest.

Type III: Moderate breast enlargement exceeding areola boundaries with edges that are distinct from the chest with skin redundancy (excess) present.

Type IV: Marked breast enlargement with skin redundancy, nipple ptosis and feminization of the breast

Depending on the severity of your gynecomastia one of a series of surgical options may be used to reduce the size of the breasts. In some cases, liposuction of the breasts alone may be sufficient to achieve an aesthetically pleasing masculine appearance to the breasts. When only liposuction is used, usually one small (2mm incision) is made in the fold of each breast so the resultant scarring from the procedure is virtually non-existent. In other instances of slightly more severe gynecomastia excision of the glandular tissue of the breasts in addition to liposuction of the fatty part of the breast tissue is necessary to achieve a flat male breast contour. When excision of glandular tissue is necessary, an additional incision at the lower border of the areola and breast skin is made. This scar usually hides very nicely and is barely visible. In more severe gynecomastia cases, the fatty and glandular tissue of the breast will be removed, skin will also have to be excised and the nipple repositioned to a higher place on the chest wall. This results in more extensive scarring, however it is the only way to address the skin redundancy. Incisions are placed in areas where the scar will be the least conspicuous, and with meticulous surgical technique the minimization of scar visibility is optimized.

Dr. Cangello and his staff will answer your questions and explain how to prepare for your surgery, as well as what you can expect in your post-operative care.

Preparing For Male Breast Reduction

Dr. Cangello is committed to achieving the best results possible. During your initial consultation, he will create a pre-operative plan for you to follow. This plan is designed for your unique needs, to make sure that you have the best outcome possible. Your pre-op plan may include changes in diet and other habits that impact your health. You will be advised to avoid ANY nicotine-containing products for at least two to four weeks before and after surgery.

It is also very important that you avoid any medications (prescribed, over the counter, or alternative) that may cause thinning of the blood for two weeks prior to your planned procedure. The most common medicines that do this are those containing ibuprofen (i.e. Advil, Aleve, Motrin, etc.) or aspirin. You should be prepared to share a list of any medicines you are taking with Dr. Cangello and his staff. They will advise you which medicines are safe to continue before surgery and which medicines should be stopped.

Dr. Cangello will ask that you see your primary medical doctor (if you don’t have one we can refer you to one) to obtain medical clearance for your surgery. Assuming you are in generally good health, the clearance will include a history and physical performed by the doctor, some routine blood work, and an electrocardiogram (EKG).

Dr. Cangello and his staff will also give you instructions for the days before your surgery. These may include shaving certain areas of the body, washing with a particular type of soap, or starting certain medications that may help prevent infection or help with bruising, etc. You will also be told not to eat beginning at midnight on the day of your surgery.

Finally, Dr. Cangello’s staff will explain your post-operative plan. They will give you prescriptions to fill prior to surgery and ask you to find someone to drive you home following surgery.

Where Will the Surgery Be Performed?

Your breast reduction surgery will be performed at Dr. Cangello’s New York City office. He has a fully accredited (AAASF) state-of-the-art operating room on-site. You are encouraged to ask for a tour of the operating facility when you come in for your consultation.

Types of Anesthesia

Male breast reduction surgery generally takes one to three hours. It may be performed using general anesthesia or local anesthetic with IV sedation. In either case, you will not feel any pain or remember the surgery.

Male Breast Reduction Surgery Techniques

If liposuction is used, Dr. Cangello will begin by making a tiny incision in the skin crease at the bottom of your breast. Next, he will insert a canula – which is a small, hollow tube – through the incision. Once the canula is in place, a fluid consisting of saline, lidocaine and epinephrine is injected to eliminate pain and minimize bleeding during the procedure. It also helps to loosen the fat and make it easier to remove. Dr. Cangello will then suction out the fluid and fat. The incision will be closed with tiny sutures.

If breast glandular tissue is removed, the surgery will begin with an incision similar to the one described above. The fat will then be suctioned in the same way as previously described. Following suction of the fatty tissue of the breast, an incision is made around the areola (at the lower border only). The excess glandular tissue is then excised. The incision sites are closed with sutures, dressings and a compression garment are placed. Although the scars are permanent, they are hidden around the areola and will fade over time to the point where they are minimally if at all visible.

