Can Gynecomastia Come Back After Surgery?

Gynecomastia, the over-development of the male breast, can be a major source of self-esteem issues for many men. While gynecomastia can occur in a range of severity, from a minor enlargement to a chest that looks more like female breasts, even moderately severe cases can affect one’s self esteem and quality of life.

It is estimated that nearly 60% of all males worldwide develop some degree of gynecomastia at some point in their lifespan. For most men, gynecomastia resolves without intervention post-puberty. For others, the over developed tissue persists requiring treatment.

Gynecomastia surgery, or male breast reduction, is the most effective way to treat gynecomastia. One of the most common questions perspective patients ask is “can gynecomastia come back after the surgery?” While the results produced by gynecomastia are permanent, there are specific issues that could cause unwanted regrowth of breast tissue.

Gynecomastia Surgery Does Offer Permanent Results

Gynecomastia surgery is considered a permanent solution as the procedure involves the surgical excision (removal) of the enlarged breast tissue that results in a more feminine appearing chest.

The procedure begins with the surgeon making small incisions in the armpit or around the nipple. The surgeon then removes targeted excess breast tissue. Depending on the needs of the patient liposuction can also be utilized to remove excess fat and further sculpt the breast.

Once the glandular tissue and excess fat is completely removed it is unable to regrow. This will enable most men to enjoy their new, more masculine appearing chest for many years.

Statistics: Gynecomastia Recurrence After Surgery

According to research featured in the Aesthetic Plastic Surgery Journal in 2017, a mere 12.5% of individuals who underwent glandular gynecomastia tissue removal encountered a recurrence beyond a decade after the procedure. As such, its estimated that 90% of patients who undergo male breast reduction will still be gynecomastia-free 10 years post-surgery.

Gynecomastia Can Recur Post-Procedure

While rare, the recurrence of gynecomastia following surgery is possible. Though the surgically removed tissue will not grow back, there is a chance of new excess tissue developing if you do not follow proper post-surgery care.

Regrowth is possible due to two factors:

1. The procedure does not remove all glandular tissue (as doing so would make the chest appear unnatural)
2. The patient has an untreated underlying medical condition that causes tissue growth
3. The patient undertakes lifestyle choices that spur tissue growth

Common Factors That Lead To Gynecomastia Recurrence

Unfavorable lifestyle habits such as an inadequate diet or insufficient physical activity can play a role in the reappearance of enlarged breast tissue. Furthermore, the use of specific medications or involvement in drug consumption post-surgery can contribute to the resurgence of chest area growth.

Drug Usage

The use of various drugs, both legal and illegal, has been shown to boost oestrogen which is the hormone that is primarily associated with male breast tissue growth. Marijuana use is the most common drug associated with gynecomastia development, especially in men aged 18-35. Additionally, steroids, opioids, and alcohol are also substances that are known to cause gynecomastia recurrence post-surgery.

Prescription Medication

Some legally prescribed drugs have been known to simulate male breast growth. These include medicines used to treat epilepsy or ulcers, heart medicines, chemotherapy, antiandrogen drugs, and antianxiety and antidepressant medicines.

Underlying Medical Conditions

Gynecomastia recurrence could also be due to the continued occurrence of an unresolved medical condition like liver or lung cancer, cirrhosis of the liver, or an overactive thyroid. The presence of cancer in the adrenal glands, testicles, or pituitary gland can also cause male breast growth.

Pseudogynecomastia

Once the fat cells are eliminated through gynecomastia surgery, they are permanently gone. However, substantial weight gain can lead to the expansion of the remaining fat cells, potentially causing enlargement. This addition of chest fat is often called Pseudogynecomastia as the chest takes on a more feminine appearance like gynecomastia but the underlying cause is excess fat (not enlarged breast tissue).

Following surgery, patients should focus on maintaining a healthy post-procedure weight to minimize any weight gain. This includes regularly exercising the chest once gynecomastia surgery recovery is fully complete. Liposuction is the most effective treatment option for patients who develop pseudogynecomastia following their gynecomastia surgery.

Dr. Cameron Erickson is a native Texan and board certified plastic surgeon practicing in the Southwest Parkway and Dripping Springs locations. Dr. Erickson specializes in aesthetic procedures including rhinoplasty, brow lifts, eyelid surgery, lip lifts, facelifts, breast augmentation and lifts, breast reduction, body contouring and liposuction, abdominoplasty (Tummy Tuck), brachioplasty (Arm Lift), 360° liposuction with fat transfer to the buttocks, vaginal rejuvenation, and hormone replacement therapy. In addition, he has had additional training in non-surgical treatments including injectables (Botox/fillers), lasers, and skin resurfacing treatments.