Gynecomastia Surgery

Before And After Photos

This is a 13 year old boy who presented to me with his Dad for evaluation of unilateral fullness in his breast. It developed during puberty over a year earlier and has not gone away. He was told by his pediatrician that it may take 1-3 years for this to resolve. It was causing significant psychological stress on this young man at a critical time in his development and his father was aware of this. He did research on the internet and learned that some people recommend treatment for gynecomastia with surgery sooner than later.

On exam, he had one sided gynecomastia that was firm and rubbery. The young man clearly was having a difficult time coping with this because he was quite active in school and was often in situations where the other boys were taking off their shirts and he didn’t feel comfortable in this situation.

I removed well localized breast tissue under local anesthesia in my office operating room while listening to his favorite music. These pictures were taken at five months after surgery. The only commend made by his dad was to question the small fold or crease just beneath the breast on the treated side.

Learning points:

  1. Unilateral gynecomastia can be seen in up to ten percent of patients. It is not different than when it presents on both sides.
  2. If it is large like it is in his case, rubbery and hasn’t changed in a years’ time and the patient is suffering from it I would suggest it is time to consider the option of treatment.
  3. The slight depression below his nipple areola complex on the treated side is simply from the removal of a firm mass and now less tissue is there and the shape is slightly different. This is no big deal – both Dad and patient agree. It could be “improved” if they wanted by injecting some fat into that area but they were not interested.
  4. When I was speaking with his Dad in my exam room on the day of these post-operative photographs it was quite obvious that the patient was very comfortable without his shirt on. In fact, I could see him staring at himself in the mirror! Quite a big change from before surgery when he didn’t want to be without his shirt, and certainly didn’t want to admire himself in the mirror! This SAYS IT ALL TO ME.
  5. Gynecomastia can cause significant psychological damage and treatment should be considered if it hasn’t gone away/improved after a years’ time after it develops at the time of puberty.
  6. Personally, I feel that I have served this patient and his Dad well, and that his son will be a much better adjusted individual in the future for having done this.