The Recovery Process

You will wake up with a surgical dressing over your incisions and possibly drains under each arm (if skin has been excised). You will also be wearing a compression garment that will reduce swelling during the healing process. Your chest may feel tender, swollen or bruised following the surgery. Dr. Cangello will prescribe pain medication to keep you comfortable.

If you have drains, they are usually removed within a few days. If you have sutures that have to be removed this will be done in seven to ten days after your surgery. You should be able to return to work within a few days, as long as your job does not require heavy lifting. You will have to continue wearing a compression garment for the first month following surgery. You can resume full activity after six weeks.

Please call our New York City office at 212-644-4416 to set up a consultation and learn how you can benefit from male breast reduction surgery.

FAQ’s

  • Will a male breast reduction leave visible scaring?

    The degree of gynecomastia will determine the amount of scarring that occurs as a result of gynecomastia surgery. Men with Grade I gynecomastia who have very little excess skin will have either a small, 2mm scar below the breast in the crease (which ends up being essentially invisible) or at the most, that scar plus a scar that goes half way around the bottom portion of the areola. Some men can obtain a sufficient correction of their gynecomastia with liposuction alone. If this is the case, the only scar will be in the breast crease. If glandular breast tissue needs to be excised then the periareolar scar is necessary as well. Both scars wind up being very inconspicuous. Patients with Grade III gynecomastia who have severe breast skin excess and some Grade II patients who have a moderate amount of skin excess will need additional scars placed on the chest and breasts. The amount of scarring that you will incur will be determined by Dr. Cangello at your consultation.
  • If my areolas are too big. Can that be fixed in this surgery?

    Areolar size can be corrected during gynecomastia surgery. If the areolas are too large their size can be reduced. You will have a scar that encircles the areola to achieve areolar reduction. In the rare event a patient wanted their areolas enlarged; this can be accomplished as well.
  • Instead of surgery, can I just do more chest workouts?

    Men with true gynecomastia will not be able to improve this condition with more chest work outs. The reason for this is that gynecomastia is caused by excess glandular and fatty tissue and in some cases excess breast skin. Hence development of the pectoralis muscles (which is what chest work outs do) will have no effect on any of the components that are responsible for the gynecomastia.
  • Will the breast tissue grow back after the surgery? / How long will the results last?

    Excessive weight gain can cause recurrence of gynecomastia. In addition certain medications or substances that are known to cause gynecomastia can cause recurrence if they are ingested or used after gynecomastia surgery. Otherwise, the results are essentially permanent.
  • Am I more prone to develop gynecomastia if I’m over weight?

    If you are overweight you are more prone to developing what is referred to as pseudogynecomastia. True gynecomastia involves excessive breast glandular tissue development. However, people who are overweight usually have breast development secondary to the growth of breast fat and depending on the severity, skin stretching.
  • What should I expect immediately after surgery?

    Immediately after surgery you can expect minor discomfort. It is usually not a very painful procedure. Some patients experience soreness for a few days. One can usually return to work (without active physical labor) on Monday if they have surgery on a Thursday. You will awaken from surgery with a chest compression garment that you will have to wear for a few weeks.
  • How long before I could exercise or swim after male breast reduction?

    Surgeons tend to differ slightly on their recommendations as to when patients can resume swimming after surgery depending on how conservative they are. Physiologically, wounds are completely healed by 4- 6 weeks after surgery and never before that time period. Therefore, to minimize risk of infection or any other issues I usually recommend patients wait 4 weeks to go swimming. If a patient has liposuction only and has only the small 2 mm incision in the breast fold the patient may be able to swim after about 2 weeks.
  • Where can I see some before and after examples?

    Before and after pictures can be viewed, Click here. More photos can be viewed in Dr. Cangello’s office at consultation.
  • Why does choosing a Board Certified Plastic Surgeon matter?

    It is extremely important that you chose a plastic surgeon who is a Diplomate of the American Board of Plastic Surgery (only) for your gynecomastia (male breast reduction) surgery.

    A surgeon who is certified by the American Board of Plastic surgery has to undergo rigorous training in the field of both cosmetic and reconstructive plastic surgery. In addition they have to pass very difficult oral and written examinations to verify their proficiency in the field. Unlike surgeons who undergo cosmetic training alone, plastic surgeons also have extensive experience with reconstruction of the entire body. So they are the most qualified to deal with any untoward event that may occur as a result of having male breast reduction (gynecomastia) surgery. They are also the most qualified to have in depth understanding of the anatomy involved when performing the procedure.

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