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Gynecomastia can cause great emotional distress in men and young adults. The embarrassment may keep them from swimming, exercising, or intimate activities. Dr. Hérve Gentile can reverse gynecomastia in men and sculpt their chest with his male breast reduction procedure.

What is Gynecomastia?

Male Chest GynecomastiaGynecomastia is a condition which feminizes the male chest due to excess breast tissue. It is a very common condition, with more than 50% of men experiencing some degree of gynecomastia. It can be temporary and disappear after teenage years, or remain present through adult life.

Gynecomastia is mostly associated with puberty and an endocrine system disturbance, disrupting the normal balance of estrogen and androgen, but it can also be seen in infants and older men. Gynecomastia does not cause any medical harm to the body, but it unfortunately can be the source of self-consciousness or embarrassment. Male breast reduction surgery is a procedure performed at A Better You Cosmetic Surgery and Laser Center which removes excess male breast tissue to create a flatter, more defined chest.

Male breast reduction can be addressed by liposuction alone or in combination with a direct excision, depending on whether the excess is caused by too much fatty or glandular tissue.

If only fat is your main component, then liposuction alone is all that is required to achieve a more attractive chest contour. Liposuction consist in vacuuming your excess fat through a tiny incision placed in your armpit. When there is also a glandular component liposuction is performed first and then a small around-the-nipple (periareolar) incision is made to remove the glandular tissue.  In extreme cases where excess skin is also an issue a breast lift would be required.

During your consultation Dr. Gentile will discuss your goals and expectations as well determine the cause of your breast enlargement.

Dr. Gentile is very experienced with both techniques. All procedures are performed on an outpatient basis under general anesthesia in our office accredited surgical center. The procedure can last from 1 to 2 hours depending on the extent of correction required.

Different Levels of Gynecomastia

There are different levels of gynecomastia that are categorized by chest size and visibility of the condition.

Level 1 – Mild: Slight protrusion of the areola due to small glandular tissue pockets.

Level 2 – Moderate: Protrusion of breast is more than just localized around the areola.

Level 3 – Visible: Visible skin redundancy with enlargement of breast.

Level 4 – Feminine: Visible skin redundancy with feminized breasts.

What Can Cause Gynecomastia?

Gynecomastia does not have one single cause, but studies have concluded that there are several factors that can lead to the onset of gynecomastia. Gynecomastia generally occurs in men with an improper balance of androgen and estrogen, or a condition which causes this estrogen imbalance.


Men create both testosterone and estrogen in their bodies, but much more testosterone than estrogen. In some cases, this ratio can be skewed and estrogen levels can rise above normal levels. Men with a high amount of estrogen can experience symptoms such as loss of muscle mass, emotional disturbances, and enlarged breasts. No physical harm comes from excess estrogen in men, but it can cause self-consciousness.


Heartbeat regulation, hormone production, and metabolism are all controlled by the thyroid gland. In some instances, its functionality can be thrown off. Hyperthyroidism is a condition where the thyroid gland produces more hormones than required by the body, including estrogen in men.

Klinefelter Syndrome

Chromosomal abnormalities can result from a rare condition called Klinefelter Syndrome. This condition creates an additional X chromosome, so men with Klinefelter Syndrome possess XXY. Some men experience no effect from this extra female chromosome, but for some it can cause symptoms like weakened muscles and enlarged male breasts.


Steroids and similar drugs can manipulate sex hormone levels, usually creating more of an increase in estrogen, which can result in enlarged male breasts. Other medications linked to an increase in estrogen and male breast tissue are some high blood pressure medication and antidepressants.


Cannabis can cause gynecomastia by decreasing testosterone levels and affecting the endocrine system.


As we age, men experience an increase in an enzyme called aromatase which converts androstenedione and estrone into estrogen. Estrogen then can cause the onset of gynecomastia.

Gynecomastia vs Pseudogynecomastia

Although similar sounding, gynecomastia and pseudogynecomastia both result in the enlargement of the male chest, but do so from different underlying sources. Gynecomastia is an excess of glandular tissue, or breast tissue, overlying the chest. Pseudogynecomastia on the other hand is a buildup of adipose tissue, or fat, under the nipples. This difference in breast enlarging sources actually requires different reduction methods.

Gynecomastia calls for male breast reduction surgery to excise the glandular tissue from the chest, since this condition cannot be reversed by diet or exercise.

