Gynecomastia Surgery BEFORE & AFTERS | Patient 22068

Patient Details

This young man developed gynecomastia after using various inputs when he was younger. Unlike the more common patient whose condition begins during puberty and persists into adulthood, he did not have puberty-related gynecomastia. His story represents what I believe is an increasingly important category of modern gynecomastia: input-associated or drug-induced gynecomastia.

Today, men are exposed to an expanding list of hormones, prohormones, performance and fitness supplements, longevity medications, lifestyle medications, and other substances that can potentially alter the balance between estrogen and testosterone or affect breast tissue through other hormonal pathways. In a susceptible male, these inputs can stimulate the development of gynecomastia. Once a clinically established gynecomastia mass has developed, simply discontinuing the offending input should not be expected to reliably eliminate the existing tissue.

In my experience, these input-associated cases frequently contain a substantial amount of dense, firm breast tissue. At surgery, the tissue can be remarkably adherent to the surrounding structures and often has a different character than the tissue encountered in the typical patient with longstanding puberty-related gynecomastia. Their clinical presentation can also be somewhat different, and I believe this will become an increasingly recognized subgroup of gynecomastia patients as the use of these substances continues to expand.

What is particularly impressive about this patient is that these photographs were taken less than 24 hours after surgery. You can already appreciate the immediate change in his chest shape, minimal bruising, and a smooth, natural, gynecomastia-free contour. While he was in my office, you could actually watch him absorbing what his new chest looked like. After living with gynecomastia for approximately 10 years, he was elated.

One of the remarkable aspects of modern gynecomastia surgery as performed at the Austin Gynecomastia Center is that the transformation is immediate. The gynecomastia tissue is gone and the new chest contour is apparent from the beginning. But the immediate result is not the final result. The chest continues to evolve over the ensuing months as swelling resolves, the skin retracts and redistributes, and the tissues soften and mature.

Achieving the optimal final result is also a partnership between surgeon and patient. Surgery creates the new anatomy; recovery allows that anatomy to heal properly. Patient adherence to our postoperative regimen is therefore an essential part of treatment. That recovery protocol has been continually refined through decades of gynecomastia surgery at the AGC outpatient surgical facility in Austin, Texas.

For this young man, the physical change occurred in less than an hour. After carrying the condition for nearly a decade, the psychological change was just as apparent.