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Gynecomastia is a benign enlargement of breast tissue in males. It is a common condition that affects approximately one third of the male population. Adolescent boys are affected even more frequently with an incidence as high as 64%. The cause of gynecomastia can be related to numerous factors, but is unidentifiable in the majority of cases. There may be an imbalance in the ratio of the estrogen and androgen hormones. This type of imbalance is usually a temporary condition in adolescence, meaning gynecomastia that occurs during puberty may resolve within a year.

A primary care physician should evaluate the new onset of gynecomastia. Medical and drug related causes can be investigated and treated if possible. However, gynecomastia that has been present for a year or longer will seldom resolve despite appropriate treatment of the underlying cause.

Surgical treatment is indicated when gynecomastia is bothersome to a patient and has been present for a year or more. The goal is to improve body image by restoring a masculine appearance to the body contour. Liposuction or ultrasound assisted liposuction are the primary surgical techniques used for treatment. Occasionally, a small amount of breast tissue located directly behind the nipple may not respond to liposuction and requires a direct surgical excision. This can usually be accomplished through a small semi-circular incision around the border of the areola.

A few patients who are older of have lost weight may demonstrate a significant decrease in skin elasticity. Patients such as these may benefit from a removal of the extra skin that remains after liposuction. It is often best to wait for at least six months after the liposuction before making a decision to remove excess skin. This waiting period allows for maximum skin retraction, or tightening, and may minimize the amount of skin that actually needs to be removed.

Patients are usually extremely pleased with the results of treatment for gynecomastia. Many who were embarrassed to remove a shirt for sports or swimming activities find that they are comfortable doing so after treatment. Recovery time is seldom longer than four weeks. Patients find this short convalescence to be well worth the long-term benefits.