Gynecomastia surgery results should not just look “flat.” First and foremost, great surgeons know the importance of eliminating all the surgical stigmata—i.e., nipple collapse, visible scars, and asymmetry—paving way for the most natural-looking appearance of the male chest.


The surgery is reserved for men whose overdeveloped chest is caused by the excess glandular tissue, which will not come out of liposuction cannula alone. Hence, it requires an excision-based surgery to flatten out the chest appearance.


But the caveat with the excision-based approach is the risk of visible scar, which can put off men who tend to be secretive about their plastic surgery, says leading Los Angeles plastic surgeon Dr. Tarick Smiley.


In order to achieve high patient satisfaction rate, Dr. Smiley highlights the importance of hiding the scar, which is done by placing it precisely at the lower border of the areola whose texture and color makes it perfect for concealing the incision site.


Meanwhile, the pictures below show a male patient who underwent gynecomastia surgery about two months ago. It should be noted that he has spent years exercising and eating healthy, which resulted in his great physique, except his chest that remained “full” and with its nipple pointing downward.

gynecomastia surgery results

Just two months after this patient’s gynecomastia surgery and the scar has already healed nicely.


Due to the discordant appearance between his chest and the rest of his body, he was deemed as a good candidate for gynecomastia surgery. Furthermore, his well-tested commitment to healthy lifestyle would be the key to the preservation of his results.


It should be noted that gynecomastia surgery results are almost always expected to be permanent, although large weight gain and the use of anabolic steroids or certain drugs and supplements may affect or even reverse the surgery.


During surgery, Dr. Smiley was able to remove a large chunk of excess glandular tissue, which he first separated carefully from the overlying skin. Nonetheless, he left behind enough tissue to achieve a smooth chest contour.


The surgery demands precise tissue excision because over-aggressive removal can lead to nipple collapse and contour irregularities. After all, men in general are reticent about their plastic surgery and so all efforts are made to eliminate telltale signs.


Before and After Photos.

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Gynecomastia surgery and liposuction can be a powerful body contouring surgery in men with breast enlargement (colloquially called as man boobs or moobs) and unsightly fat rolls especially along their flanks, says leading Beverly Hills plastic surgeon Dr. Tarick Smiley.


Gynecomastia surgery (i.e., the standard technique) creates an incision below the areola’s border so the resulting scar blends well into the dark-light skin junction. This allows the surgeon to remove the excess breast tissue that is causing the herniated-looking or “puffy” nipple area.


gynecomastia surgery and liposuction

Liposuction, meanwhile, uses a few round incisions (usually less than ¾ cm) to remove the excess fat causing the appearance of “love handles” and other unsightly bulges. Despite being a powerful tool in body contouring surgery, Dr. Smiley warns that it is only reserved for healthy, normal weight patients who are committed to maintain a stable weight through superb diet and regular exercise.


“The caveat of liposuction is that we only remove the excess superficial fat right beneath the skin and not the deeper visceral fat linked to obesity. This stubborn fat rolls are mostly determined by genetics and so despite impeccable lifestyle that involves rigorous exercise some men simply can’t show good muscle definition. Hence, for these individuals liposuction could be a good option,” he says.


While gynecomastia surgery can be performed as a stand-alone procedure, a simultaneous liposuction could deliver smoother, more proportionate results.


“The goal is to create a more masculine torso by removing the appearance of love handles. We don’t want the waist line to deviate from the athletic-looking chest contour,” explains the celebrity plastic surgeon.


Gynecomastia surgery and liposuction generally entails a two-week off to allow most of the swelling and bruising to subside, although some patients may return to work/school within a week provided that they avoid heavy lifting, strenuous exercise, or anything that can raise their blood pressure and heart rate.


A good rule of thumb is to avoid over-exertion for at least three weeks and then after this period the patients may gradually resume their exercise provided their doctors give them permission.

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While you may be pretty much aware of what to expect in your gynecomastia surgery recovery—e.g., postop swelling and bruising, mild to moderate pain, and tenderness—some things may take you by surprise.


