While it is surprising for many men to learn there is a medical term used for enlarged male breasts (gynecomastia), they are even more surprised when they find out there are actually different types, which have different treatments. Most men just know they have enlarged breasts and they want it gone. Those who have done research about gynecomastia often conclude their excess chest volume needs to be removed through liposuction only. The is because so many plastic surgeons address most types of gynecomastia this way. Fully understanding gynecomastia is the first step in understanding why liposuction alone may not be the best solution in every case.
There are typically three primary reasons causing the enlarged male breasts. There can be just one issue present or a combination of any listed below.
- Excess Fat
- Excess Breast Tissue
- Excess Skin
Joseph T Cruise, MD has created a classification system for determining which type of gynecomastia a patient suffers from. This system allows him to determine which treatment is necessary to achieve the best results. While there are up to 7 different stages of severity, there are really 4 main types that are most commonly seen.
Puffy – Quite common and often seen on slender fit patients. This is caused by excessbreast tissue underneath the nipple and areola, which causes them to protrude and look puffy. Treatment: Removal of breast tissue.
Classic – Most common type of gynecomastia. Consists of primarily excess breast tissue,
however often there is some excess fatty tissue. Treatment: Removal of breast tissue and possibly some fatty tissue.
Fatty – Consists mostly of fatty tissue, but frequently has some component of excess breast tissue as well. Treatment: Weight loss recommended, however if unsuccessful, surgical removal of fatty tissue and possibly some breast tissue.
Saggy – Significant excess skin causing the areola and nipple to drop downward. Typically seen in patients who have experienced major weight loss. There are varying degrees of saggy gynecomastia. Treatment: Removal of excess skin to raise the position of the areola. In many cases, liposuction and/or breast tissue removal by be necessary as well.
The most common question asked by patients who have done their research on gynecomastia is:
“ Will liposuction alone work or do I need to have breast tissue removed?”
Joseph T Cruise, MD frequently sees patients who have had prior male breast reduction surgery, which resulted in an unsatisfactory result. In almost every case liposuction alone was performed, when what was truly needed was both liposuction and breast tissue removal. For example, when liposuction alone is performed on patients who have fatty gynecomastia, there is typically a component of excess breast tissue that remains. By not removing it, the chest takes on a puffy nipple appearance after surgery.
When it comes to classic and fatty gynecomastia Joseph T Cruise, MD finds that in the vast majority both are necessary. While this is evaluated during the physical examination, there are often times where this cannot be determined until the surgery actually takes place. The amount of fatty tissue in relation to breast tissue will vary from patient to patient, therefore each case must be treated on an individual basis rather than a one size fits all.