Gynecomastia Surgery or Liposuction: Which Do I Need?

Excess breast tissue is associated with a feminine appearance and can cause discomfort in men experiencing the condition. Both gynecomastia surgery and liposuction are possible treatments for enlarged male breasts. Which is best for you depends on the underlying cause of the condition and the type of tissue to be removed.

What Causes Enlarged Male Breasts?

Enlarged male breasts may be the result of a medical condition called gynecomastia, or a related but different condition called pseudogynecomastia.

Gynecomastia is the excess development of breast tissue in men. The common condition is the result of hormonal imbalance. It most often occurs during puberty, or later in life as a side-effect of certain medications.

Pseudogynecomastia or ‘false’ gynecomastia may look just like gynecomastia, but involves excess fat, rather than glandular tissue. Stubborn pockets of fat in the breast area may not be responsive to diet and exercise alone. Stretched or sagging breast tissue due to weight loss or aging can also contribute to the appearance of enlarged breasts.

About Gynecomastia

Gynecomastia is a medical condition which leads to the enlargement of one or both male breasts. This condition is typically not treatable with diet and exercise alone, since excess tissue is not fat, but glandular breast tissue.

Gynecomastia is first treated by addressing the underlying health issue, which may be related to genetics, age, excess alcohol consumption, hormonal imbalance or prescribed medications. Surgical excision of the excess tissue is currently the only way to reduce and resculpt the chest.

Gynecomastia Surgery (Male Breast Reduction Surgery)

Surgical correction of gynecomastia involves removing the excess fibrous tissue, something that cannot be done by liposuction alone. Instead, fibrous tissue is removed through a small incision made along the lower curve of the areola. Gynecomastia surgery is also recommended to correct loose or sagging skin in the breast area.  Skin removal typically requires the placement of longer incisions.

While done under anesthesia, the surgery is considered an outpatient procedure. Patients are advised to wear compression garments for around four to six weeks during recovery. At around the 6-week mark most patients are considered fully recovered and cleared to resume strenuous exercise.

About Pseudogynecomastia

Pseudogynecomastia is a result of excess fatty tissue in the chest area. While diet and exercise are typically recommended to reduce body fat, even men who are not overweight may carry stubborn fat in the breast area.

Treatment Options For Pseudogynecomastia

Fatty tissue in the breasts may be removed through liposuction. Tiny incisions are hidden in the armpits or the sides of the chest. A small cannula is then inserted into these incisions to remove the fat cells via suction. Ultrasound or laser assistance are often used to enhance the effectiveness of the procedure.

Recovery typically involves wearing a compression garment to minimize swelling and accelerate contouring. Generally, patients can return to work and other daily activities after one week, and return to exercise after 4 weeks.

Which Treatment Do I Need?

Your surgeon will examine you and counsel you on your treatment options:

• Glandular tissue may feel rubbery or dense. Gynecomastia surgery is necessary to remove this type of tissue.
• Fatty tissue may feel softer, more like fat found elsewhere on the body. This type of tissue is easily removed via liposuction.

If fat deposits are minimal, a non-invasive form of fat reduction such as CoolSculpting or Kybella may be options for more subtle improvements.

A combination of gynecomastia surgery and liposuction is needed when both glandular and fatty tissue are present, or in cases where fatty tissue is the cause of enlargement but there’s also a need for skin removal.

A consultation with a qualified physician will help you identify which is best for you, gynecomastia surgery, liposuction, or both.

A united group of skin care specialists from Westlake Dermatology & Cosmetic Surgery, Austin's leader in Dermatology and Plastic Surgery. Articles posted under WD staff are authored through combined contributions from our entire team, including Plastic Surgeons, Dermatologists, Aestheticians, Physician Assistants, Aesthetic Nurses, and Patient Coordinators.