Can I get my gynecomastia removed with liposuction or is surgery required?

Answer: Enlargement of the male breast in gynecomastia may be caused by overgrowth of either glandular tissue or of fatty tissue or by a combination of the two. The glandular tissue tends to be very dense, fibrous and firm and is usually located in the central breast just beneath the areola. Glandular tissue is often tender to touch. Prominent fatty tissue is usually more widely dispersed throughout the breast. It can be somewhat fibrous in gynecomastia but is generally much less dense and firm than glandular tissue. When gynecomastia is due primarily to excess fatty tissue, it may well be able to be removed with liposuction, especially when additional advanced techniques utilizing energy sources such as ultrasound, laser or mechanical power are employed.

When overgrowth of glandular tissue significantly contributes to gynecomastia then direct surgical excision through an incision at the lower edge of the areola is usually required. This may or may not be combined with liposuction, depending on whether or not excessive fatty tissue is also present. The other variable determining the most appropriate treatment plan for gynecomastia is whether or not excess skin is also present and if so, the amount and quality of that skin. When there is a slight or moderate amount of skin excess and skin elasticity is good, the skin should retract well and result in an acceptable contour after liposuction alone. When there is a large amount of excess skin, and/or thin skin with poor elasticity, then excess skin must be excised by combining the glandular and fatty tissue excision or liposuction with a breast lift type procedure which will result in the desired contour improvement but more scars.