Gynecomastia, or enlarged male breasts, is typically thought of as a cosmetic issue. That is, having breasts that are feminine in appearance – an understandably distressing, embarrassing and even anxiety producing situation – is not otherwise associated with any physical symptoms such as neck and back pain. Yes, they may inhibit the person from engaging in certain sports or activities such as swimming but this is only due to embarrassment related to appearance rather than as a result of pain and discomfort.
Most men affected by gynecomastia fall into this category. Their breasts are enlarged to some degree but are not gigantic. They often are associated with emotional pain but rarely with physical discomfort.
There is a relatively small percentage of men who have such large and pendulous breasts that they cause a variety of physical symptoms just like those in women with very large breasts. These can include neck, back and shoulder pain, rashes, foul odors and skin breakdown. Though there are a few causes of this massive breast enlargement in men, most often it is seen in those who are or were morbidly obese.
Treatment of this massive gynecomastia can only be realized by surgery. There isn’t any non-operative approach which will permanently and definitively treat this. The surgery, which is more precisely a mastectomy rather than just a breast reduction, involves the removal of the excess offending tissue – skin, fat and glandular (when present) tissue.
The following patient of mine is a good example of this massive gynecomastia and subsequent treatment:
This gentleman, in his seventies, had lost close to one hundred pounds as a result of a gastric sleeve procedure. He was left with enlarged breasts that were causing severe back pain in addition to rashes that required active treatment and pain medication (photos A, C and E) and limited his level of activity. After reviewing his options, thoroughly discussing surgery including risks, complications and expectations, he elected to proceed with surgery. This consisted of a mastectomy (breast reduction) with his nipples removed and reattached as skin grafts (free nipple grafts or FNG) with the only incisions being located in the crease at the bottom of his breasts and around the new site of his nipple-areola complexes. Over five and a half pounds of tissue were removed (photos B, D and F).
He was extremely happy with the outcome and very appreciative of the overall results including full alleviation of his symptoms.
For more information on gynecomastia and its treatment or breast reduction in general or to schedule a consultation, please contact my office at (480) 451-3000.
Steven H. Turkeltaub, M.D. P.C.
Scottsdale and Phoenix, Arizona