It’s not just women who struggle with body confidence. If you’ve been dealing with enlarged breast tissue as a male, it’s likely that you’ve thought about male breast reduction. However, you may not know when it’s a good time to get the procedure done. Our experts at Metairie Plastic Surgeons in Metairie, LA, just 10 minutes from New Orleans, can help you determine if this surgery is right for you.
When Should You Consider Male Breast Reduction?
Since breast reduction surgery is a major surgical procedure, you want to be sure you have carefully considered all options available to you for treatment. If, however, you have lived with enlarged breast tissue as a result of puberty, weight gain, or use of marijuana or anabolic steroids, you may be ready to take the next step toward removing the excess breast tissue, especially since gynecomastia, the medical name for this condition, can be tough to live with.
There is no single answer for when you should consider male breast reduction, but if you are self-conscious about your breasts and your doctor has already ruled out breast cancer, you should know that there’s a way to get you the smoother chest you want so that you can regain confidence in your body and put your past embarrassment behind you. Surgery for enlarged male breasts is a major decision, but it could also be a life-changing one.
Causes of Gynecomastia
Gynecomastia is essentially the result of a hormonal imbalance in your body. There are several causes of this hormonal imbalance, which causes testosterone levels to be lower than estrogen levels, which are responsible for the development of breasts. Gynecomastia can occur at any age, and is in fact, a normal part of puberty when hormone levels fluctuate significantly. Some causes other than puberty include the following.
- Testicular injury or disease
- Thyroid disorders
- Cancer of the lung, pituitary gland, or adrenal glands
- Drugs such as anabolic steroids, heroin, and marijuana
- Kidney failure
- Liver disease
Additionally, there are several medications that have the side effect of breast enlargement in men. If you are taking any of these medications or drugs, you may not need surgery, since your condition can likely resolve itself if you switch or discontinue the offending substance.
In men, anti-androgens are prescribed to treat prostate cancer and an enlarged prostate. Anti-androgens work by blocking the production of testosterone, which allows the hormone levels in men to become imbalanced, with higher levels of estrogen than testosterone. The condition of enlarged breasts usually subsides once this medication is discontinued.
Steroids cause fat cells to be converted into estrogen. While the reduction of fat cells is what someone who is using steroids wants, it also has the side effect of causing a hormonal imbalance in the body because the fat cells that are converted to estrogen mean there is more estrogen than testosterone in the body. Once you develop this condition due to steroid use, it may not go away on its own and could require surgery.
Although what causes some HIV-positive men to develop enlarged breasts is not well understood, it is suspected that hypogonadism, a common comorbidity with HIV, causes a reduction in testosterone production, thereby leading to an imbalance between testosterone and estrogen in the body. There is also some evidence that the antiretroviral therapy that HIV-positive patients undergo could be responsible for hypogonadism.
Altered dopamine neurotransmission, which is caused by some anti-anxiety medications such as diazepam (Valium), can cause enlarged breast tissue in men. The condition can usually be resolved by changing medications to one that does not contain sertraline.
Beta-blockers and calcium channel blockers, which are often prescribed to treat heart conditions and high blood pressure, can lead to the development of gynecomastia. The condition resolves itself once these medications are removed. If these medications cannot be removed, surgery may be a solution.
Ulcer Drugs and Stomach-Emptying Medicines
Other medications like over-the-counter ulcer drugs (Tagamet) and some stomach-emptying medicines like Reglan can lead to gynecomastia. However, when removing these drugs, the condition usually resolves itself.
Initially, you may discover that you have a firm but tender mound of tissue that is centrally located under one or more of your nipples. While you’ll want to have this lump examined, breast cancer is usually harder than developing breast tissue and is typically accompanied by enlarged lymph nodes and discharge from the nipples. It is important that you have a medical examination to rule out cancer or other medical issues. Gynecomastia itself does not present any health danger.
When you visit a physician’s office to have your lump or lumps examined, you’ll be given several tests to rule out other conditions and confirm a gynecomastia diagnosis. These tests may include one or more of the following.
- MRI scan
- CT scan
- Testicular ultrasound
- Blood test
- Urine test
You’ll also be asked if you have been taking any medications or drugs, and if you’ve had any kidney or liver problems, or mumps. Be sure to disclose all medications and drugs you’ve taken, both legal and illegal, since there are so many that can have gynecomastia as a side effect. Sometimes, enlarged breasts can be resolved simply by changing or discontinuing the medications or drugs you’re taking.
