My gynecomastia is pretty bad: it almost looks like I have female breasts. What do you do for that?
In almost all situations, it is also treated with removal of the gland through an incision around the areola and with liposuction. Even with fairly extreme cases of gynecomastia, the skin shows a powerful ability to contract. But there are some extraordinary cases in which skin does need to be removed essentially doing a breast lift. When a patient has a lot of laxity and I am concerned that this is a possibility, I will discuss it ahead of time. But because the extent of skin contraction is so great, I typically do not do a skin excision at the same time as the removal of the gynecomastia. I will do an excision of the gynecomastia with liposuction, place a drain, have the patient wear good compression, and then come back and reassess, only doing the lift later, which is rarely necessary. Breast lift scars on a man can be very unsightly, and are often more cosmetically debilitating than a bit of skin laxity, so we try to avoid breast lift scars on a man at all costs.
