There’s a question posted in a man boobs forum about why doctors talk about “realistic expectations” when it comes to gynecomastia surgery. The guy who created the post seemed to think that using the term is a way to establish a disclaimer before the procedure. As if the results could easily be sub par and the surgeon wants to fend off complaints before they happen.
We won’t speak for other board certified plastic surgeons, but this is far from the case in our practice in New York. Gynecomastia has been a specialty—even a sort of calling for us—for more than thirty years. If we agree to work with a man or adolescent with moobs, it’s because we are confident we can improve his appearance tremendously.
Here are the three leading reasons we use the term “realistic expectations” with our New York gynecomastia patients.
1) Bodies aren’t perfect. Most guys who seek our help with man boobs aren’t the underwear and cologne models on the billboards in Times Square. Some carry a few extra pounds. A few have a rib cage shape that’s slightly outside average proportions, whether it’s a bit barrel shaped or a bit concave. Many, whether they realize it or not, have breasts that are somewhat asymmetrical. We work to even things out when we perform surgery, but we also tell patients, “Your breasts are brothers, but not identical twins.”
All these factors contribute to the results of male breast reduction surgery. That said, we know we can deliver results that are “much better” than the way our patients looked prior to surgery. (Browse some of our before and after gynecomastia surgery photos and you’ll see.) If a guy has an objective view of his appearance before and after surgery, he will be satisfied.
2) Healing is unpredictable. After three decades of working with New York gynecomastia patients, we can usually make educated guesses about how each guy’s healing process will unfold. But we certainly can’t guarantee what the body will do after the trauma of surgery. There will be bruising and swelling to be sure, but how much, where and when are uncertain. Scar tissue will form under the skin, and again, we can’t be certain about the details.
We review the possibilities with patients during their consultation, and make sure each guy knows what can happen and what he can do to help his body heal. We also encourage post-surgical patients to call us with any concerns, and be sure to keep every post-op appointment so we can monitor progress closely.
3) Some guys have a touch of obsession. Many patients wait a long time before finally committing to man boob surgery. After years of trying to tape, bind, camouflage and wish their enlarged breasts away, and looking in the mirror several times a day, it can be a challenge to relax about the appearance.
Worse, societal trends seem to be leading to extreme perfectionism in some people. A team of British researchers noticed the phenomenon and studied it recently; we wrote some observations about perfectionism and gynecomastia patients upon reading their report. You can find the blog post here.
It’s certainly understandable that guys with man boobs suffer some preoccupation with their chest. The condition is embarrassing in the extreme for many. We do our best in our New York gynecomastia consultation room to talk through each guy’s mindset, and if we are concerned that a patient may not be satisfied no matter what, we may suggest counseling and/or decline to operate.
Of course the right way to ensure optimal results is for patients to choose a gynecomastia specialist. This means a board certified plastic surgeon with many dozens or even hundreds of man boob patients annually—not just a few. It also means proof of good results, through photos and first hand accounts from satisfied patients. It can mean media appearances, publications and other evidence that the doctor is a leader in treating moobs.
If you’re considering man boob surgery, we would welcome you to our practice. Yes, we’ll discuss your expectations and ensure they are realistic, and we’ll be honest and open about what we can do for you. As our plastic surgeon says, “I can’t guarantee the results of surgery—but I can guarantee I will do my very best.”
Give us a call at 561-367-9101 if you’d like to find out more.

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