Dr. Medalie is a specialist in the surgical treatment of gynecomastia or male breast reduction surgery in Cleveland, Ohio.

Comprehensive Guide to Gynecomastia Surgery: Male Breast Reduction

What is Gynecomastia Surgery?

Although rarely discussed, male breast enlargement is a common condition. There is no specific cause for gynecomastia, although there has been some correlation with various medical conditions or drugs (anabolic steroids, some heart medications, marijuana, etc.). Men who feel self-conscious about their appearance are helped with male breast reduction surgery. The procedure removes fat and/or glandular tissue from the breasts, and in extreme cases removes excess skin, resulting in a contoured chest that is flatter and firmer. Gynecomastia surgery, also known as male breast reduction, is the cosmetic surgical procedure that removes excess glandular tissue, fat, and sometimes skin from the chest. The goal is to create a flatter, firmer, and more masculine chest contour.

This procedure is one of the most commonly performed surgeries for men seeking to correct the appearance of enlarged male breasts, which can be caused by hormonal imbalances, genetics, medications, or weight fluctuations.

Who is a Candidate for Gynecomastia Surgery?

Men may consider gynecomastia surgery if they experience:

• Enlarged or swollen male breasts (typically since adolescence) that don’t improve with diet and exercise.
• Tenderness or discomfort in the chest area.
• Self-consciousness in fitted shirts, swimwear, or while being shirtless. Frequently males will complain about nipple show through their t-shit.
• Stable body weight and good overall health.

Ideal candidates are non-smokers with realistic expectations and no untreated medical conditions contributing to breast enlargement (such as medical therapy for prostate conditions).

Gynecomastia Surgery Techniques

The surgical approach depends on the type and severity of gynecomastia:

1. Liposuction-Only Technique
   • Best for patients with excess fatty tissue but minimal glandular tissue.
   • Small incisions allow a cannula to suction fat from the chest.
   • Results in minimal scarring and a faster recovery.
   • When liposuction is used to remove excess fat, the cannula is usually inserted through the existing incisions or in an inconspicuous location under the arm.
   • I find it very infrequent that I only use liposuction for gynecomastia reduction. Almost always there is a dense nodule of glandular tissue under the nipple that can not be removed with liposuction alone.
2. Excision Technique
   • Used when glandular breast tissue or excess skin must be removed.
   • Incisions are typically placed around the areola for a discreet scar.
   • Allows repositioning of the nipple if necessary.
3. Combination Technique (Dr. Medalie's preferred technique)
   • In many cases, both liposuction and excision are used for optimal results.
   • Provides the most natural, masculine chest contour.
   • If excess glandular tissue is the primary cause of the breast enlargement, it typically requires sharp excision. The excision may be performed alone or in conjunction with liposuction. Dr. Medalie prefers power assisted liposuction because it has greater efficacy in the dense fibrous tissue under the nipple.
   • In a typical procedure, an incision is made at the skin-areola junction in the 4-8 o’clock position. Working through the incision, Dr. Medalie removes the excess glandular and fatty tissue from beneath and around the nipple. The remaining excess tissue is contoured via liposuction to blend smoothly with the rest of the chest wall.
   • Major reductions that involve the removal of a significant amount of tissue and skin may require larger incisions that result in more conspicuous scars. The most aggressive is the double incision mastectomy with free nipple grafting typically used in instances of massive weight loss where there is a great deal of excess skin.

The Gynecomastia Surgery Procedure: Step by Step

1. Anesthesia – Local anesthesia with sedation or general anesthesia is administered. Dr. Medalie always uses local in addition to the general in order to keep his patients comfortable when they wake up.
2. Incision Placement – Strategically placed around the areola or in the natural chest folds.
3. Tissue Removal – Fat, glandular tissue, and sometimes skin are removed.
4. Sculpting – Liposuction smooths transitions for a natural chest shape.
5. Closure – Incisions are closed with sutures; drains may be placed in certain cases.

Recovery After Gynecomastia Surgery

• Immediate Post-Op: Compression garments are worn to reduce swelling and support healing. Drains are also typically used for around 5 days.
• 1–2 Weeks: Most patients return to light work; bruising and swelling begin to fade. The compression vest is used for 2 weeks.
• 4–6 Weeks: Strenuous activity and leg workouts can usually be resumed. No heavy olifting with the arms for 8 weeks.
• Final Results: Improved chest contour is visible within weeks but continues refining over several months.

Risks and Considerations

Like all surgeries, gynecomastia surgery carries risks, including:

• Temporary bruising, swelling, or numbness
• Asymmetry in chest contour
• Scarring around the areola
• Nipple healing complications in more extensive surgeries
• Rare complications such as infection or fluid accumulation

Choosing a board-certified plastic surgeon such as Dr. Medalie significantly reduces risks and ensures natural, balanced results. He has been performing this type of surgery since 1999 and is an expert in male chest and body contouring.

Benefits of Gynecomastia Surgery

• Permanent removal of excess tissue
• Improved self-confidence and body image
• Ability to wear fitted clothing comfortably
• More masculine chest contour
• High patient satisfaction rates

Cost of Gynecomastia Surgery

The cost of gynecomastia surgery varies based on:

• Surgical technique required (liposuction vs. excision)
• Duration of the procedure
• Local vs general anesthesia

When you consult with Dr. Medalie he will explain your options and e-mail you a comprehensive price quote the same day that includes the gynecomastia surgery, the anesthesia and the facility costs.

