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.

Answer: It is possible for breast tissue to grow back after surgery for gynecomastia.

Gynecomastia occurs in men from an accumulation or overgrowth of glandular breast tissue and/or fat. When the excess tissue is glandular, it usually has developed because of stimulation from endogenous (internal) or exogenous (external) hormone exposure, or from hormone mimicking prescription or illicit drugs, i.e. marijuana. The treatment of gynecomastia includes identifying and discontinuing any causative agents and then surgery only if there is no spontaneous resolution. If the stimulus remains after surgery, the glandular overgrowth and associated symptoms may recur. This is due to the fact that a small amount of the glandular tissue is usually left behind on the undersurface of the nipple areolar complex (NAC). This tissue is attached to and continuous with the skin of the NAC. If it is thinned excessively during surgery then the circulation of the NAC may be compromised, resulting in necrosis and possible loss of part or all of the NAC. Also, and more commonly, the consequence may be contraction and or adhesions from scarring that may distort the appearance of the NAC.

When the excess breast tissue in gynecomastia is in part or completely fatty in nature, the risk of recurrence is less than with glandular tissue. In this case the standard treatment is with liposuction, and recurrence risk would be more or less the same as with liposuction in any other area of the body. Re-accumulation of fatty tissue may occur with subsequent weight gain after liposuction. Areas previously treated with liposuction, however are usually more resistant to this re-accumulation than other untreated areas of the body.

Answer: Gynecomastia can be caused by either excess fat, excess glandular breast tissue, or a combination of the two. The excess fat is typically removed by liposuction. Excess glandular tissue may be able to be removed by liposuction, especially if ultrasound generating devices are utilized. Very often however, the dense fibrous glandular tissue can only be effectively removed by direct excision alone. Fat removed from the breast by liposuction for treatment of gynecomastia will not return, as long as your weight remains stable. If you gain weight after your procedure, fat may reaccumulate in the breasts as it will in other areas of the body. Typically however, areas of the body previously treated with liposuction, particularly with ultrasound assisted liposuction, tend to be somewhat resistant to reaccumulation of fat compared with untreated areas.

It is possible for excess glandular tissue to recur after excision for gynecomastia. Sometimes all or nearly all of the glandular tissue is removed. Not infrequently however, it is necessary to leave a small amount of glandular tissue behind on the undersurface of the nipple areola complex in order to avoid complications that may develop from over-aggressive thinning of the tissues. When this is required, there is usually adequate correction of the cosmetic deformity and no more glandular tissue remains than is normally present. Recurrent growth of the small amount of glandular tissue may occur if some type of stimulus remains or is re-introduced after surgery. Various forms of endogenous and exogenous steroids as well as prescription and non-prescription drugs are known to cause gynecomastia. If identified, these stimulants must be discontinued and time allowed for regression, before considering surgery.

Answer: Gynecomastia can be caused by either excess fat, excess glandular breast tissue, or a combination of the two. The excess fat is typically removed by liposuction. Excess glandular tissue may be able to be removed by liposuction, especially if ultrasound generating devices are utilized. Very often however, the dense fibrous glandular tissue can only be effectively removed by direct excision alone. Fat removed from the breast by liposuction for treatment of gynecomastia will not return, as long as your weight remains stable. If you gain weight after your procedure, fat may re-accumulate in the breasts as it will in other areas of the body. Typically however, areas of the body previously treated with liposuction, particularly with ultrasound assisted liposuction, tend to be somewhat resistant to re-accumulation of fat compared with untreated areas.

It is possible for excess glandular tissue to recur after excision for gynecomastia. Sometimes all or nearly all of the glandular tissue is removed. Not infrequently however, it is necessary to leave a small amount of glandular tissue behind on the undersurface of the nipple areola complex in order to avoid complications that may develop from over-aggressive thinning of the tissues. When this is required, there is usually adequate correction of the cosmetic deformity and no more glandular tissue remains than is normally present. Recurrent growth of the small amount of glandular tissue may occur if some type of stimulus remains or is re-introduced after surgery. Various forms of endogenous and exogenous steroids as well as prescription and non-prescription drugs are known to cause gynecomastia. If identified, these stimulants must be discontinued and time allowed for regression, before considering surgery.