Experts at the California Surgical Institute have explained the things to watch out for. It is important to note that while serious complications are very rare (provided that the surgery is performed by a board-certified plastic surgeon), they do happen. The key to prevent them from causing more problems is to identify them early on.


gynecomastia surgery recovery

  • Constipation


While not commonly talk about, constipation is actually not uncommon after any type of surgery. There are many factors that contribute to this, although it is more closely linked to the use of narcotics pain meds; for this reason, they are best avoided once the pain becomes more manageable.


Other ways to prevent constipation include drinking more fluids than usual, eating high fiber foods, (days leading up to the surgery and after), limiting certain foods (e.g., cheese and meat), and performing light exercise (short walks throughout the day).


  • Infection


While infections rarely occur, when they do happen they could lead to more problems such as poor scarring and sepsis, which can be life-threatening. Typical signs of infection include fever, increasing pain or swelling of the surgical site, warmth and redness, pus or drainage, and foul smell coming from the wound.


Antibiotics can treat most wound infections, although some patients may need surgery to treat this complication.


  • Persistent swelling


Persistent swelling can impede with healing or may even be a sign of infection. This might also be caused by seroma or collection of fluids under the skin surface.


Large seromas must be drained as the fluids may attract infection. Small seromas, meanwhile, often resolve on their own within a few weeks.


It is important to note that gynecomastia surgery recovery tips may differ from surgeon to surgeon, so any prudent patient should stick to his doctor’s specific advice.

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One of the ways to maintain gynecomastia surgery long-term effects is to keep a normal weight through proper diet and regular exercise. Nevertheless, a few patients may still experience tissue re-growth that could warrant a revision in which the previous incision sites are used again to avoid additional scars.

Gynecomastia surgery, or male breast reduction procedure, is only intended for normal weight individuals who understand the importance of healthy lifestyle to maintain its results. It is important to note that fad diets and “miracle” weight loss programs will not work long term because they generally require restrictive lifestyle (e.g., avoiding certain food groups, low calorie diet, and the likes).

gynecomastia surgery long-term effects

Photo credit: imagerymajestic at

A healthy lifestyle after surgery is not just for weight management. Another intended goal is to avoid medical conditions known to cause overdevelopment of male breasts.

Liver cirrhosis, kidney disorder, malnutrition, hyperthyroidism, hypogonadism, and tumors are known to cause gynecomastia, as suggested by Dr. Tarick Smaili, a leading Orange County plastic surgery expert.

Aside from a healthy lifestyle, another key variable to preserve the surgically enhanced chest is to avoid drugs link to abnormal enlargement of the male breasts.

  • anabolic steroids and androgens
  • anti-anxiety medications such as Valium
  • certain anti-depressants
  • some AIDS medications
  • anti-androgens or drugs used to treat prostate cancer
  • some drugs for heart problems
  • chemotherapy and other types of cancer treatments
  • ulcer medications
  • some antibiotics
  • certain herbal products, such as those containing lavender and tea tree oil

If the patient needs to take one of the aforementioned drugs, he may ask his doctor for possible alternatives. Also, it makes sense to avoid them before considering any plastic surgery to achieve more predictable, cosmetically appealing results.

Some “street” drugs can also cause abnormal enlargement of male breasts, such as marijuana, amphetamines or poor man’s cocaine, heroin, and alcohol.

In terms of scar appearance, after about a year it will mostly blend in with the skin, especially that most incision patterns are placed around the areola’s border and within the submammary fold. However, a prudent patient must avoid sun exposure for 6-12 months because the UV rays are known to cause hyperpigmentation in which the scars darken permanently.

Because some of the UV rays pass through the fabric fibers, some surgeons recommend sunscreen underneath the clothes to further minimize risk of permanently dark scars.

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Male breast reduction after weight loss involves unique challenges because of the severity of skin laxity and excess fibrous fats that result in a woman-like breast.

