Dr. F. Ouakil, aesthetic surgery Paris, information, prices, photos, blog on breast surgery in men, liposculpture (lipofilling of the pectorals), hyaluronic acid injection (Macrolane, Hyacorp) in men's pectorals. By an expert aesthetic surgeon trained by the best Brazilian and French aesthetic surgeons, with over 30 years of experience in the field of plastic surgery for men, reviews.

Gynecomastia and Adipomastia

Surgical breast reduction (male) is the most effective treatment for gynecomastia. This aesthetic surgery procedure removes excess fat and breast glandular tissue to restore a flatter, firmer, and thus more masculine contour to the male chest.

Definition and Origin of Gynecomastia

Gynecomastia is defined as an increase in volume (hyperplasia), either unilateral or bilateral, of the breast gland in men. Contrary to popular belief, men do indeed possess a breast gland physiologically. Generally idiopathic (without a known cause), and developed during growth, gynecomastia can result from the intake of certain medications or abnormal hormonal production.
In infants, gynecomastia is very common (due to the passage of maternal estrogens through the placenta).

Later, during puberty, steroidogenesis can lead to the development of gynecomastia in adolescents, often a source of deep psychological complex. In men over 50, gynecomastia appears in more than 50% of cases, due to androgen deficiency.

A complete clinical, radiological, and hormonal assessment is necessary to eliminate any potential cause, especially in cases of recent onset.
Hypertrophy of the chest in men can be primarily fatty, referred to as adipomastia. Its treatment will most often consist of liposuction alone of the chest in men.

Who is the breast reduction surgery for in men?

Any hypertrophy of the breast gland (isolated gynecomastia) or breast fat (adipomastia) or both (referred to as adipo-gynecomastia), giving the appearance of "large breasts" for a man, and experienced as psychologically bothersome and/or painful to the touch, should lead to a consultation for surgical correction.

This is related to the engorgement of the areola and nipple due to very central hypertrophy of the gland, which requires surgical treatment with direct access.

Prior exclusions include:

• very young subjects still in growth
• men with significant overweight who will first be prescribed a weight loss program
• any hormonal or tumor causes responsible for gynecomastia
• any medications, hormonal supplements, or drugs responsible for breast hypertrophy in men

What surgical interventions are possible to reduce breast volume in men?

The basic surgical procedures proposed for the reduction of adipomastia and/or gynecomastia include:

• liposuction of the chest in men with 3 mm incisions around the treated areas
• direct surgical reduction, simple subcutaneous excision of excess breast gland, performed through a scar around the lower half of the areola (stage 2)
• skin remodeling with widened scars allowing for the reduction of breast tissue and resection of excess skin (stage 3)

Additionally, in the context of a gynecomastia treatment associated with liposuction of other areas (most often abdomen and hips), this autologous biological material can be used to enhance the pectoral muscles by infiltrating them with one's own fat. This lipofilling of the pectoral muscles will particularly enhance the upper part of the torso. This allows for optimizing the balance between the upper chest, which is more rounded, and the lower part that better follows the contour of the pectoral muscle.

The surgical treatment of gynecomastia offers significant improvements, with minimal scarring most of the time. This simple procedure still requires a qualified and experienced aesthetic surgeon. A very precise size of the gland and a measured reduction of excess fatty and glandular tissue are necessary to leave a masculine breast with a harmonious, virile, and natural shape.

Cryolipolysis and Gynecomastia?

For a long time, the only response to the complaint of a chest that is too large in men was surgical excision with scars. Social security coverage was indeed possible at that time.

The development of liposuction techniques (liposuction) has allowed for the treatment of certain cases of adipomastia (gynecomastia with a predominance of fat) without scarring. Unfortunately, this technique remains partially effective, as it does not reduce the breast gland and fails to remove the fat present within the excess glandular tissue.

In recent years, cryolipolysis has allowed for effective treatment in the office, without surgery and without constraints, for localized fat excesses. This method has proven particularly effective for this indication of gynecomastia. The results are impressive after 2 to 3 sessions. Even for small excesses of breast tissue in men, it can be proposed with almost no contraindications.

What type of anesthesia and what is the duration of hospitalization for gynecomastia treatment?

Stage 1 and 2: under local anesthesia enhanced by sedation (diazanalgesia), on an outpatient basis.

Stage 2 and 3: under general anesthesia, with a 24-hour hospitalization.

Note: no anesthesia for cryolipolysis.

Costs and coverage for gynecomastia?

In the case of stage 1 adipomastia, treated by liposuction alone, the procedure is considered aesthetic and the prices are similar to those of classic liposuction.

In the case of a reduction with surgical access, a base coverage in conventional pricing is automatic, with the price of your gynecomastia being those of the additional fees requested.

What are the postoperative follow-ups?

They are slightly painful and require a simple, preventive pain treatment, systematically.

Relative rest for 5 days:

• driving prohibited
• minimize any significant movement of arm extension
• wearing a bolero for 3 weeks
• sports involving the shoulder girdle prohibited for 6 weeks, particularly weight training

Subsequently, all activities will be allowed without restriction.

Potential early complications include hematoma and infection (very rare).

Long-term complications concern the aesthetic result: correction defects requiring possible touch-ups at least 8 to 12 months later, and healing problems necessitating appropriate additional treatment depending on the cases.