Gynecomastia Surgery

Before And After Photos


This is a 56 year old man who is 5’6″ and 170 pounds who presented to me with a history of gynecomastia since puberty. He recently lost twenty pounds. He told me he didn’t know that you could do anything about gynecomastia. He has several medical conditions including hypertension and sleep apnea.

On examination I could appreciate that he has lax skin and a fair amount of dense tissue on both sides. We specifically discussed his risk of collapse of the skin after removal of the tissue because of the quality of his skin, his age, and his weight loss history. He understood the fact that he is likely to have some irregularities, but he wanted all the tissue removed and preferred not to have scars across his chest after skin removal.

He is seen here after gynecomastia surgery with tissue removal through an incision at the bottom of the areola and liposuction. He has a small indent on either side of his nipple-areola complex.

Lessons to learn:

  1. It’s never too late to have treatment for gynecomastia. As long as you are able to tolerate surgery and some anesthesia, all things are a go. We make sure your safety is not put at risk.
  2. Older patients, and those with a significant history of weight loss generally have lax skin. This raises the issue of “What to do?”. Do you leave tissue behind to keep things full? Do you excise skin and tissue and leave scars across the chest? Do you do the full removal of the tissue at the risk of some lax skin and contour irregularities? This is best answered in consultation with an experienced gynecomastia surgeon who listens to his patients. There is no “right or wrong” per se. Whatever makes you happy is what’s best for you. I will give you my opinion. Most patients would prefer to have all the breast tissue removed and a slight irregularity (especially at his age).
  3. His only regret is not having done this a long, long time ago.
  4. If you have gynecomastia, and you suffer from it on a regular basis, have it treated.
  5. For me, the decision on whether or not to remove skin is pretty straight forward. I can tell on examination if this is something that I would recommend. If it needs to be done it has to be done and the scars are worth it. Otherwise the loose, hanging skin can be very bothersome. It’s always possible to simply remove skin as a secondary procedure if there is any doubt about the expected result.
  6. The body is simply not the same as we get older. There is not a day in my practice when I have to modify my procedures based on the skin changes that accompany the aging process. It is what it is.