Breast Reduction for Males (Gynecomastia) in Miami

Miami Male Breast Reduction Surgery (Gynecomastia) It is important to choose a talented surgeon who specializes in male breast reduction surgery as the condition can be caused by a complex combination of factors. Dr. Tal Roudner in Miami, has a great deal of knowledge in this particular type of surgical procedure. He understands that men with male breast enlargement often feel upset and embarrassed by the condition, and he will work with you to help you become more comfortable in your own skin.

Gynecomastia is a Greek term used to describe the abnormal enlargement of the male’s breast (“man boobs”). It is commonly treated with a male breast reduction procedure. According to the American Society of Plastic Surgeons in their cosmetic national data bank statistic reports of 2014, breast reduction in men (gynecomastia surgery) was performed in 26,175 patients that year. That is a 14% increase in male breast reduction procedures compared to the year 2013 and a 29% increase compared to the year 2000.

Dr. Roudner’s surgical goal is to remove the excess glandular and soft fatty breast tissue and contour the breast to a natural aesthetic male breast appearance while minimizing visible scars.

Dr. Roudner may perform a series of different procedures while reducing the breast tissue such as: suction assisted lipectomy (SAL), ultrasonic assisted lipectomy (UAL), direct glandular excision (reduction mammaplasty/mastectomy), removing and repositioning the skin and soft tissue as well as repositioning the areola and nipple, or a combination of these surgical techniques.

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Miami Male Breast Reduction (Gynecomastia) Before & After Photo Gallery

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Breast Reduction for Men (Gynecomastia) Surgery Overview

Gynecomastia is a condition that may occur physiologically in neonates due to circulating maternal hormones, in adolescence due to imbalance of sex hormones or tissue responsiveness to the hormones that occurs during puberty, and in the elderly due to reduction in testosterone levels. The causes for those hormonal changes are varied and each case must be assessed individually.

The condition is often a source of distress especially in adolescent boys, although the majority of the cases that are caused by developed glandular breast tissue resolve within a couple of years. Up to 10% of the cases are caused by medications such as: spironolactone, digoxin, furosemide and many more. The use of illegal drugs such as anabolic steroids and marijuana has been also implicated in the cause of male breast enlargement.

When the male breast enlargement is caused by excess glandular breast tissue, chest adipose tissue (fat) and skin it is termed gynecomastia. When the prominence is mainly due to adipose tissue it is referred to as pseudo-gynecomastia. The male breast hypertrophy should also be distinguished from pure pectoralis muscle hypertrophy caused by exercise.

Enlarged Nipple Areolar Complex (NAC) is among one of the most common forms of gynecomastia. The glandular breast tissue hypertrophy is concentrated under and confined to the nipple areolar complex, or maybe slightly protruding outside the NAC forming a dome shaped NAC.

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Miami Male Breast Reduction Gynecomastia Before & After Photo

Your Male Breast Reduction Consultation

When you call our Miami office, you will be scheduled for a consultation with Dr. Roudner. At your initial consultation, Dr. Roudner will perform an examination, discuss your current health as well as your health history, and review the medications you are currently taking and have taken in the past.

Because male breast enlargement is often caused by hormonal imbalance, Dr. Roudner will also order blood work and possibly a hormonal work-up. Dr. Roudner will also take photos for your file.

Male Breast Reduction (Gynecomastia) Surgery Consultation in Miami FL

It’s important to be honest with Dr. Roudner about your goals and expectations surrounding this surgery. We want to make sure you understand what male breast reduction surgery can do for you and what to expect following your surgery. Once you and Dr. Roudner agree that male breast reduction is the right choice to treat your condition, your pre-operative appointment date and surgery date will be scheduled.
At your pre-operative appointment, which will take place about two weeks before your surgery, Dr. Roudner will review your blood work with you as well as the results of any consultations. Once you are approved for surgery, Dr. Roudner will give you your pre-operative instructions. You may be asked to reduce or to avoid certain medications, supplements and foods as they can increase your risk for bleeding during surgery.

For more information on male breast reduction or to talk with Dr. Tal Roudner, contact our Miami office for your consultation.


Prepping for Male Breast Reduction (Gynecomastia) Surgery in our Miami office:

Male Breast Reduction (Gynecomastia) Surgery Miami FL

Patients undergoing the male breast reduction procedure are seen in our Miami office at the time of consultation and two weeks prior to surgery for pre-op. At the pre-operative appointment, necessary blood work (in some cases hormonal work up) and other test are performed, consents are reviewed and signed and medical clearance is obtained as necessary. In some cases a medical clearance from an endocrinologist (hormone doctor) is required. Pre-op photos are taken. Patients that smoke are required to stop smoking 4 weeks before the procedure and for 3 weeks after the surgery. It is important to inform Dr. Roudner if you smoke at the initial consultation.

