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Company logo: Elliot W. Jacobs, MD, FACS - Diplomate, American Board Of Plastic Surgery

Specializing in Primary &
Revision Gynecomastia Surgery

815 Park Avenue New York, NY 10021

Gynecomastia Surgery: A Little Mystery is Good

New York gynecomastia

We love the guys we work with! It’s a joy to serve men and boys with gynecomastia in New York and help them on the road to a new life. We’ve heard their worries too. What’s “in there?” Is it really breast gland? How bad is my case of man boobs? Living with a prominent body feature that’s considered feminine is no picnic.

Having met thousands of patients with moobs, many who are nothing short of obsessed with their condition, we understand why some guys might feel they need a precise surgical plan for male breast reduction. With all that anxiety on board, who wouldn’t want to know just what’s going to happen?

Still, we tell most of our New York gynecomastia patients that a little mystery is actually a good thing. Here’s why.

What’s “In There”

One of the first things a prospective gynecomastia surgery patient needs to understand is that even the most skilled and experienced plastic surgeon can’t know the exact makeup of enlarged breasts prior to surgery. Fat can feel hard and lumpy, and breast tissue can be soft.

This is why we don’t often forecast exactly how a procedure will go. We will know what to do when we can see beneath the skin, meaning how much fat and gland to remove, where to target our instruments and whether additional techniques are needed. If it requires extra work and takes longer to get the result we’re aiming for than we first thought, so be it.

This is also why we designed our own instruments years ago. We use our patented cannulas with special tips that allow us to perform liposuction and gland excision at the same time, minimizing trauma to the area and avoiding additional scars when possible.

Possible Surgical Scenarios

Of course we give our New York gynecomastia patients an idea about what to expect the surgery may entail—we don’t leave them completely in the dark!

In cases of mild to moderate gynecomastia, we first make a tiny nick at the side of the chest. After anesthetic and medication are introduced in saline solution, we then use our instruments to remove a thin layer of fat and breast tissue as needed, allowing the skin to re-drape smoothly over chest muscles and reveal masculine contours. For some patients, that’s all that’s required! But if there’s a bit of excess fat at the sides of the chest, we can use those same incisions to suction it away. The tiny scars fade and become nearly invisible.

If a hard lump of breast gland exists under the nipple/areola, we may need to make an additional incision around the edge to remove it. We take great care to leave enough tissue to avoid cratering. If there’s any doubt about whether there’s enough support for the nipple/areola, we may position small fat flaps to reinforce the area.

When we work with bodybuilders with puffy nipples there’s often no fat to banish at all. These guys need incisions at the edge of the areolas and direct breast tissue excision. We DO use small nicks at the side of the chest for our cannulas, but with the suction turned off. We use the instruments instead to gently loosen the skin so it re-drapes properly.

On the other hand, guys who are overweight or have lost weight may need skin removal as well as liposuction and gland excision. In these cases, we talk through the options with patients, discussing skin quality, one- or two-stage procedures and so on.

Skill and Agility

Given all these possibilities and more, it’s hard to understand why some cosmetic surgeons tell patients up front that liposuction alone will do the job, or that only gland removal is needed. Some even offer different prices for different approaches.

Let us reiterate: with rare exceptions, it’s impossible to know exactly what needs to be done until the physician can see under the skin. The plastic surgeon and team need to be skilled and agile enough to handle just about anything they find.

Some guys know this—like this member of gynecomastia.org who posted the next logical follow-on thought:

…when it comes to gynecomastia, your surgeon’s experience level is EVERYTHING!

He also commented that he knew he could have had surgery cheaper, but wouldn’t trust just any cosmetic surgeon with his chest.

When we post on gynecomastia.org, we encourage guys to spend a great deal of time researching plastic surgeons to make sure they have a good measure of specialization in gynecomastia surgery. They should also be open to traveling for the right expertise—and we don’t mean to a cut-rate clinic continents away.

That would be the kind of mystery to avoid.

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