Hi, Dr. Gardner again talking about gynecomastia. What is gynecomastia? Gynecomastia literally means female breasts in a male. This is a very troubling problem for a lot of people. In fact, 50 to 60 percent of adolescent males have a little bit or a lot of gynecomastia. 70 to 90 percent of males from the age of 59 to 70 have gynecomastia. So very difficult to wear a tight-fitting shirt, difficult to take the shirt off on the beach if you’ve got breasts that look like a girl.

What are the treatments for gynecomastia? Well, the first thing we do when we see a patient for gynecomastia is make sure they’re not taking any kind of hormone therapy that might be causing the gynecomastia. We make sure that their blood work looks okay. If they do have some hormonal issues, we get them on the right hormones to correct that. But if that doesn’t help the gynecomastia go away, surgery is really the only option.

So what do we do for gynecomastia surgically? In some patients, we’re actually able to treat it with liposuction. We fill the breast tissue up with a fluid that contains a numbing medicine and a medicine that keeps it from bleeding, and it breaks up the fat. Then we just suction out all the excess fat. In a subset of patients, that actually works really well—no scars, and they get better.

However, most patients with gynecomastia have a little bit of what we call a breast bud. Sometimes it’s a little breast bud; sometimes it’s a big breast bud; sometimes the entire breast is filled with breast tissue. That doesn’t really respond very well to liposuction. In those patients, we do go ahead with liposuction, and for my purposes, I actually go in and liposuction under this area of the underarm, where the breast tissue extends out this way so that they don’t have a roll of fat there, and that contours that area. Then I’ll liposuction the chest, get it nice and flat, and then whatever breast tissue is left, I’ll go through that nipple incision right under the nipple, open up the space, take all the breast tissue off of the muscle, remove it so that the only thing that’s left behind is the pectoralis major muscle, the skin with a little bit of fat on it, and it gives them immediate and noticeable improvement in the gynecomastia.

So what is gynecomastia? It’s female-looking breasts in a male. It usually has a component of fat and breast tissue, so both have to be removed to get an effective treatment. In some patients, there’s so little breast tissue, liposuction alone will do the trick. But in most patients, you have to go through a small incision, barely noticeable, and take out the breast tissue as well. Thanks for your time.