Gynecomastia Surgery FAQ

1. Can exercise alone get rid of gynecomastia?
In cases of true glandular gynecomastia, no amount of diet or exercise can remove the tissue. Surgery is the only effective treatment.

2. Is gynecomastia surgery permanent?
Yes. Once glandular tissue and excess fat are removed, results are generally permanent if patients maintain a stable weight and avoid medications or conditions that trigger recurrence.

3. Will there be noticeable scars?
Incisions are usually placed discreetly along the edge of the areola or chest folds, making scars minimal and well-hidden for small to medium gynecomastia. FOr larger procedures, the scars are either circum-areolar or placed in the crease oif the pectoralis major muscle.

4. How painful and long is recovery?
Mild to moderate discomfort is expected, but pain is usually well-managed with prescribed medication. Dr. Medalie always uses tumescent local anesthesia prior to the surgery in addition to the general in order to keep his patients comfortable when they wake up. This is a fairly well tolerated operation and requires a short recovery. Pain that may require narcotic pain medicine typically lasts 3-4 days. After that, ibuprofen (Motrin and Advil) is sufficient. I recommend that patients take at least 1 week off from work. The post-op care involves a compression vest for several weeks and scar massage after that. Most of the swelling and all of the buried stitches have disappeared by 3-4 months.

5. Are there bleeding risks
During the surgery, local anesthetic is injected into the tissue-this blocks the sensation and also constricts blood vessels. As a result, there is very little bleeding during the surgery. I have NEVER had a patient have a severe bleeding complication post-op, but it is not impossible and a return trip to the OR may be necessary. No one has ever needed a blood transfusion for this procedure.

6. What is the chance of infection?
I typically give my patients antibiotics intravenously prior to surgery. I have never had a post-op infection or an implant extrusion.

7. When can I resume normal activity
I recommend that patients refrain from exercise for at least 2 weeks after surgery. Even after 3 weeks, the incisions may be sensitive and patients need to use caution (focus on leg work more than arm work and no heavy lifting). Full activity can resume by 8 weeks post-op.

8. Can other procedures be performed during gynecomastia reduction
Yes – I often perform multiple simultaneous procedures on gynecomastia surgery patients. Frequently, I perform liposuction (love handles are most commonly asked for) or tummy tuck (typically in patients with massive weight loss who have a great deal of excess skin).

Conclusion: Is Gynecomastia Surgery Right for You?

Gynecomastia surgery offers a safe and effective solution for men struggling with enlarged male breasts. By eliminating excess glandular tissue and fat, the procedure restores a masculine, sculpted chest and greatly improves confidence.

If you are considering male breast reduction surgery, schedule a consultation with a Dr. Medalie to determine the best approach for your needs and goals.

Gynecomastia Treatment Comparison Chart

Treatment Option	What It Is	Effectiveness	Best For	Recovery & Downtime	Pros	Cons
Gynecomastia Surgery (Male Breast Reduction)	Surgical removal of excess glandular tissue and fat (liposuction and/or excision).	Highly effective – permanent solution for true gynecomastia.	Men with glandular tissue, excess fat, or skin causing enlarged male breasts.	1–2 weeks off work; full recovery in 4–6 weeks.	Permanent results, immediate chest contour improvement, high patient satisfaction.	Requires anesthesia, surgical risks, cost ($4,000–$8,000).
Diet & Exercise	Lifestyle modifications to reduce overall body fat.	Limited – helps with chest fat but not glandular tissue.	Men with pseudogynecomastia (fat-related breast enlargement).	No downtime; gradual changes over time.	Improves overall health, no cost beyond lifestyle adjustments.	Ineffective for true glandular gynecomastia, requires discipline and long-term consistency.
Hormone Therapy	Medical treatment to correct hormonal imbalances (e.g., testosterone therapy, medication adjustment).	Variable – may reduce breast tissue growth if hormone imbalance is the cause.	Men with gynecomastia linked to hormonal conditions or medications.	Minimal downtime, depends on ongoing treatment.	Non-surgical option, addresses root hormonal cause.	May not fully reduce existing tissue, potential side effects, requires medical supervision.
Non-Surgical Devices (CoolSculpting®, Ultrasound, etc.)	Non-invasive fat reduction or skin tightening treatments.	Limited – may help contour chest if excess fat is the main issue.	Mild chest fullness without significant glandular tissue.	No downtime, multiple sessions required.	Non-invasive, little to no recovery time.	Expensive, inconsistent results, not effective for dense glandular tissue.

Key Takeaways

• Gynecomastia surgery is the only permanent and reliable solution for true glandular gynecomastia.
• Diet and exercise are helpful for fat reduction but won’t fix gland-related breast tissue.
• Hormone therapy may help if the cause is hormonal, but it rarely eliminates existing tissue.
• Non-surgical devices can contour fat but are not substitutes for male breast reduction surgery.

 For men seeking a defined, masculine chest, gynecomastia surgery remains the gold standard treatment.