As with any plastic surgery after weight loss, male breast reduction entails having a stable weight for a minimum of six months to ensure that the patients can maintain the results through a healthy lifestyle that involves proper nutrition and regular exercise.

male breast reduction after weight loss

before-and-after photos

But for optimal results, some patients are required to wait for two years after the start of their extensive weight loss program. In doing so, they can accomplish several things such as:

  • Enough time to recover from malnutrition. Anemia and other forms of malnutrition are not uncommon after massive weight loss due to the changes made during bariatric surgery and/or significantly reduced caloric intake.

Vitamins and supplements, along with healthy lifestyle, can help these patients achieve their best health.

  • Improved contour. It is ideal to wait for the skin to shrink down to the best of its ability before male breast reduction or any form of plastic surgery after weight loss is attempted.
  • Enough time to adjust to their new lifestyle. Weight loss journey does not stop after reaching one’s weight goal; it requires a lifetime commitment to proper nutrition and regular exercise.

If the patients feel that they can commit to a healthy lifestyle, they may consider male breast reduction or any other body contouring surgery.

Male breast reduction after weight loss typically involves removing the excess skin and tissue and repositioning the nipple area. A good surgeon will make every effort to place the scar around the areola’s border and within the submammary fold, so the patient will not be uncomfortable joining activities that require him to go shirtless.

Contrary to popular belief, liposuction or fat removal surgery does not address “real” gynecomastia in which the enlargement is primarily caused by excess tissue and/or skin.

Liposuction of male chest can only improve the appearance of men with pseudo gynecomastia in which the underlying problem is the excess fat. Massive weight loss patients rarely benefit from this technique unless combined with an excision-based surgery.

It is not uncommon to combine liposuction and excision-based male breast reduction because the former is known to fine tune the results. However, it is important to maintain some fats to prevent sunken areola deformity and skin asymmetries.

The results of male breast reduction, with or without liposuction, are supposed to last a lifetime, assuming that the patient is able to maintain a healthy weight long term, as suggested by Orange County plastic surgery experts.

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Before you go under the knife to eliminate your “man boobs,” it is imperative that you first scrutinize your surgeon’s male breast reduction before and after photos, which will reveal his level of creative and technical skills.

The surgery often requires direct skin excisions to correct the woman-like breasts, although a good surgeon will make every effort to hide the scars within the submammary fold and around the areola’s perimeter.


But in situations where the male breasts are too large, a more visible scar pattern is an acceptable tradeoff just to achieve a more masculine contour.

Aside from scar appearance, another thing you must pay close attention to is how natural the results look. First and foremost, there should be a good amount of symmetry between the two breasts, the nipple area must look relatively flat, but not hollowed, and there is a smooth transition between the submammary fold and the actual chest.

While the surgery is designed to remove the excess fat, glandular tissue, and/or skin, over-correction—i.e., removing too much tissues—can lead to a wide range of problems such as poor scarring, nipple collapse, and skin asymmetries.

Nipple collapse, which may become more obvious when the patient raises his arm, may also be caused by scar tissue that leads to adhesion between the areolar complex and the chest muscle. For this reason, correcting it may involve releasing the scar tissue and adding more tissue coverage.

Fat grafting is one way to improve tissue coverage and correct nipple collapse, according to Orange County plastic surgery experts. This revision surgery involves collecting donor fats, purifying them, and re-injecting them into the breast or any area that needs correction or augmentation.

For some patients, their excision-based male breast reduction is performed in conjunction with liposuction in which the excess fatty tissue is removed with the use of cannula, or slender hollowed tube attached to a vacuum. To achieve a smoother torso, the adjunct procedure might also be used to treat their flanks and abdomen.

But for a small number of patients, a liposuction-alone surgery is enough. However, this approach is only suitable for men with pseudo or fake gynecomastia in which the enlargement is only caused by their excess fat, and there is no or very little excess skin.

In liposuction-alone procedures, look at the patients’ chest; the round tiny scars should blend in well with the skin (invisible or at least barely detectable). Take note that a good surgeon will place the incisions near the armpit and/or within the areola’s perimeter or submammary fold to “hide” the telltale sigs of surgery.

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