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Blog. Real Patient Question: Surgery and/or Liposuction for Gynecomastia?

We fielded a question on the other day about surgical technique. The prospective patient was apparently confused by the input he received from a cosmetic surgeon in consultation. The patient related that the doctor had said his gland tissue seemed softer than most and that it was possible the patient might need liposuction only, but not certain.
We understand the patient’s discomfort. When preparing for any kind of surgery, people want to know exactly what the plan is. Hearing terms like “may” and “be prepared for” might pose a challenge to a patient’s confidence level. Nevertheless, we agreed with the guy’s surgeon that the final determination of gynecomastia surgical technique should be made in the operating suite. Here’s the way we explain it to our patients.

Our Gynecomastia Surgery Technique

Enlarged male breasts contain a combination of gland and fat. The ratio is different for every man and so is the density of the tissue. Very experienced gynecomastia surgeons can make an educated guess as to “what’s in there,” but it’s impossible to know for sure until male breast reduction surgery is underway.
Many years ago, we developed both a staged approach to gynecomastia surgery and special instruments for the task. Our surgical tools allow us to remove both fat and gland aggressively yet gently. That’s the first stage of surgery for most guys. If we are able to remove sufficient tissue and resculpt the chest adequately in this first stage, we stop there and the patient is left with a tiny liposuction-like nick on each side of the chest.
If there’s any doubt about whether we’ve removed enough tissue, or if dense tissue remains (usually in the center of the breast), we proceed to stage two. Through a very small incision at the edge of the areola we carefully excise the remaining breast gland and ensure the skin will re-drape smoothly. This is how we achieve natural, masculine contours for our gynecomastia patients without causing unwanted hills and valleys beneath the surface. These additional incisions heal well and leave nearly invisible scars.

What this Means to You

Perhaps it’s starting to become clear why we strongly encourage guys with man boobs to seek out the most experienced gynecomastia surgeon available. Here are a few key takeaways from our years of treating man boobs:
• Some cosmetic surgeons aren’t very experienced with the wide range of ways gynecomastia can manifest in patients. Many of these doctors offer liposuction only.
• In three decades of perfecting our male breast reduction technique, we have found that only about 10% of our patients are appropriate for liposuction-only surgery. Exceptions tend to be older guys, whose breast tissue can be softer than typical. For men who are roughly 45 years old and above, about 20-25% need just our stage one treatment for good results.
• Liposuction-only patients constitute a big group of our revision gynecomastia patients. They are guys who suffer crater deformities, lumps and bumps and otherwise unsatisfying results.
We know it can provoke a bit of anxiety to head into gynecomastia surgery not knowing exactly what your doctor will find. Did we mention the importance of choosing a highly-qualified plastic surgeon with vast experience?! This is exactly why. You want to know that whatever may be “in there,” your doctor will know exactly what to do and have the tools to do it right.
No matter where you may live, why not consult us? We can work with you electronically to begin, and should you decide to have surgery for gynecomastia in the Miami area with us, we can make your fly-in experience a good one. Send us an email and let’s talk.


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.


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