Gynecomastia.

Gynecomastia is common and can occur at several life stages, including infancy, puberty, and later adulthood.

Many cases—especially during puberty—improve over time without surgery. In other situations, breast enlargement persists, progresses, or causes discomfort or distress. Because gynecomastia can occasionally be related to medication effects, hormone imbalance, or underlying medical conditions, an evaluation by a physician is an important part of care before any procedure is considered.

Dr. Sadowski approaches surgery to correct gynecomastia as an anatomy-based, medically guided process. The goal is to identify the likely contributors to chest enlargement, clarify whether surgery is appropriate, and develop a plan that prioritizes safety, predictable healing, and a natural chest contour.

Why Choose Dr. Sadowski?

Dr. Sadowski is a double board–certified plastic and reconstructive surgeon and a member of the American Society of Plastic Surgeons. Her approach emphasizes careful evaluation, thoughtful surgical planning, and clear communication about options and tradeoffs.

Gynecomastia surgery can range from relatively straightforward (fat-predominant enlargement treated with liposuction) to more complex (dense gland removal, skin excess, or significant asymmetry). Dr. Sadowski’s planning process is focused on tissue characteristics, scar placement, nipple–areola positioning, and long-term chest contour stability.

What is Gynecomastia?

Gynecomastia refers to enlargement of the male breast region. Clinically, it is helpful to distinguish between:

• True gynecomastia: enlargement driven primarily by glandular breast tissue, often felt as a firm or rubbery disc beneath the nipple–areola complex.
• Fat-predominant chest fullness (sometimes called pseudogynecomastia): enlargement driven primarily by fatty tissue, often associated with overall weight gain.
• Mixed gynecomastia: a combination of gland and fat, which is common.

Gynecomastia may be related to physiologic hormone shifts (such as puberty), medications or substances, chronic medical conditions, endocrine disorders, or, more rarely, tumors that affect hormone production. While breast cancer in men is uncommon, new or unusual breast findings should be evaluated—especially if there is a hard mass, nipple discharge, skin changes, rapid growth, or enlarged lymph nodes.

Are there different kinds of Gynecomastia and what are they?

Gynecomastia varies in both tissue composition and skin/contour changes. Surgical planning is typically based on:

• The amount of glandular tissue
• The amount of fatty tissue
• Skin elasticity and degree of excess skin
• Nipple–areola size and position
• Asymmetry between sides
• History of weight change or prior chest procedures

Common surgical approaches include:

Liposuction-focused reduction (fat-predominant or mixed cases)

When excess volume is primarily fat (or fat with a smaller gland component), liposuction may be used to reduce fullness and refine contour through small incisions. Liposuction alone may be sufficient in selected patients with good skin elasticity.

Gland excision (dense glandular tissue beneath the areola)

When firm gland tissue is a significant contributor—especially beneath the nipple—direct excision is often necessary. This is typically performed through a carefully planned incision along the areola border to minimize scar visibility. Many patients require a combination of liposuction and excision for balanced contour.

Skin tightening or skin removal (cases with skin excess)

If the skin has stretched significantly—due to long-standing gynecomastia, major weight loss, or aging—additional procedures may be needed to address excess skin and nipple position. Options vary by anatomy and may involve longer scars. This portion of planning is highly individualized because scar placement and contour goals must be balanced carefully.

Staged versus single-stage approaches

In many patients, reduction can be performed in one surgery. In others—particularly when skin excess is significant or when contour refinement is complex—staging may be discussed to improve predictability and reduce risk.

Am I a candidate for Gynecomastia Surgery?

Candidates for gynecomastia surgery often include patients who:

• Have persistent chest enlargement that has not resolved over time
• Have discomfort, tenderness, or functional limitation related to chest tissue
• Have stable weight (or a realistic plan for stability)
• Are in good overall health for surgery and anesthesia
• Do not smoke/vape nicotine or are willing to stop (nicotine increases wound-healing risk)
• Understand the role of scars and the healing timeline in achieving improved contour

You may need additional evaluation or preparation first if you:

• Are in childhood or early puberty (observation is often appropriate unless there are special circumstances)
• Have recent-onset enlargement, rapid growth, a hard mass, nipple discharge, or skin changes
• Have a medication/substance exposure that may be contributing (including anabolic steroids, certain supplements, or marijuana products)
• Have symptoms or history suggesting an endocrine, liver, kidney, or testicular condition
• Are planning significant weight change in the near future
• Currently smoke or vape

What are the benefits of Gynecomastia surgery?

Benefits vary based on anatomy, tissue type, and skin quality. During consultation, the discussion focuses on what changes are realistic and what tradeoffs (including scars) may be involved.