MALE BREAST REDUCTION
Male breast reduction surgery is becoming an increasingly standard procedure and one of the most requested in male plastic surgery. Many men experience abnormal enlargement of the breast area, known as gynecomastia, which can cause understandable physical and psychological discomfort, and it can affect one or both breasts.
It is essential to consider this condition in relation to your age. In adolescence, gynecomastia is usually temporary and often resolves on its own.
In adulthood, it is more commonly associated with the aging process and can be linked to underlying health conditions, certain medications, or alcohol use. There are also cases with a clear genetic predisposition.
On the other hand, pseudogynecomastia, or false gynecomastia, occurs when excess fatty tissue in the male chest creates an enlarged chest appearance. This condition is more common in men who are overweight or obese and tends to worsen with age.
“Surgery allows for masculinization of the chest by removing excess glandular tissue and fat. In certain cases, the procedure may also involve removing excess skin, resulting in a flatter, tighter, and more defined chest.”
Given the variety of clinical situations, there are several techniques available to correct gynecomastia and achieve a more masculine chest.
UNDERSTANDING THE PROCEDURE
The approach I use depends on the size of the breast before surgery and on the assessment carried out during the consultation. My professional experience, supported by research on anthropometric measurements, allows me to determine the most appropriate surgical plan for you. I always request a preoperative ultrasound evaluation to identify whether the excess volume is primarily due to glandular tissue, fat, or a combination of both.
In younger patients with a significant fatty component, I prefer to perform liposuction.
When the glandular tissue is more prominent, which can sometimes be accompanied by discomfort or milk secretion, liposuction alone is not enough. In these cases, I combine it with a gland excision to partially or completely remove the glandular tissue.
“I carefully assess the most appropriate surgical incision based on various factors to achieve the best possible aesthetic result. When the glandular tissue is minimal, I typically perform a periareolar incision (around the areola). If a greater amount of glandular tissue or skin laxity is present, I may opt for a combined periareolar and inframammary incision, known as the buttonhole pattern or inverted-T technique.”
FOR A MORE CONSCIOUS CHOICE
The ideal candidate for gynecomastia surgery is a healthy male of any age, often an adolescent, who experiences emotional distress due to abnormal breast enlargement. In some cases, this condition is also accompanied by pain or a feeling of tightness around the areolas and nipples. Occasionally, the increase in breast volume may be linked to hormonal imbalances involving the testicles, liver, or thyroid, or may result from certain medications, such as anabolic steroids, antineoplastic drugs, calcium channel blockers, or psychiatric medications. In other cases, no specific cause can be identified.
If your chest causes embarrassment or discomfort in social situations, leads you to avoid going shirtless, or affects the way you dress, it may be time to consider a solution. Sometimes the issue is simply excess fat, and a subtle contouring procedure can enhance not only the appearance of the breasts but also the overall chest shape. In other cases, the presence of excess glandular tissue, combined with breast sagging and skin laxity, can create such marked discomfort that discussing it with loved ones or even with a specialized surgeon feels very difficult. We will help you understand exactly what you can do to improve your relationship with your body and restore a masculine chest. Dr. Elisa Bolletta’s surgical philosophy is to make each procedure as efficient and natural-looking as possible, maximizing the transformative impact this surgery has on her patients.
Being in excellent physical and mental health is essential for a successful procedure. Smokers must stop several weeks before surgery, as nicotine can impair blood flow and healing. Maintaining a stable body weight both before and after the operation is also crucial to ensure the full and lasting benefits of the surgery, especially when combined with liposuction. We also recommend carefully planning the timing of your surgery to fit your lifestyle and daily activities. Most patients can return to office work in about 2 weeks, but if you lead a more active lifestyle, we advise avoiding any strenuous activity for roughly 1 month after the procedure.
After surgery, it is important to give your body time to heal. The treated area may be swollen, bruised, and sometimes sensitive. You will need to wear a compressive dressing and a shaping chest garment for 40 days following the procedure. We generally recommend taking 1-2 weeks off work and 3-4 weeks away from light physical activity. Heavy lifting and exercises that engage the chest and upper body should be avoided for up to 6 weeks. Scars from the procedure gradually become less noticeable as they mature. Their final appearance, however, depends on your skin type and age. Younger patients and those with darker skin tones may develop slightly more visible scars.
On the day of your surgery, you will be welcomed to the operating room and prepared by our medical team. After your pre-operative evaluation and surgical markings with Dr. Elisa Bolletta, you will be administered either local anesthesia with sedation or general anesthesia. We will then proceed with the technique best suited to your type of gynecomastia, whether it involves liposuction, removal of excess glandular tissue, or a combination of both. You will be supported and guided at every step of your journey, from the pre-operative phase through recovery.
The length of the procedure depends on its complexity. A simple liposuction usually takes about 60 to 90 minutes, while cases that require glandular removal or skin correction can last up to two to three hours.
Thanks to anesthesia, you will not feel any pain during the procedure. In the hours and days following surgery, it is normal to experience mild pain or chest tightness, which can be easily managed with prescribed pain medication. Swelling, bruising, and sensitivity are also common and will gradually subside over the following days.
Most patients can return to light daily activities within 2-3 days. For sports or more intense exercise, it is best to wait at least 3-4 weeks. Over the following weeks, the chest will continue to take shape as swelling and bruising gradually subside.
Wearing the compressive garment provided after surgery is essential for reducing swelling and shaping the treated area. You should avoid strenuous activity, heavy lifting, and sports until you have fully recovered. You will also be instructed to keep the area clean and dry and watch for any signs of infection or bleeding.
The main risks include infection, hematoma, asymmetry, noticeable scarring, or changes in sensation in the treated area. With thorough pre-operative evaluation and precise surgical technique, these risks are rare.
Every chest is unique, and the final result depends on factors such as age, skin quality, and the distribution of fat and glandular tissue. Maintaining realistic expectations and carefully following post-operative instructions are key to achieving a natural, long-lasting outcome.
We will schedule follow-up appointments at regular intervals, during the first few days, after 1-2 weeks, and then at 1,3, and 6 months, as well as 1 year after the procedure to monitor healing, track scar formation, and evaluate the end result.
The team includes plastic surgeon Dr. Elisa Bolletta, a qualified anesthesiologist, and nursing staff specialized in aesthetic surgery. They all collaborate to ensure your safety, comfort, and a calm, positive experience throughout your entire journey.
