Firm, white, glandular tissue located almost exclusively underneath the nipple/areola
Breast tissue – extends over pectoralis muscle border
Nipple position – at or above pectoralis border
Chest fold shape – tight skin, rounded chest fold
Most common demographic: 16 – 35 years old, frustrated young adults.
Anesthesia: Typically performed under local anesthesia in the office, however, general anesthesia is available as well.
Cost: Average cost under local anesthesia is $8,500 – $9,500. The cost will vary if combined w/ other procedures or performed under general anesthesia.
Consultation fee: Charged upon scheduling a consultation.
Recovery: 2 days for sedentary work, 4-6 weeks if the job requires heavy labor.
Based on over 2500 gynecomastia surgeries, Dr. Cruise has classified gynecomastia into 6 different types. Each type is unique in its own way and must be treated differently. The purpose of the Cruise Classification System is to:
“A classification system is only useful if it outlines a treatment plan.” – Dr. Cruise
Type 2 Gynecomastia has breast tissue that extends over the pectoralis muscle causing a feminine, rounded appearance.
Fortunately, Type 2’s have tight skin which acts like a compression garment – holding the breast tissue tight and flat. In fact, this compression may be so effective that it makes the gynecomastia tissue appear as well developed muscle to causual observers. However, the rounded, undefined lower pectoralis border is what gives it away as breast tissue. Another way to distinguish breast tissue from muscle is to squeeze all the tissue directly below the areola with your thumb and index finger. Breast tissue will have a firm, gritty texture. If left untreated, over time the weight of the breast tissue will cause the skin to relax and likely progress to Type 3 or Type 4.
Unfortunately, the clinical definition for optimal results for gynecomastia is virtually non-existent; even in plastic surgery literature. Type 2 Gynecomastia does not necessary mean easiest. In fact, Type 2 patients are very particular and do not tolerate complications such as persistent puffy nipple, cratering, contour irregularities, etc. Type 2 patients are typically in very good physical shape to begin. While puffy nipple is of the major concern, there are many other aspects of Type 2 gynecomastia that absolutely need to be addressed in order to not only achieve optimal result but, more importantly, avoid complications.
External view of optimal result
Inside view of optimal result
The Cruise classification accurately defines “where you are.” Now, we need to clearly define in surgical terms “where you want to go.”
With this is mind, we asked Dr. Cruise to outline the most important aspects that need to be addressed when surgically treating Gynecomastia Type 2 and what they should ideally look like.
Type 2 gynecomastia patients do not have much to worry about extra incisions as their skin is already tight. Their incision will be limited to around the areola. There are some Type 2’s that have very low nipples. In these patients, nipple elevation is usually required to prevent the nipple from “falling off the pectoralis border.” If this happens, the nipple falls into the chest fold and it looks like it is “cratered.” Clearly, not desirable. This requires a superior areola incision which is slightly more visible but still not an issue. As one of the best gynecomastia surgeons in the world, Dr. Cruise is extremely skilled with his incision techniques.
Incision visibility is less of an issue with Type 2 Gynecomastia compared to the other types. This is because even the most aggressive incision still remains within the areola. Incision choices for Type 2 are:
Crescent excision means that a 1/4″ to 1/2″ crescent shaped piece of skin is removed just below and above the areola. This does several good things beyond tightening the chest skin. More importantly, it pulls the areola tight similar to getting the wrinkles out of a bed sheet. This little maneuver has a large impact in getting rid of excess skin that has been stretched over time. It also flattens the lower and upper chest skin mildly so that it better wraps around the pec. border improving definition. One incision is located above and second below the areola.
Crescent incisions, however, create skin margins that do not line up exactly. The side toward the areola will always be shorter than its counterpart. When sutured together this length mismatch will create mild bunching that takes a little longer to fade away than a linear incision would.
View our gallery of before and after photos to see the results from Type 2 Gynecomastia surgery. Remember, each patient is unique and results will vary from person to person.
The pain and suffering associated with gynecomastia is unlike any other condition in plastic surgery and perhaps in all of medicine. The range of its impact is stunning. Some men (usually older) can be relatively unaffected while others (usually the younger) can be completely devastated and even suicidal.
Most of the time, your son will not want to “speak up” about his embarrassment of Gynecomastia. In addition, he probably does not even know there is a name for the condition that he suffers with. The key here is to educated the child on Gynecomastia. The best way is to first approach your child and ask them why he has not been going to the pool or avoiding shirtless situations. If you have a specific example, use it. Have this conversation in a private place where he has your full attention and feels safe to open up. Using media coverage such as the article in Parenting OC is a good way to break the ice. Some intro statements could be:
Very important: Let your child know that you are judgement free.
If gynecomastia surgery is a procedure that you are considering or you just want to learn more about your options, fill out our online contact form and you will be contacted with the next steps to resolve your gynecomastia. Feel free to also call our office at (949) 644-4808.