Gynecomastia removal

A distinction must be made between "true" gynecomastia caused by an increase in glandular tissue and "false" gynecomastia: While "true" gynecomastia consists of enlarged mammary gland tissue, "false" gynecomastia is mainly composed of increased fatty tissue (lipomastia or adipomastia).

We recognize "false" gynecomastia most frequently, as there is usually also increased fatty tissue (excess weight) in other parts of the body at the same time. These breast changes are often perceived as embarrassing by the men affected and can consequently lead to a considerable loss of self-confidence, which is why patients want to have their breasts removed.

Hormonal dysregulation is one of the most common causes of gynecomastia, which can occur particularly during puberty. As soon as these return to normal, gynecomastia can usually be reversed, but not in every case. Additional factors can activate breast growth, which is why male breast causes also include the intake of female hormones (e.g., through beer consumption, meat, etc.), the natural drop in testosterone levels with increasing age, the intake of anabolic steroids or hair loss medication and, of course, genes. Being overweight also increases the appearance of breasts, but is not in itself the cause. Men's breasts can be found in both slim and overweight men. It is typical that the shape cannot be changed – neither can the male breast be trained away nor can a man specifically lose weight on the male breast through dieting.

Men's breasts can look completely different.

For most affected men, "man boobs" are a huge psychological burden, as there is no way to conceal or hide them. There is little information available on how those affected can get rid of man boobs. As a result, many men suffer in silence and, for example, put on weight so that their breasts don't look so big (if the stomach is also big, the overall appearance looks more harmonious). Men often put on oversized t-shirts to make their breasts less noticeable. Swimming pools, beaches or saunas are generally avoided as the discomfort is enormous. This problem is usually not taken seriously by family doctors.

Findings & diagnosis

As a rule, men are bothered by the feminine appearance of their breasts: This can take the form of a pointed areola, a massive accumulation of fat or sagging breasts (ptosis). Often, all three problems exist at the same time.

Depending on its severity, gynecomastia is divided into different stages. In principle, these have more of a scientific meaning, but in practice they have an influence on the cost of treatment. An increasing stage describes the change in nipple position compared to the lower growth line of the breast. With each higher stage, the "drooping" and the volume increase.

The experienced, palpating hand of the doctor is actually sufficient for the diagnosis. The palpation findings alone give an indication of how much fat and how many glands the breast is made up of.

Of course, further diagnostics such as ultrasound or MRI X-rays can be used to clarify the breast in detail.

At the LIPOCLINIC, no further diagnostic measures are required for the treatment of gynecomastia apart from the palpation findings, as we always remove not only the fat but also the gland completely. We correct male breasts primarily for aesthetic reasons, which is why the aim is always to achieve the flattest possible end result.

Men want a very masculine breast, i.e. a rather angular breast with an areola that lies as flat as possible on the pectoral muscle. This result can only be achieved by completely removing the excess breast fat as well as the gland.

Treating gynecomastia

Depending on the findings and your wishes, in rare cases only a gland removal is required, but usually a combination with liposuction and, depending on the skin quality, additional tightening procedures with special cannulas (tightening cannulas or heat/RENUVION). Each treatment must be carried out at the appropriate stage so that the result is as perfect as possible.

In almost all cases, the treatment of gynecomastia is very simple and straightforward: we perform the procedure on an outpatient basis, under local anesthesia without anesthesia (completely painless with additional twilight sleep) and without special aftercare. You can return to work the next day or the day after the procedure at the latest.

The first step is to suction out the excess fat. This is a procedure in which the excess fat is removed from the breast using a cannula and vacuum. However, this only removes the fat, the gland remains untouched. For a masculine-looking breast, it is important that the nipple lies as flat as possible on the muscle, which is why the gland must be completely removed by making a millimeter incision in the nipple. This technique from South America was modified by Dr. Linde so that it is minimally traumatic and leaves no visible scars. Dr. Linde named this technique "minimally invasive glandular excision", or MIGE for short. In contrast to the conventional method performed in many hospitals, there is no need for the ugly semi-circular incision around the nipple with scars that remain visible forever. With the MIGE technique, there are no gynecomastia scars, which is why it is so popular with men.

Incidentally, after gynecomastia surgery using the MIGE technique, gynecomastia never returns because the gland is completely removed.

Depending on the stage – i.e., sagging of the tissue and size of the male breast – it may be necessary to additionally tighten the skin to achieve a good result. Otherwise, a breast looks like a balloon that has been deflated.

There are two methods for optimal tightening: On the one hand, special tightening cannulas can be used, the design of which irritates the connective tissue fibers of the skin so much that they contract very well. However, maximum tightening of the skin can only be achieved using heat, this treatment is also known as J-Plasma or RENUVION.

Plasma energy heats the connective tissue fibers under the skin to approx. 60-80°C, causing them to contract "like a steak on the grill". The simultaneous release of helium gas cools the surrounding tissue so that it is protected from the heat and therefore not damaged. The tightening effect is so strong that a large part of the result can often be seen and felt immediately after the RENUVION treatment. Renuvion is very complex in terms of equipment (expensive disposable handpiece), which explains the price.

Procedure of the treatment

Liposuction, the MIGE technique and the use of tightening cannulas or Renuvion can be performed under local anesthesia (i.e. no anesthesia or partial anesthesia) and as an outpatient procedure. The treatment is completely painless and is performed under sedation. The entire stay with us takes about 3 hours, including explanation of the procedure, filling of the breast with local anesthesia, surgery, dressing and discussion of the aftercare. You can go home immediately after the procedure and return to work the next day.

Aftercare consists of a bandage for 24 hours and, depending on the findings, an adhesive plaster for 7-10 days. No other measures are necessary and you can usually return to sport after just a few days. Significant "after-effects" such as pain after the procedure are rare.

The result is long-lasting and can be seen immediately after the procedure. The skin tightens immediately and leads to an excellent aesthetic result. The stitches are removed from the nipple after approx. 10 days and a further follow-up check is recommended after 3-6 months.

Methods & costs of male breast removal

Enlarged mammary gland only

In some cases, the problem of gynecomastia is simply an enlarged gland without fatty tissue. This is often the case in young men where genetics, hair growth products or anabolic steroids have led to gynecomastia. In such cases, it is sufficient to remove only the gland using the MIGE technique.

Costs: CHF 2500.00

The normal case: fat and gland

The main finding is actually always a combination of fatty tissue and (enlarged) gland. In such cases, the fat must be removed by liposuction as well as the gland.
In the case of soft, sagging skin, an additional tightening procedure should be used even if there is no significant "sagging" of the skin.

Costs: CHF 4000.00-CHF 6500.00 (Renuvion)

Fat, gland and "sagging skin": Ptosis

If the breast is sagging, an additional procedure must always be used to tighten the skin: Either using special tightening cannulas or heat (Renuvion).

Costs: CHF 5000.00-CHF 6500.00 (Renuvion)

Follow-up treatment

Since the MIGE technique in combination with tightening cannulas or heat (Renuvion) virtually initiates an internal compression, no special measures are required after the procedure. It is only important from stage II that the breast is fixed upwards with adhesive strips. This causes the skin to stick a few centimetres higher, which leads to a perfect position of the nipples. Further compression devices are not necessary, but may of course be applied if desired.

After 10 days, the stitches are removed from the nipples and the breast is briefly checked. Further checks are then advisable after 4-6 months.