Gynecomastia (Male Breast Reduction)

Welcome to Los Angeles County’s most comprehensive resource for gynecomastia / male breast reduction surgery. Dr. Cruise, a board certified plastic surgeon and top gynecomastia specialist, believes patient education is a priority. With this in mind, Dr. Cruise has filled this site with highly relevant information, which is easy to understand, along with a comprehensive library of pictures.

Below you will find a list of some of the important topics that will be discussed throughout this site. As stated above, you will also be able to review the many gynecomastia before and after pictures of Dr. Cruise’s patients.

  • What type of gynecomastia surgery is best?
    Is liposuction alone an option or will I need to have breast tissue removed?
  • Compression garments.
    Suggested options for optimal results throughout the healing process.

The purpose of the site is to give you all the information you need to make an educated decision about whether or not to pursue gynecomastia surgery. We believe you will find the animation section of how Dr. Cruise routinely does his surgery very interesting, along with the explanation of the gynecomastia classification system. We hope you find the content, videos, and pictures useful during your research process.

Overview of Gynecomastia Surgery

Gynecomastia is the medical term used for enlarged male breasts. The ideal male breasts are muscular and well defined, which signifies strength and masculinity. In some cases, the male breast becomes fatty and can even sag. This results in an unhealthy, out of shape, more feminine appearance. When this happens many men become quite self-conscious and may even withdraw from certain physical or social activities.

The causes of this problem can be anything from hormonal changes, medications, or even genetic predisposition. It is actually not uncommon for healthy teenage boys, beginning around 14 years of age, to have this problem through puberty. It is almost always a result of hormones and goes away in a couple of years.

Before

After

Often, the cause of gynecomastia is never identified. Certain diseases and medications can be the cause but these need to be looked into by your family doctor. The medical causes range from deficiency of testosterone to excess of estrogen. Being overweight can cause too much estrogen and, therefore, it is highly recommended to lose weight.

There are many medications which are known to be a direct cause of gynecomastia. Here is a list to review: Estrogens, digitalis, clomiphene, ketoconazole, metronidazole, cisplatin, spironolactone, cimetidine, isoniazid, methyldopa, tricyclic antidepressants, valium, heroin, and marijuana. Liver problems can also cause the male breast to change. While medications and liver issues are two common causes, there are many other reasons, and only a medical evaluation can determine what could be contributing to your situation.

The great news is that gynecomastia can be effectively treated through modern advances in plastic surgery. You no longer have to live in shame or embarrassment. The surgical options for gynecomastia depend on what is causing the problem. The three components of gynecomastia are 1) excess fat, 2) excess breast tissue, and 3) excess skin.

Before

After

Excess Fat
This is found in almost every gynecomastia patient. It is centered around the nipple/areola, but frequently covers the entire chest. This is typically removed with liposuction alone, if the cause is simply excess fat. In most cases, the skin tightens back up resulting in a great result.

Excess Fat and Breast Tissue

You may be surprised to know that all men have breast tissue. It is the same type of breast tissue that women have, but in much smaller amounts. With gynecomastia, the breast tissue tends to over “grow” and is typically located right under the nipple/areola. If a man squeezes the tissue directly below his nipple, it could feel like a squishy, football shaped lump.

Before

After

Often times with gynecomastia this tissue mass will dramatically enlarge. In these cases, liposuction alone will rarely remove this tissue. It will usually need to be cut out. The incision is typically located just below the areola where it is very well hidden and will ultimately fade to a point where it isn’t visible.

31 year old man who had liposuction and breast tissue removal.

Excess Fat, Breast Tissue and Skin

When the fat and breast tissue are surgically removed, the skin usually will retract or shrink back resulting in a nice flat appearance. There are times when a man has poor skin quality and too much excess skin will still remain after surgery. In these cases, the skin will need to be removed to obtain the desired result.

Before

After

The excess skin is obvious. Other patients who may need skin removal are those with poor skin that does not have the elastic properties to shrink back. These are usually older patients or those with significant stretch marks. Dr. Cruise typically is able to remove skin by making an incision only around the areola. This incision is well hidden because it is masked by the interface between the skin and the areola.

26 year old with severe gynecomastia treated with liposuction, breast tissue removal, and skin excision.