Male Breast Reduction Beverly Hills: Gynecomastia Surgery

Gynecomastia, the enlargement of breast tissue in men, is more common than most people realize. Estimates suggest that it affects up to 65 percent of men at some point in their lives, though for most it is a temporary condition during puberty that resolves on its own. For a significant subset, however, it persists into adulthood and creates ongoing discomfort, self-consciousness about shirt fit and swimming, and reluctance to engage in activities where the chest is visible.

Male breast reduction surgery addresses this directly. The procedure removes excess glandular tissue, fat, or both, restoring a chest contour that looks and feels consistent with a masculine body. At our Beverly Hills practice, Dr. Michael Newman performs gynecomastia surgery for patients across a wide spectrum of cases, from those with mild firmness beneath the nipple to those with significant bilateral breast tissue development.

What Causes Gynecomastia?

The chest tissue found in gynecomastia patients is either glandular breast tissue, excess fat, or a combination of both. Understanding the composition of the tissue affects the surgical approach, which is why an accurate assessment at consultation is important.

Common causes and contributing factors include:

• Hormonal imbalance: An imbalance between estrogen and testosterone is the most common cause. This can occur naturally during puberty or with aging-related testosterone decline.
• Medications: A wide range of medications can cause gynecomastia, including certain antidepressants, anti-androgens, chemotherapy agents, calcium channel blockers, and proton pump inhibitors.
• Anabolic steroids: Steroid use is a well-established cause of gynecomastia and is common among patients who have used them for athletic or bodybuilding purposes.
• Cannabis: Regular cannabis use has been linked to gynecomastia in some patients.
• Medical conditions: Liver disease, kidney failure, hyperthyroidism, and testicular tumors can all contribute to gynecomastia through hormonal mechanisms.
• Idiopathic: In many cases, no identifiable cause is found.

Who Is a Good Candidate for Gynecomastia Surgery?

The best candidates for male breast reduction surgery are men who:

• Have stable gynecomastia that has not improved with lifestyle changes, weight loss, or discontinuation of causative medications
• Are at or near their goal weight (significant weight gain after surgery can cause fatty tissue to accumulate in the chest again)
• Are in good overall health with no active medical conditions that would increase surgical risk
• Have realistic expectations about what surgery can achieve
• Non-smokers or those who have stopped smoking at least four weeks before the procedure

Age is not a strict criterion, but for adolescents whose gynecomastia has persisted beyond the typical pubertal resolution period, many surgeons prefer to wait until the patient has reached physical maturity before operating. Dr. Newman will assess each situation individually at consultation.

Surgical Technique: Gland Excision, Liposuction, or Both

The appropriate technique depends on the composition of the chest tissue.

Liposuction alone

When the excess tissue is primarily fatty rather than glandular, liposuction alone can achieve an excellent result. A small cannula is inserted through a tiny incision, and fat is removed using a controlled suction technique. The scarring from liposuction-only gynecomastia surgery is minimal, as the access incisions are typically a few millimeters in length and placed in inconspicuous locations.

Glandular excision

True gynecomastia involves glandular breast tissue that has a firm, rubbery quality beneath the nipple. This tissue cannot be removed by liposuction alone because it is too fibrous to pass through a liposuction cannula. Excision requires a direct incision, typically placed along the lower edge of the areola at the areola-skin junction, where it heals to a nearly invisible line in most patients. The glandular tissue is removed through this incision, and the incision is closed.

Combined liposuction and excision

Most patients with significant gynecomastia have a combination of glandular tissue and fat. Dr. Newman typically addresses this with a combination approach: liposuction to remove the fatty component and create a smooth chest contour, followed by direct excision of the residual glandular tissue through the periareolar incision. This combination provides the most comprehensive result for mixed-composition cases.

Grades of Gynecomastia and What to Expect from Treatment

Gynecomastia is commonly graded by severity, which affects both the surgical approach and the extent of improvement:

• Grade I: Small enlargement with no skin redundancy. Typically well-addressed by liposuction alone or with minimal excision. Excellent results with minimal scarring.
• Grade II: Moderate enlargement without skin redundancy. Combined liposuction and excision typically produces a flat, well-contoured result.
• Grade III: Moderate enlargement with minor skin redundancy. Combined approach with skin tightening. May have some residual laxity depending on skin quality.
• Grade IV: Marked enlargement with significant skin excess and feminization of the chest. More extensive skin excision may be required, resulting in more visible scars in exchange for a flatter result.

Recovery Timeline

Recovery from gynecomastia surgery is generally manageable for most patients.

• Days 1 to 3: Discomfort is well controlled with oral medication. A compression vest is worn continuously during this period.
• Days 4 to 7: Most patients can shower and move around comfortably. Bruising and swelling are present but tolerable. Many patients return to sedentary work within five to seven days.
• Weeks 2 to 3: Significant improvement in how the patient feels. The compression vest is typically worn for three to four weeks. Driving is permitted when the patient is comfortable and off pain medication.
• Weeks 4 to 6: Light exercise may be resumed around week four. Chest exercises and heavy lifting are restricted until approximately six weeks post-surgery.
• 3 to 6 months: Final result is visible as residual swelling completely resolves. Scars continue to mature over 12 months.

Cost of Gynecomastia Surgery in Beverly Hills

Gynecomastia surgery is generally not covered by health insurance unless a medical necessity (such as a hormone-secreting tumor) can be documented. Dr. Newman's office can assist with obtaining a predetermination letter if a medical cause has been confirmed. Financing through CareCredit and Alphaeon Credit is available for patients who prefer installment payment options.