Gynecomastia | Jonathan Hall, MD, FACSJonathan Hall, MD, FACS

Gynecomastia Patient #39

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Gynecomastia Patient #39

A man in his early 30’s with gynecomastia since the age of 16. He was a significant user of marijuana at the time, which may have been the predisposing factor. He is bothered by the appearance of his chest with his shirt off and in fitted shirts.

He is shown before and again, 5 months after power-assisted liposuction combined with direct excision of breast tissue through an incision at the lower areola. The “hands-on head” view corrects his baseline skin laxity and demonstrates the breast component before and after treatment. He is thrilled to have a normal-looking chest and now feels comfortable with his shirt off. Additional tightening of the skin would require a skin excising procedure which would trade a visible scar for a tighter contour and would not be desirable in his case.

Gynecomastia Patient 38

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Gynecomastia Patient 38

A Hispanic male in her later 30’s is bothered by gynecomastia. He developed female-appearing breasts at the age of 11 or 12. He is bothered by the appearance of fitted clothes and at the beach. He wears compression garments to camouflage his appearance. His weight has fluctuated up and down and he is mildly overweight. As people gain and lose weight their skin has less elasticity. The skin will shrink a little but the only way to tighten loose skin is to take a piece out and leave visible scarring on the chest which would make it difficult to take a shirt off at the beach. Many patients prefer to have a correction of the contour and accept some looseness of the skin as he has here, to still be able to look normal with a shirt off.

Gynecomastia Patient 37

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Gynecomastia Patient 37

A man in his early 30’s is bothered by female breast development which happened at the age of 15-16. He was a regular marijuana smoker at the time and this may have been the cause. He is bothered by the appearance of his chest with his shirt off and in fitted shirts. He wears compression shirts under his shirt to camouflage his appearance. He is shown before and again, just 6 weeks after bilateral gynecomastia excision with power-assisted liposuction using the S.A.F.E. technique combined with direct excision of breast tissue from an incision around the lower areola. With the S.A.F.E. technique ( Separation Aspiration Fat Equalization) a finned cannula is used initially to breast up the fa. Unlike energy-based liposuction such as Vaser or laser, this does not damage the fat cells. Then liposuction is performed, then breast tissue is excised. Then the remaining fat is smooth or “equalized” with the finned cannula… In my hands, this has given the smoothest result. Scars are at their reddest and thickest at 6 weeks and will now soften and fade over the next year or more. Topical silicone is prescribed to improve scar maturation. Swelling will continue to improve over the next 4 ½ months. He is already thrilled with his result. He is looking forward to a beach wedding, and finally feeling comfortable with his shirt off.

Gynecomastia #37

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Gynecomastia #37

A young man in his later teens with gynecomastia since the age of 13. He does not have a history of marijuana or anabolic steroid use so this is most likely idiopathic in origin. Idiopathic is a medical term for “we don’t really know why” and is a common presentation at puberty. He is bothered by fitted shirts and with his shirt off. He is shown before and again, just 6 weeks after surgery with Power Assisted Liposuction using the S.A.F.E. technique ( Separation/Aspiration/Fat Equalization) combined with direct excision of breast tissue from an incision along the lower areola. Scars are typically at their reddest at 6 weeks and we will now have him use topical silicone to help the scars soften and fade faster. He is thrilled with his result and can now resume normal activities and the gym.

Gynecomastia Patient 36

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Gynecomastia Patient 36

A man in his middle 30’s who had had gynecomastia (development of female-appearing breasts) since he was 13. He wears Spanx under his shirts to camouflage the appearance of his chest and is bothered by his appearance in most fitted shirts and with his shirt off. He is shown before and again, 6 weeks after bilateral gynecomastia surgery using the S.A.F.E. technique ( Separation Aspiration Fat Equalization) utilizing power-assisted liposuction combined with direct excision of breast tissue through an incision around the areola. A finned “Becker” cannula is used to breast up the fat mechanically, followed by liposuction, then the excision, then smoothing of the fat with the finned cannula again. In my hands, this has given the most consistent results. At 6 weeks he is already thrilled with his improvement and ready to resume normal activity. A mole was removed from his right shoulder at the same time.

Gynecomastia – Patient 165

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Gynecomastia – Patient 165

A student in his later teens who has been bothered by female appearing breast development ( gynecomastia) since the age of puberty. He was bothered with his shrt off and wore additional shirts to camouflage the appearance. He is shown before and again, 8 months after bilateral gynecomastia excision with power assisted liposuction using the S.A.F.E. technique combimed with direct excision of breast tissue through an incision along the lower areola.