Pseudogynecomastia can be diminished by exercise and good diet since the source is fat just like fat in any other part of the body. But in extreme cases, liposuction can be used. To determine if you suffer from gynecomastia or pseudogynecomastia, a consultation examination with Dr. Hérve Gentile is necessary.

Good Candidates

Candidates for male breast reduction surgery are men who think they may suffer from gynecomastia or are unsatisfied with the contour of their chest. This can appear in one or both breasts. These men find that despite much effort at the gym, they are unable to define their pecks. This is most likely because the issue is not fat but breast tissue, in which case the only solution is to seek help from a gynecomastia specialist like Dr. Hérve Gentile. He has considerable experience in properly diagnosing gynecomastia and pseudogynecomastia and determining the appropriate treatment for each of his patients.

There is no age limit for male breast reduction surgery, but it is preferred that patient’s chests are fully developed. If teenagers wish to undergo this procedure, they may require future reduction procedures as their chest continues to develop with age.


Before male breast reduction surgery, some tasks must be completed to help ensure a smooth procedure and recovery. You will receive individualized preparation instructions at your consultation, but general guidelines typically consist of:

  • Schedule at least 4 days off work to make sure you have ample recovery time.
  • Pick up prescribed medications so they are readily available for you.
  • Do not drink alcohol, smoke, or take anti-inflammatory medication 4 weeks prior to surgery.
  • Complete any medical tests ordered by Dr. Gentile.
  • Arrange for someone to take you home after the procedure.
  • Just in case you need it make sure to have a supply of gauze and a 4“inch ace bandage.
  • Wash yourself with antibacterial soap the night before the procedure.
  • Immediately notify the office if you begin to feel the slightest bit ill before your surgery date.

Male Breast Reduction Process

Male breast reduction surgery takes roughly 1 – 2 hours to complete and is performed on an outpatient basis under your choice of general anesthesia or local with sedation. Most often Dr. Herve Gentile corrects the gynecomastia via a small incision combined with liposuction. The incision is made around the areolas to allow Dr. Gentile access to the breast tissue while a tiny incision will also be made in your armpit for the liposuction. He will excise the majority of the glandular tissue, leaving only an appropriate amount and he uses liposuction to feather the surrounding tissues thereby ensuring a natural-looking definition. Rarely a much longer incision is required along the natural breast crease if you have a female breast. Sagging skin can also be removed to match the newly contoured pecks.

Liposuction alone can be used instead of male breast reduction only when the cause of enlarged breasts is solely due to fat deposits. Incisions will be made on both sides of the chest, and in some cases the armpit and the edge of the areolas.

Each patient will undergo an individualized procedure to ensure the contoured results are proportionate with their body. Once the desired result is achieved, the incisions are then sutured, surgical dressings will be applied, and a compression garment will be wrapped around the chest to reduce swelling.

Postoperative Recovery

After the procedure, drains are often inserted by Dr. Gentile to catch any excess fluids; special instructions will be provided. Drains are typically removed a few days later at your follow-up appointment. You will be able to return to work and your normal daily routine in 3 – 5 days depending on the specific case, and strenuous activities in 2 – 3 weeks. Bruising and sensitivity is normal and will subside with time, but pain medication can be prescribed if necessary.

Patients are able to see chiseled, defined results as soon as the swelling subsides. Resulting scarring from the incisions are very small and will fade with time. Often times after men get male breast reduction surgery, they experience newfound confidence to take up sports and feel more comfortable in intimate settings. Your results should last for many years to come if you continually exercise and eat healthy. Male breast reduction surgery cannot fight the inevitable aging process and aesthetic changes that may come with it, such as sagging skin.


female face with wrinkles on her foreheadDuring your initial consultation, Dr. Gentile will perform an examination to determine whether you’re experiencing gynecomastia, pseudogynecomastia, or a combination of the two; he is able to correct all cases. Once the cause of your enlarged breasts is determined, Dr. Gentile will come up with an individualized procedure plan to provide you with optimal results that are proportionate with your body. He will show you before and after pictures of previous patients and explain realistic expectations for your case. Dr. Gentile will also provide you with preparation and recovery instructions, as well as review the procedure process and what to expect. If you have any questions about any part of the process, he will gladly address them.

If you think you suffer from gynecomastia and are interested in male breast reduction surgery, feel free to set up a consultation and Dr. Gentile will gladly assess your candidacy.


The cost of male breast reduction surgery will vary depending on the extent of the case and whether you choose to undergo additional body contouring procedures. A quote will be provided to you after a consultation examination.