Up to 70 percent of men experience gynecomastia at some point in their lives, often around puberty, yet most never talk about it. For the men it bothers, enlarged breast tissue can make fitted shirts, the gym, and the beach feel like something to avoid. If you are weighing gynecomastia surgery, what men should know before a consultation is mostly practical: what is causing the fullness, how it is removed, how long you will be out of commission, and what to bring to your first appointment.

Fat, Gland, or Both: The Question That Decides the Operation

Gynecomastia, also called male breast enlargement, can be made of stubborn fat, firm breast tissue, or a combination of both. That difference matters because the two respond to different techniques. Male breasts are not always caused by being overweight, so men who are otherwise at a healthy weight can still have them. During your physical exam at your consultation, Dr. DiFrancesco determines what your chest is made of, and that finding shapes the rest of your plan.

What Causes It, and When to Start With Your Doctor

Male breast development is often the result of a hormone imbalance. It can also be triggered by certain medications or recreational drugs, by some medical conditions, or by genetics. In some men, treating the underlying medical condition improves the gynecomastia without surgery, so it is worth reviewing your health history and medications with your doctor. Surgery is most helpful for men who have not seen improvement through lifestyle changes or medical treatment.

Two Techniques, Often Used Together

• Liposuction is often most effective when fullness comes from excess fat. Breast tissue itself is usually too fibrous for traditional liposuction, although power-assisted liposuction can sometimes help break it up.
• Surgical excision removes firm breast tissue through a small, well-hidden incision around each areola.

Many plans use one or both, depending on Dr. DiFrancesco’s assessment. You can read more about each approach on the gynecomastia surgery page, and if you are also thinking about fat elsewhere on your body, the liposuction for men page covers other areas.

In the Office, Not Always the Hospital

Depending on your plan, gynecomastia surgery can be performed under local anesthesia with light sedation at the practice’s Atlanta office. We keep incisions small and place them within the natural contours of the chest so they are easy to conceal. Once the tissue is removed, the incisions are closed, and you go home the same day with someone to drive you.

Your Calendar for the Six Weeks After

• The first few days. Expect swelling and some discomfort, managed by following Dr. DiFrancesco’s aftercare instructions. Most patients can shower the day after surgery.
• Week one to week two. Most men with office jobs go back to work after a week or two. Physically demanding jobs may need a few more weeks off.
• Through week six. Wear your compression garment for six weeks to help the skin adhere to its new contour. Avoid heavy lifting and strenuous physical activity for at least six weeks, avoid sleeping on your stomach or side for the first few weeks, and skip alcohol and smoking while you heal.
• Six months to a year. You may notice improvement within the first week, but swelling can hide the final contour at first. It usually takes six months to a year to see your full result. The gynecomastia before-and-after gallery shows healed results.

What to Bring to Your First Appointment

Come with a complete list of your medications and supplements, and be candid about any recreational drug use, since these can contribute to breast tissue growth and affect your plan. Bring questions about technique, incision placement, and how much time to request off work. Dr. DiFrancesco will assess your chest, review your history, and build a plan around your goals, then walk you through preparation, the procedure, and the recovery timeline.

Credentials Worth Checking Before Anyone Operates

Before you book any chest surgery, check who will be performing it. At DiFrancesco Plastic Surgery, that is Dr. Lisa DiFrancesco, the practice’s primary provider. She brings a rare combination in Atlanta: a female, double board-certified, fellowship-trained plastic surgeon recognized by her peers as a Castle Connolly Top Doctor, who served as a physician for the PGA Championship Tour and has appeared as a plastic surgery correspondent on Fox, CBS, and NBC. Her full-service practice treats men’s concerns as seriously as any other, with a plan built for each patient. Learn more about her training and experience or the other procedures for men she offers.

Straight Answers for Men on the Fence

Can gynecomastia go away without surgery?

Sometimes. If an underlying medical condition is causing it, treating that condition may improve the gynecomastia.

Will I lose weight from the surgery?

No, gynecomastia surgery isn’t a weight-loss procedure, but it can make your chest look more fit and toned.

How long do I wear the compression garment?

Dr. DiFrancesco asks patients to wear the compression garment for six weeks after surgery.

When will I see my final result?

Swelling and bruising can hide your result at first. It usually takes six months to a year for the full result to show.

Book the Exam That Settles Fat Versus Gland

The fastest way to know which technique you need, and how much time off to plan, is a single exam. Consultations are private and straightforward. Fill out the consultation form or phone the practice to talk with Dr. DiFrancesco’s team.

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