Male breast reduction, also know as gynecomastia, is quite common but rarely talked about. Gynecomastia is the overdevelopment of the male breasts, a condition which affects an estimated 40 to 60 percent of men. Gynecomastia surgery removes fat and/or glandular tissue from the breasts, and in extreme cases removes excess skin, resulting in a chest that is flatter, firmer, and better contoured. Dr. Rohrich has pioneered new, less-invasive techniques for gynecomastia surgery using ultrasound technology. Using his technique, patients have better surgery results with smaller incisions.

Dr. Rohrich is a *board-certified world-renown plastic surgeon and educator who has over a decade of experience in plastic surgery. He is co-author of "Ultrasound-Assisted Liposuction," the first textbook on ultrasound technology and its use in liposuction.

The information provided will give you a basic understanding of the procedure but it can't answer all of your questions, since a lot depends on your individual circumstances. Please be sure to ask Dr. Rohrich if there is anything about the procedure you do not understand. For more information, please view the "Frequently Asked Questions".

* American Board of Plastic Surgery

Am I a good candidate for the surgery?

Surgery to correct gynecomastia can be performed on healthy, emotionally stable men of any age. The best candidates for surgery have firm, elastic skin that will reshape to the body's new contours. The most common cause of gynecomastia is idiopathic which means the cause is unknown. Surgery may be discouraged for obese men or for overweight men who have not first attempted to correct the problem with exercise or weight loss. Also, individuals who drink alcoholic beverages in excess or smoke marijuana are usually not considered good candidates for surgery. These drugs, along with anabolic steroids, may cause gynecomastia. Therefore, patients are first directed to stop the use of these drugs to see if the breast fullness will diminish before surgery is considered an option.

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What should I expect from my consultation?

During the consultation, Dr. Rohrich will examine your breasts and check for causes of the gynecomastia, such as impaired liver function, use of estrogen-containing medications, or anabolic steroids. If a medical problem is the suspected cause, you'll be referred to an appropriate specialist. Dr. Rohrich may, in certain cases, recommend a mammogram or chest x-ray. This will not only rule out the very small possibility of breast cancer, but will reveal the breast's composition.

After your consultation a photographer will take photographs for your medical record and you will meet with Dr. Rohrich's patient coordinator to discuss the surgery fees and scheduling dates. You may also schedule an additional consultation to view computer imaging so that you can visualize the results of the surgical technique that Dr. Rohrich has specifically designed for you.

You should come to the consultation prepared to discuss your medical history. This will include information about any medical conditions, drug allergies, medical treatments you have received including previous surgeries and medications that you currently take. It is important for you to provide complete information.

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How is the surgery performed?

If excess glandular tissue is the primary cause of the breast enlargement, the tissue will be removed. In a typical procedure, an incision is made in an inconspicuous location - either on the edge of the areola or in the breast fold. Working through a small incision, Dr. Rohrich removes the excess glandular tissue and fat from around the areola and/or bottom of the breast using ultrasound-assisted liposuction.

If your gynecomastia consists of primarily excessive fatty tissue, Dr. Rohrich will most likely use ultrasound-assisted liposuction in specific areas to remove the excess fat. This procedure is done by creating a small incision, less than half an inch in length in the breast fold. A slim hollow tube called a cannula that is attached to a vacuum pump is then inserted into the incision. Using strong, deliberate strokes, Dr. Rohrich moves the ultrasound cannula through the layers beneath the skin which melts the fat. He then suctions it out using a traditional liposuction cannula.

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What happens the day of surgery?

Your gynecomastia surgery will be performed at either one of our specialty hospitals or an accredited outpatient surgery facility.

Prior to the procedure, medications are administered for your comfort and to lessen the anxiety if need be. General anesthesia is used for patients undergoing gynecomastia. The surgery usually takes 1 to 2 hours depending on the technique used. After surgery, you will awake in a recovery area where you will be closely monitored.

Be sure to arrange for someone to drive you home and stay with you to assist you the first couple of days while at home. The "Patient Care" section on this site will give you instructions to prepare for surgery, including guidelines on eating, medications to avoid, drinking and smoking. If you are a smoker, you will be asked to stop smoking well in advance of surgery.

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What is the recovery like?

Whether you've had your breast tissue excised or suctioned, you will feel some discomfort for a few days after surgery. However, discomfort can be controlled with medications prescribed by Dr. Rohrich. You'll be swollen and bruised for a while. To help reduce swelling, it is important that you wear an elastic pressure garment continuously for 4 weeks and for an additional 4 weeks longer at night in order to maximixe your results. Although the worst of your swelling will dissipate in the first few weeks, it may be three months or more before the final results of your surgery are apparent. In the meantime, it is important to begin getting back to normal. You'll be encouraged to begin walking around on the day of surgery and you may return to work when you feel well enough, which could be as early as 2-3 days after surgery. All sutures will be removed 1 to 2 weeks after surgery.

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What should I know about my results?

Whenever surgery is performed on your body, a scar will result. The scars for this procedure are at the bottom of the breast fold and/or around your areola. They will fade with time and barely be visible.

The procedure may also result in permanent pigment changes in the breast area, or slightly mismatched breasts or nipples. If asymmetry is significant, a second procedure may be performed to remove additional tissue. The temporary effects of breast reduction include loss of breast sensation or numbness, which may last up to a year.

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What does the surgery cost?

At the time of your initial consultation, you will be quoted a price that will include Dr. Rohrich's fee as well as hospital and anesthesia fees. Fees are due in full at least two weeks prior to your surgery. Checks, money orders, cash and credit cards may be used for payment. A $500.00 deposit will reserve a specific time and date for your surgery.

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