Restore a masculine chest contour with surgical correction.
Gynecomastia surgery flattens and reshapes the male chest by removing gland, fat, or both. In severe cases of gynecomastia, the weight of excess breast tissue may cause the breasts to sag and stretch the areola. In these cases, the position and size of the areola can be surgically improved and excess skin reduced.
InquireGynecomastia correction is tailored to the grade of tissue enlargement. In Grade I and II cases, power-assisted liposuction (PAL) is first used to reduce the fatty component and pre-treat the fibrous glandular tissue. A periareolar incision along the inferior areolar border then allows direct excision of the firm subareolar glandular disc, which does not respond to liposuction alone. In Grade III and IV cases with significant skin redundancy, a skin-tightening approach using periareolar or concentric circle excision patterns is incorporated. The areola is reduced and repositioned as needed. A compression vest is applied immediately postoperatively.
Gynecomastia surgery is a good fit for men whose chest fullness has not improved after reversible causes have been addressed. Candidates present with persistent unilateral or bilateral breast enlargement due to true glandular hypertrophy, fatty hypertrophy, or a combination of both. Stable weight, good skin elasticity (for cases not requiring skin excision), non-smoking status, and clear expectations about chest contour improvement and scar placement are essential criteria.
A compression vest is worn continuously for three to four weeks after surgery to reduce swelling and support the new chest contour. Most patients get back to desk work within seven to ten days. Exercise involving chest movement, pushing, pulling, and lifting, is restricted for four weeks. Contact sports require six weeks of clearance. Final chest contour becomes apparent as swelling fully resolves over three to six months.
Compression vest worn continuously. Drain managed if placed. Chest soreness and swelling expected.
Return to desk work and light daily activities. Significant swelling diminishes. Compression vest continues daytime use.
Lower body exercise permitted. Chest activity restrictions begin to ease. Areolar scar fading.
Full activity resumed. Chest contour final result apparent as all swelling resolves.
Gynecomastia surgery risks include contour irregularities from uneven resection, seroma formation (particularly after aggressive liposuction), hematoma, and changes in nipple-areolar sensation. Asymmetry may persist and occasionally requires revisional surgery. Under-resection is preferable to over-resection, which can result in a saucer deformity. Skin redundancy in severe cases may necessitate additional skin excision procedures.
For pseudogynecomastia - chest fullness caused entirely by adipose tissue without true glandular hypertrophy - liposuction alone may achieve excellent results with minimal scarring. Hormonal evaluation and endocrinology consultation are recommended before surgery to rule out correctable causes. In patients on medications known to cause gynecomastia, discontinuation and watchful waiting may lead to partial resolution.
Performed by Dr. Ruben Castro in Newport Beach, California