Advanced Gynecomastia: Understanding Your OptionsAustin Gynecomastia Center

This is a powerful case of advanced gynecomastia—and an example of how treatment decisions are often more about personal priorities than surgical perfection.

Why do I call this advanced? Because this patient is approaching 60, and his skin quality is significantly diminished. As we age or experience major weight changes, our skin loses elasticity—it no longer “snaps back” the way it did in youth. This matters in gynecomastia surgery: the better the skin quality, the smoother and more predictable the result. So what do we do when the skin is marginal?

There are two treatment paths:

1. Surgical skin removal, which leaves large, permanent scars across the chest and around the areolas.
2. My minimal incision technique, which removes the gland and fat through small, hidden incisions and lets the skin retract on its own.

What Do Most Men Choose?

I know men. I know how they think. For many of my patients, avoiding visible chest scars is more important than achieving a textbook-perfect chest. They tell me they’d rather have a flatter, masculine chest with some natural creases or asymmetries than wear lifelong scars from skin removal.

If your goal is to look great in a shirt—and feel confident shirtless—then the scarless approach is usually the better option. And yes, I always share what I would choose if I were in their shoes. That guidance means a lot.

Shared Decision-Making Is Key

Every patient is different. That’s why I take the time to understand:

• What results are important to you?
• How do you feel about visible scars?
• Are you committed to following post-op care to get the best possible skin retraction?

This Patient’s Result

This patient chose the minimal incision approach. His result?
Not perfect. Some creases and asymmetries remain.
But he’s thrilled. He confidently takes his shirt off, feels lighter, and reports a significant boost in confidence. That, to me, is success.

He wanted to share his story so that others facing advanced gynecomastia can make an informed, realistic, and personal choice.