Some prescription medications, non-prescription medications as well as anabolic steroids and marijuana may cause enlargement of the male breast and should be stopped after consultation with their primary care physician to see if a reduction in the breast size followes prior to surgery.

Medications (aspirin, ibuprofen, etc) supplements and herbs can cause bleeding problems during the surgery and post surgery. Therefore a list of any medication, supplements or herbs that should not be taken a few weeks before the procedure is given at the time of the consultation.

Prior to surgery it is important to eat a healthy diet and avoid drinking alcohol a few days prior to the procedure. Exercise and being in good shape prior to surgery is generally good for the patient’s overall health and a speedy recovery; however, day prior to the breast augmentation procedure patient’s should avoid strenuous exercise.

Patient’s should not eat or drink anything, including water, after midnight the night before surgery. The patient’s should shower the night prior to the surgery and wash the surgical site with antimicrobial soap. After the shower the patient’s should avoid wearing any products such as: oils, creams, makeup, moisturizers, or lotions — including deodorant.

The morning of the surgery the patient’s may brush their teeth, but should not swallow more than a sip of water. If instructed by the primer care physician, patient’s may take any needed prescribed medication with sipping a minimal amount of water.

On the day of surgery the patient should wear loose-fitting clothes that open in the front and comfortable flat shoes that are easy to put on.

Arrangements for transportation of the patient to and from our Miami office as well as a someone to stay with the patient for the first 24 hours after surgery should be made in advance.

Care for small children, should be arranged prior to the surgery as well as preparation of extra food and drinks. Responsibilities at home and at work should be taken care of prior to surgery in order to have worry-free and relaxing recovery.

Prescription medications maybe filled at the time of surgery by the person accompanying the patient to surgery or a in advance prior to the day of surgery.


What you should expect from Male Breast Reduction (Gynecomastia):

Prior to undergoing male breast reduction surgery a consultation with Dr. Roudner will be scheduled at our Miami surgical center. At the consultation a detailed review of the past and current medical history and a physical exam that will focus on the breast. A discussion with Dr. Roudner regarding the concerns, goals and expectations of the gynecomastia procedure will take place. At the time of the consultation the Dr. will analyze the breast and will recommend the appropriate procedures to be performed to accomplish the goals desired. At the time of the exam a testicular exam will be performed as well to rule out testicular cancer as the cause of the breast enlargement. The consultation will include a detailed discussion regarding the risks, benefits and complications associated with the breast reduction procedure and will answer any questions regarding the procedure. The highlights of the pre and post operative instructions will be reviewed to ensure proper preparation prior to the procedure and a safe and speedy recovery after the surgery.

The practice coordinator will be seen and review information regarding medications and herbal supplements to avoid as well as medical clearances to be obtained if needed prior to surgery. Surgery scheduling as well as pricing will be available to review. If desired, before & after male breast reduction surgery pictures will be made available.

At the pre-operative appointment the procedure will be reviewed once again any remaining questions will be answered pictures will be taken. The informed consent forms and post-operative instructions will be given to read carefully and sign at that time as well as copies to review at home prior to surgery. If required medical clearances will be obtained prior to the surgery.

Anesthesia used during Male Breast Reduction (Gynecomastia):

Dr. Roudner performs breast reductions for male patients while the patient is under general anesthesia. In select cases were the reduction is small twilight sedation with local anesthesia maybe used.

Length of time for Male Breast Reduction (Gynecomastia) Surgery:

The length of male breast reduction surgery depends on the extent of the amount of breast tissue to be removed, the approach to the reduction procedure and the need for ancillary procedures such as liposuction. On average the length of the procedure may vary from 30 minutes to about 2 hours.

Male Breast Reduction (Gynecomastia) – Post-Surgery:

It is crucial to follow the post-operative instructions as given prior to surgery and during follow up appointments. The period after surgery should be for rest and recovery. Avoiding excessive forces and motion as well as abrading the surgical incisions will optimize the ability of the incisions to heal and minimize the chances of wound break down resulting in unsightly scaring. In cases were drains are placed it is imperative to empty the drains as instructed and record the amount of fluid drained as well as keep the tubing clear from blood clots. If liposuction is performed a compression garment will be worn as instructed. If any concerns arise during the recovery period Dr. Roudner’s should be informed.

Recovery time from Male Breast Reduction (Gynecomastia) Surgery:

After the male breast reduction surgery, in our Miami surgical center, it will be required to take a week off for rest. If drains are placed they will be removed once the drainage output will be less then 30cc over 24 hours period (most commonly 3 to 7 days). While it may take a few weeks for initial recovery and six weeks to return to full normal activity, it takes six months to a year for the swelling to subside, the skin to contract and for the breast to shape into their final results.

