Information on Gynecomastia Surgery
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Gynecomastia is defined by the National Institutes of Health (NIH) as the development of abnormally large breasts in males. This is not to be confused with simple fat deposition that occurs in the chest of obese people. Men that have gynecomastia develop abnormal quantities of breast tissue. Despite this clear definition, what qualifies as gynecomastia differs among medical practitioners. There is no consensus as to what degree of breast tissue in males is clinically relevant. In some boys and men, even a small degree of breast tissue can result in significant emotional trauma, especially during puberty and adolescence, when gynecomastia begins to develop. Other men live their entire lives with gynecomastia with no apparent problems.

 If one includes the presence of any palpable or visible breast tissue in men, then gynecomastia is extremely common. In some estimates, approximately 40% of healthy men have gynecomastia and as many as two thirds of men above the age of 60 have some degree of breast tissue formation. Given the prevalence of gynecomastia it is perhaps not surprising that breast reduction surgery is one of the most commonly performed cosmetic surgery procedures in men.

Gynecomastia surgery is performed through either liposuction, surgical resection (cutting and removal), or a combination of these procedures. The goal of gynecomastia surgery is to remove glandular breast tissue and fat and contour the pectoral region to provide a more masculine appearing chest. Perhaps counter intuitively, men sometimes choose to have pectoral implants placed at the same time as breast reduction surgery. In truth, pectoral implants are much higher on the chest than where gynecomastia breast tissue forms. While men with gynecomastia have loose and sometime pendulous breast tissue, pectoral implants provide broad, flat areas that appear like pectoral muscles.

Before gynecomastia reduction, it is important to have a medical work-up; not simply to prepare for the cosmetic surgery itself, but to rule out the more serious causes of gynecomastia. Often certain medications like steroids or drugs that are similar to estrogen in chemical structure cause gynecomastia. These drugs may be easy identified in patients who developed gynecomastia later in life, after starting a new medication. The most serious cause of gynecomastia is when it results from a hormone secreting tumor. While this is a rare cause of gynecomastia, a hormone secreting cancer should be considered in cases where other signs of cancer are present or if the male breast tissue is exceptionally fast growing. It is not uncommon for men with testicular cancer to develop gynecomastia, either from the surgical removal of the testicles or from the hormonal therapy given as treatment.

Despite being very psychologically troubling for boys and men, gynecomastia reduction surgery is not usually covered by health insurance. It is considered a cosmetic procedure and, as such, must be paid for out of pocket. Recent surveys by the American Society for Aesthetic Plastic Surgery estimate the average gynecomastia surgery cost to be about $3,400 for the surgeon fees alone. The cost for anesthesiologist and facility fees for gynecomastia surgery may be an additional $1,500.