It is so rare for gynecomastia to come back that we advise guys who fret about this before man boob surgery not to be concerned. We have almost never seen a recurrence. That being said, it’s not completely unheard of.
It’s important to understand that no surgeon with decent experience with gynecomastia removes every scrap of breast gland. That would leave an unsightly mess of craters and valleys. Every guy should have a bit of gland and a smooth, even layer of fat to create those masculine contours. That’s why it’s not 100% impossible to have man boobs come back. Still, after thirty plus years of performing man boob surgery, the worries we hear are most often related to one of these issues:
Not too many guys confuse swelling with breast growth, but it happens occasionally. Because swelling is rather unpredictable and can occur suddenly—usually after activity—or on just one side, it can cause patients to be concerned about what’s going on.
We remind our man boob patients that swelling peaks days and even weeks post-op, not right away. And we advise them to get plenty of rest, wear their compression garment and not engage in physical activity too soon. If swelling is excessive, or if a seroma is present, we can drain fluid as needed.
Subcutaneous scar tissue is probably the most common condition mistaken for breast gland growth. Scarring is the natural way the body re-knits structures together. Scars tend to form weeks after gynecomastia surgery—hence the panic about moobs recurring—and they can feel disc-like or lumpy.
We evaluate subcutaneous scars as patients return to us for post-op appointments. If knobby tissue can be felt but not seen, if surface contours look smooth, we encourage guys not to worry about it. Scarring is unavoidable and appearance is what’s most important! If the tissue is bothersome, we can administer steroid injections to reduce it.
Usually gynecomastia surgery inspires patients to get in better shape and look after their overall health, but some patients do put on weight over time. It is not unusual for breasts to enlarge with weight gain as men tend to pack on the pounds around their midsection and chest.
Since effective primary gynecomastia surgery removes fat cells as well as gland tissue, most often male breasts will not grow out of proportion with the rest of the body with weight gain. Of course, the best course of action is for patients to get plenty of exercise, eat a healthy diet and maintain their weight as the years pass.
Most of the patients who experience re-growth are guys we counsel on line, making it doubly challenging to pinpoint what’s going on. We suspect that in many cases, an inexperienced cosmetic surgeon has left too much breast gland behind.
With a fair amount of gland tissue present, other factors can come into play. A guy may be prescribed medication that triggers growth, such as Finasteride for thinning hair. Certain cancer drugs can act on breast gland tissue, as well as other drugs. Steroids and even plants with estrogenic properties, such as marijuana, can be factors. Heavy alcohol use can play a role. Certain diseases such as kidney failure can contribute.
Then there’s the ever-frustrating “idiopathic” breast growth, meaning no one can pinpoint the exact cause. When we advise men on gynecomastia.org, we usually tell them to return to their primary surgeon for an examination and discussion. We often suggest they don’t rule out a trip to their primary care physician too, as a thorough health check may be a good idea. The doctor can then determine whether a referral to an endocrinologist is in order or any other steps.
If we can be of help to you, whether you’ve had gynecomastia surgery or not, please send us an email.
Dr. Elliot William Jacobs is a board-certified aesthetic plastic surgeon who specializes in FTM top surgery, gynecomastia surgery, revision gynecomastia surgery and male breast reduction. He is a native of New York and has over 40 years of experience in his field. Dr. Jacobs is a highly respected and sought-after surgeon who is known for his skill, experience, and compassion. Whether you are interested in gynecomastia for the first time, or are looking to correct a gynecomastia you aren’t happy with, Dr. Jacobs can deliver amazing results.
DR. ELLIOT JACOBS M.D., F.A.C.S., F.I.C.S
Reach out to Dr. Jacobs today to schedule your consultation!