Can you reduce male breasts with tumescent liposuction?

Excessive fat around male breasts can be unattractive and many men decide to tackle the issue using liposuction. The aim is to improve appearance by taking away as much fat as possible, without damaging the skin or muscles.

The breasts are one of the four most commonly treated areas on men, the others being the flanks, the abdomen and the cheeks, chin and jowls area.

Men who have a lot of fat on their breasts can achieve a dramatic improvement in the appearance of their physique through the use of liposuction.

How much fat is there in the normal male breast?

A normal and healthy male breast will consist of both fatty tissue and a more fibrous glandular tissue. The fatty tissue is far easier to remove using liposuction, so the results of the treatment will depend to a large extent on how much fat is on the breasts compared to this glandular tissue.
This can be quite difficult to assess in advance of treatment, and may involve an X-ray of the chest, a mammogram.

What is pseudo-gynecomastia?

A male breast abnormally enlarged because of an accumulation of fatty tissue is called pseudo-gynecomastia. This condition involves a normal amount of glandular breast tissue – it is only the fatty tissue which has become an issue.

Usually, men who have unusually large breasts will find that this is caused by excessive fat. It is common for this to develop to a slight extent as men age, but fatty breasts can be common even in younger men if they become obese.

What is true gynecomastia?

True gynecomastia is where a man’s breasts become enlarged because of excessive glandular breast tissue, and is relatively uncommon.

True gynecomastia can be caused by various factors, including alcoholism, the testicles not producing enough sufficient testosterone, or  many medications.

Bilateral gynecomastia has also been associated with HIV (human immunodeficiency virus), infections, cancers such as testicular cancer, and adrenal corticosteroid secreting tumours as well as renal failure treated with hemodialysis.
If only one breast is enlarged the patient may be advised to investigate the risk of a tumour. A mammogram should be considered only with recent asymmetric growth to one breast.

Can drugs cause gynecomastia?

Some drugs can cause gynecomastia. They include: amiloride (Moduretic), amiodarone (Cordarone), amphetamines, anabolic steroids, antiandrogens (cyproterone), anticancer (cytotoxic) drugs, androgens, busulfan (Myleran), captopril (Capoten), cimetidine (Tagamet), clomiphene (Clomid), diazepam (Valium), diethylpropion (Tenuate), digitalis, domperidone, estrogens, isoniazid, ketoconazole (Nizoral), marijuana, methyldopa, metoclopramide, nifedipine (Procardia), nitrosourea, penicillamine, phenothiazines, phenytoin (Dilantin), reserpine, spironolactone (Aldactone), tricyclic antidepressants, vincristine.

Is liposuction appropriate for all enlarged male breast?

Liposuction is a most effective treatment for pseudo-gynecomastia. With true gynecomastia it is difficult to remove the dense and fibrous breast tissue with a liposuction cannula.

Most healthy, normal men will have a large amount of fatty tissue and less glandular tissue. Both can be removed from a healthy and normal male breast using microcannulas.

Those with especially dense glandular breast tissue may need this surgically removed with a scalpel, which will require sutures to close the stitches.

What’s the best surgical technique for male breast liposuction?

While liposuction of the male breast has become a widely recognised procedure there is as yet no standardised technique or agreement on instrumentation.

In our experience, however, the use of the smallest microcannulae for liposuction of male breast glandular tissue will deliver the best and most consistent results.

The use of larger cannulae up to 4mm is preferred by some but we believe the microcannulae with inside diameter ranging from 1.2mm to 1.8mm, and sometimes up to 2.2mm will achieve the best results.

We do not share the preference of some surgeons for the process of excision of male breast tissue with a scalpel. This process is plagued by a high incidence of scarring and disfigurement.

Do you carry out tumescent liposuction by local anaesthesia?

Local anaesthesia is all that is needed for tumescent liposuction of the male breast. This involves a simple and painless injection into the area of the skin over the breasts. We then make multiple 1.5mm adits (holes) using a biopsy punch. We then inject a large amount of tumescent local anaesthesia into the breasts. This helps to reduce the resistance of glandular breast tissue to penetration by a microcannula.