What Type of Gynecomastia Do You Have?
What are the various types of gynecomastia? Which kind do you have? And, most importantly, how will the tissue affect the strategy best suited for your man boob surgery?
New York patients most often come to their consultations with us having some idea about “what’s in there.” They know that unwanted breast growth can be triggered and shaped by a variety of factors including their weight, age, medication and steroid use and many more. What guys don’t know is how the particular tissue they have will impact the surgical technique.
In our decades of working with patients with man boobs in New York, we’ve found three basic types of male breast tissue. They roughly parallel those discussed in an article published several years ago in the Journal of Ultrasound—read that piece if you’re interested in a technical discussion. Here’s what we find in our operating suite.
The Most Common Gynecomastia
The most frequent cases of gynecomastia we treat are those that develop in puberty and continue on into adulthood. Although some teens with moobs are fortunate enough to get surgery early, most guys suffer with enlarged breasts for some years due to lack of information, support or funds to get man boob surgery.
New York patients with the most common form of gynecomastia have solid gland tissue under the nipple/areola complex that thins and spreads out into the rest of the breast. Hence the term “dendritic,” or branch-like, in the technical article. Most of these cases require a combination of liposuction and gland excision for best results. Unfortunately, some guys end up with cosmetic surgeons who perform liposuction only, leaving behind breast gland that causes irregular contours. We perform many revision gynecomastia surgeries annually for guys who have chosen a doctor using the wrong approach.
Discs, Lumps, Nodules
Another kind of gynecomastia is solid, dense tissue that results from steroid or supplement use. Guys with this type feel lumps or disc-shaped nodules under the nipple/areola complex. Usually the breast gland extends into the muscle fascia, making it another strategic challenge for the surgeon.
Appropriate treatment consists of removing the gland, which can leave the crater deformities that are another reason we perform so many revision gynecomastia operations. We have learned to prevent craters by rotating fat flaps into depressions caused by gland removal, but many cosmetic surgeons don’t know to do this. Before surgery is complete, we also undermine and re-drape the skin to lie flat over the new contours.
Layers of Fat and Gland
The third general type of gynecomastia we’ve found usually presents in older men. This kind, called “diffuse” in the article referenced above, consists of layers of fat and breast gland interspersed. We’re not completely sure what causes this kind of composition—it could be pubertal gynecomastia that has persisted for decades, changes in hormone levels or other reasons.
We can often achieve great results with instruments we designed ourselves especially for gynecomastia. The tool we use most frequently is a slim cannula that enables aggressive liposuction. The cannula has a sharp end we can employ if needed for a bit of gland excision as well.
Getting it Right
There are some footnotes to all this. The first is one you have probably figured out: there are overlaps in these groups. No two cases are exactly alike. Another is one you may not know. Although we can make educated guesses about “what’s in there” after treating thousands of cases of man boobs in New York, no plastic surgeon knows exactly what’s under the skin until they take a look. The surgeon should be thoroughly experienced so he or she can do anything needed to achieve the very best possible results during the initial operation, no matter what surprises may be in store.
Getting great results from gynecomastia surgery the first time is important. Although we will—and we do—treat many revision patients each year, a second operation is more challenging chiefly due to scar tissue. Choosing a gynecomastia specialist is critical.
We would be very pleased to be your choice! Call us at 212-570-6080 today.