Additional info regarding Male Breast Reduction (Gynecomastia) Surgery:

Prior to having male breast reduction surgery, Dr. Roudner will review some of the common risks, benefits, and complications associated with gynecomastia male breast reduction surgery. Its is important for each individual considering male breast reduction surgery to define their goals for the breast surgery prior to the procedure and weigh the benefits against the risks and potential complications of male breast reductions surgery.

Any patient undergoing male breast reductions surgery at our Miami office will be required to sign consent forms to ensure that they fully understand any risks or potential complications that may results from the surgery.

General surgical risks include: bleeding, infection, seroma, unsightly scars, wound healing complications, blood clots, anesthesia risks, skin pigmentation changes, injury to deep structures (blood vessels, nerves, muscles etc.) temporary or permanent, cardiac and pulmonary complications, pain, allergic reactions. Some of the risks that are specifically related to male breast reduction surgery are breast contour and shape irregularities, changes in nipple and breast sensation, breast asymmetry, fat and deep tissue necrosis, contour irregularities/deformities rippling and loose skin( when male breast liposuction is used), nipple lose (extremely rare) and need for revision surgery.


Techniques used for Male Breast Reduction (Gynecomastia) Surgery

There are many techniques used in male breast reduction surgery also know as gynecomastia surgery or reduction mammaplasty. The goal of all techniques are to reduce the breast size, flatten the chest and enhance the chest shape and contour.


In minor cases of male breast enlargement due to excess fatty tissue with out enlargement of the glandular breast tissue, also known as pseudogynecomastia, use of suction assisted lipectomy (liposuction) may be sufficient to treat the condition.

Direct Excision – Partial Mastectomy

If glandular breast tissue enlargement is present a partial mastectomy (removal of glandular breast tissue) using a peri-areolar incision maybe needed to remove the fibrous breast tissue. Other methods are described using Ultrasonic liposuction combination or other suction assisted devices but in my experience the best results when dealing with glandular breast tissue direct excision gives the mos aesthetic results.

Moderate cases were both glandular and fatty tissues are present require a combination of direct excision (partial mastectomy) as well as feathering suction assisted lipectomy (liposuction).

Liposuction – Direct Glandular Excision – Skin Excision

In severe cases of gynecomastia, in addition to the excess of glandular breast tissue as well as excess fatty tissue there is excess sagging skin as well as possible enlargement of the nipple areolar complex. These cases require excision of the excess sagging skin, reduction and repositioning of the nipple areolar complex as well as removal of the breast glandular tissue and fatty tissues as described above. In these case scaring can be unsightly and should be taken into consideration prior to surgery.

Reasons for Male Breast Reduction (Gynecomastia) Surgery

The main reasons to undergo gynecomastia surgery is to remove the excess glandular and soft fatty breast tissue and contour the breast to a natural aesthetic male breast appearance while minimizing visible scars. Improve self- esteem and confidence and encourage participating in social activities that have been avoided due to embarrassment.

What can Male Breast Reduction (Gynecomastia) do for me?

Gynecomastia surgery can reduce enlarged breast size, flatten the chest and enhance the chest shape and contour. Many patients experience an improved self-esteem and confidence allowing them to participate in many activities they have never felt comfortable participating before.

What anesthesia do you recommend?

Anesthesia provided during the procedure to provide comfort may include intravenous sedation with local anesthetic or general anesthesia. The surgeon and anesthetist will recommend the best choice for you.

Who is a good candidate for surgery?

Patients who are good candidates are the ones that are healthy to undergo elective surgery and have excess breast fat, glandular breast tissue that has been present since puberty. Patients that have developed gynecomastia after use of certain medications, marijuana and anabolic steroids. Men after bariatric surgery with excess glandular tissue and sagging skin.

How long will I need to recover from Male Breast Reduction (Gynecomastia)?

After surgery is complete dressings or bandages will be applied to the incisions, as well as a support garment to help minimize swelling, improve skin retraction and help contour the chest . A drain will be placed until the drainage decreases to eliminate excess blood and fluid that may collect. External stitch’s will be removed at 10 days. You will need a week of rest right after surgery. At 4 weeks gradual return to mild to moderate exercise and at 6 weeks you will resume normal activity.

Is the recovery process painful or discomforting?

Most patients experience pain and discomfort that is moderate to severe in the first 3 days to a week although some have minimal pain. As healing progresses and you become more active the pain will appear as you over exert yourself at that time you should stop the activity and rest. Some pain and discomfort is due to the drain and will improve once removed. By 6 weeks rarely do people complain of pain but may have some discomfort.

For more information on male breast reduction or to talk with Dr. Tal Roudner, contact our Miami office for your consultation.

Male Breast Reduction (Gynecomastia) Surgery Miami