Gynecomastia – Patient 164

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Gynecomastia – Patient 164

An early ( 6 week) result for a man in his late 20’s with gynecomastia since the age of 17, most likely from weight lifting supplements. He is shown before and again, just 6 weeks after treatment with a combination of power assisted liposuction using the S.A.F.E. technique, combined with a direct excision of breast tissue through a peri-areloar incision

Scars are typically at their thickest and reddest at 6 weeks and will now soften and fade over the next 2 years. Tattoos have been blurred for his privacy

Gynecomastia – Patient 163

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Gynecomastia – Patient 163

A man in his late 30’s with gynecomastia since puberty. He was heavier as a child and had a maximum weight of 250 lb. He took some anabolic prohormones in his early 20’s and developed some tenderness and increasing fullness of his breasts. He has reduced his weight to 190 lbs but continues to have female appearing breasts which are prominent in fitted shirts and also bother him with his shirt off. He wears extra shirts to try and camouflage the appearance.

He is shown before and again, 6 months after surgery with power assisted liposuction using the S.A.F.E. technique combined with direct excision of breast tissue through a periareolar incision.

Although he continues to have mild skin laxity from decreased skin elasticity following his weight loss, his appearance is greatly improved. The only reliable way to tighten loose skin would be to place a visible scar on his chest which would not be worth the tradeoff.

Gynecomastia – Patient 162

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Gynecomastia – Patient 162

A young man in her late teens with bilateral gynecomastia since puberty. He is shown before and again 4 months after a combination of power assisted liposuction using the S.A.F.E. technique ( Separation/aspiration/Fat Equalization) combined with a direct excision of breast tissue through a periareolar incision.

Gynecomastia – Patient 161

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Gynecomastia – Patient 161

A man in his late 20’s who developed mild gynecomastia following a year of Finasteride use. He is 5’ 8 ‘ and 162 lbs. He is shown 2 months after bilateral chest liposuction with the

removal of 200 cc of fat from his right chest, and 250 cc of fat from his left chest, to help balance his asymmetry. External Ultrasound was used initially to soften the fat, and then Power Assisted liposuction was used. Initial fat undermining was performed with a Becker cannula not attached to suction to loosen the fat. A Becker cannula has small “fins” a the tip to help break up the fat.

Then liposuction was performed. At the end of the procedure, fat equalization was performed by again using the Becker cannula to smooth and redistribute the remaining fat. At 2 months, he still has some swelling that will continue to improve over the next 6 months. The liposuction access incisions in the upper chest are at their reddest and most noticeable at 6 weeks after surgery and then will fade and improve over the next 24 months.

Gynecomastia Gallery

Jonathan D. Hall, MD, FACS

Gynecomastia Patient #39

Gynecomastia Patient #39

Gynecomastia Patient 38

Gynecomastia Patient 38

Gynecomastia Patient 37

Gynecomastia Patient 37

Gynecomastia #37

Gynecomastia #37

Gynecomastia Patient 36

Gynecomastia Patient 36

Gynecomastia – Patient 165

Gynecomastia – Patient 165

Gynecomastia – Patient 164

Gynecomastia – Patient 164

Gynecomastia – Patient 163

Gynecomastia – Patient 163

Gynecomastia – Patient 162

Gynecomastia – Patient 162

Gynecomastia – Patient 161

Gynecomastia – Patient 161

Jonathan D. Hall, MD, FACS

Cosmetic & Plastic Surgery Specialist

Gynecomastia Gallery

Jonathan D. Hall, MD, FACS

Gynecomastia Patient #39

Gynecomastia Patient #39

Gynecomastia Patient 38

Gynecomastia Patient 38

Gynecomastia Patient 37

Gynecomastia Patient 37

Gynecomastia #37

Gynecomastia #37

Gynecomastia Patient 36

Gynecomastia Patient 36

Gynecomastia – Patient 165

Gynecomastia – Patient 165

Gynecomastia – Patient 164

Gynecomastia – Patient 164

Gynecomastia – Patient 163

Gynecomastia – Patient 163

Gynecomastia – Patient 162

Gynecomastia – Patient 162

Gynecomastia – Patient 161

Gynecomastia – Patient 161

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Jonathan D. Hall, MD, FACS

Cosmetic & Plastic Surgery Specialist