In some cases, as with age, steroid use, and obesity, the problem of enlarged breasts in males may not go away with time. This is when surgery becomes an option. There are two main surgical procedures that can flatten your chest. This is where our expertise comes in. We will determine which procedure is the best for your needs and carefully sculpt your chest to have a more masculine appearance that is proportional to the rest of your body.
The two procedures used to reduce breast tissue are liposuction and mastectomy. With liposuction, we’ll remove excess fat from the breasts and ensure that your chest is symmetrical and flat. With a mastectomy, we will surgically remove your breast gland tissue to create a flat, masculine chest. We carefully place our incisions to minimize the appearance of scars after your surgery. We will be able to determine which procedure is right for you at your initial examination.
Although you can’t completely eliminate the risks of gynecomastia because your body naturally produces less testosterone as you age, which can cause an imbalance between it and estrogen, you can take some precautions to minimize your overall risk. Refrain from using drugs like heroin, marijuana, androgens, anabolic steroids, and amphetamines, as these are known causes of enlarged breast tissue in men. Additionally, if you do drink alcohol, do so in moderation, as the phytoestrogens in alcohol inhibit testosterone production.
Stay at a healthy weight, since obesity is known to lower testosterone production, which then leads to a hormonal imbalance with more estrogen in the body than testosterone. Talk to your physician if you think you may be taking a medication such as those listed above that might be contributing to your gynecomastia. If you are taking one of these medications, ask if there are alternatives that do not have this side effect.
The ideal candidate for male breast reduction surgery is a male whose gynecomastia cannot be treated through the removal of certain medications or through more conservative methods. You should be healthy overall, with no medical conditions that will interfere with healing, and they should not be a smoker or drug user. Additionally, your weight should be normal and your breast development should be stable, meaning that growth has ceased. We will also explore your mental state as well.
Although you may be bothered by your enlarged breasts, you should also be optimistic that the surgery will improve your physical appearance without having unrealistic expectations. Factors such as being overweight and having poor skin (thin or with minimal elasticity) can affect your ultimate results. These factors will be discussed at your consultation to ensure you understand how they may limit your progress. You should have also seen a doctor who’s ruled out underlying conditions like cancer or liver disease.
Complete All Household Tasks
As with all major surgeries, there are some things you need to do to prepare for breast reduction surgery. You want to make sure you take care of all important household tasks before surgery since you will not be able to perform them immediately following the procedure. Clean your house, go grocery shopping, wash your car, and whatever else you’ll want to be done when you’re recovering.
Secure Child Care
If necessary, make sure you have arranged for your children to be taken care of during your recovery. You won’t be able to lift anything heavy for a while, so young children need to be in the care of someone who can. You should also rest as much as possible, so providing alternate activities for your kids is also a good idea.
Prepare a Recovery Area
You’ll want to have an area that is dedicated to your recovery, whether it’s in your bed or on your couch. It should be easily accessible to anyone who is taking care of you and convenient for you to reach everything you need (water, medication, snacks, books, phone, etc.). Include pillows for cushion and support, along with a blanket to keep you warm.
Get Someone To Stay With You
You will be required to have someone drive you home after your surgery and to stay with you for the first 48 hours to ensure there are no complications. Arrange for this person ahead of time so that you aren’t stressing over it when you’re trying to recover.
Other preparations you’ll be asked to make are the following.
- Quit smoking at least three weeks before your surgery
- Refrain from using NSAIDs, aspirin, and ibuprofen in the 10 days prior to surgery
- Discontinue use of vitamin C and E supplements, and any other homeopathic or herbal treatments at least 15 days prior to surgery
- Do not consume alcohol the day before surgery
- Do not wear piercings, jewelry, contacts, or other accessories to your surgical appointment
- Do not eat or drink anything in the eight hours leading up to surgery
- Wear comfortable clothing, including a shirt that opens in the front and loose pants on the day of your surgery
- If you have diabetes, your condition will be assessed on the day of your surgery.
There’s no reason for you to continue to be embarrassed about the way you look. With male breast reduction surgery, you can eliminate the self-consciousness you feel when going shirtless. Contact us at Metairie Plastic Surgeons in Metairie, LA to schedule your initial consultation today. You’ll be glad you did.