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Dr. Linder's Blog


Category: Gynecomastia

Popular Plastic Surgery Procedure For Men

male plastic surgery

Early this month (March 8, 2017), FoxNews.com published a piece on “The 5 Most Popular Plastic Surgeries For Men” by Stephanie Bucklin, which was based on the American Society for Aesthetic Plastic Surgery’s statistics on the most popular plastic surgery procedures of 2016. One of the top procedures for men was male breast reduction (gynecomastia surgery).

In my Beverly Hills practice, I am presented often with men who are looking to restore a more naturally masculine appearance to their chest. Gynecomastia is a very common occurrence among men; however, there isn’t one single cause for this condition. There are several factors that have been studied that may cause gynecomastia, including a high level of estrogen, Klinefelter Syndrome (chromosomal abnormality), hyperthyroidism (overactive thyroid gland), aging (causes low levels of testosterone), and steroids, which can manipulate testosterone and estrogen levels.

The great news is we can treat this condition in a discreet and relatively painless manner. If you have gynecomastia, don’t let it keep you from feeling confident.

To schedule your consultation with Dr. Linder and learn more about male breast reduction (gynecomastia surgery), call our office at (310) 275-4513 in Beverly Hills or fill out our online contact form today.




Male Breast Reduction Procedure

gynecomastiaI was presented a 23 year-old male who was self-conscious about the size of his breasts. During the consultation and examination we discussed how to remove the excessive glandular breast tissue and fat by performing gynecomastia surgery. The procedure was performed under general anesthesia supervised by a board-certified anesthesiologist.

The photo to the right shows three weeks post-op, and as you can see the enlarged breast has been reduced and are well balanced. The patient is extremely happy with his appearance and will continue to follow my postoperative instruction for a few more weeks (light actives can be resumed – no heavy lifting).

To schedule your consultation with Dr. Linder or learn more about gynecomastia surgery or male breast reduction, call our office at 310-275-4513 or fill out our online contact form today.




Male Body Contouring Beverly Hills

I was presented with a 23-year-old male who was looking to reduce the size of his chest and stomach area. During the consultation, we discuss the amount of glandular tissues behind the nipple areolar complex and his fatty tissue extending along the chest wall. His other concern was the lower abdominal area that was bothersome to him.
After setting the expectation, we performed the procedure called gynecomastia surgery to the chest area. The patient has excellent skin tone in the abdominal area, allowing us to liposuction the fatty area and smoothing and contouring his mid-section.
The patient to the left is now four weeks post op and is healing nicely. He is extremely happy with his results.
If you would like more information regarding male plastic surgery or want to set up a consultation today, call us at 310-275-4517 or fill out our online contact form.
The patient since his surgery has had to follow up appointments and as you can see by the post op photos below his results are excellent.
4 Month Post Op

4 Month Post Op


7 Months Post Op


Gynecomastia has been well-defined as “woman-like breasts” in fact it has been found in as many as 40 to 60 percent of men, and can occur in one or both breasts. Risk factors associated with gynecomastia have included decrease in androgen production or increase in estrogen formation. It can also be associated with hormones such as anabolic steroids or even certain antibiotics, anti-ulcer medications, cancer chemotherapeutic drugs as well as recreational drugs such as marijuana and alcohol.

Unilateral Gynecomastia


Bilateral Gynecomastia




The best candidates are healthy men who are psychologically stable and have no medical conditions. Obese men should be discouraged from having gynecomastic surgery until they have had sufficient weight loss; they should be as close as possible to their normal baseline. Most risks are minimal and secondary, small revision surgeries can help with these if problems should arise. The risks of gynecomastic surgery may include: bleeding, hematomas, seromas, fluid collection, infections, skin loss, nipple loss, skin necrosis, asymmetry, and dimpling of the nipple areolar complex. We urge our patients who smoke to refrain from smoking for at least 14 days prior to their surgery; this is to reduce the incidence of vascular compromise and bleeding problems. Patients should be cleared prior to surgery by an endocrinologist in order to determine hormonal assay levels of testosterone and estrogen.


The surgery is performed on an outpatient basis in our Beverly Hills Surgical Center under general anesthesia by a Board Certified Anesthesiologist. Brighton Surgical Center is a State Licensed, Medicare certified, ambulatory facility. Surgical approaches include; Liposuction with direct excision through a periareolar incision (“partial subcutaneous mastectomy with liposuction”) or a direct breast reduction and lift with Wise-pattern-like incisions or anchor scars. The approach is specifically dependent upon the amount of and the stage of gynecomastic tissue that you have.

For mild to moderate forms usually direct liposuction as well as an incision under the areolar and a partial subcutaneous mastectomy can be performed with a fantastic result. It is extremely important that compressive garments be worn after surgery and in most cases we have the patient use a chest upper pole band for four to six weeks after surgery to help you achieve the best result.

Male breast reduction

Over the past year, I have seen an increase in the procedure gynecomastia. Gynecomastia surgery is a procedure to reduce enlarged male breasts. I believe the stigma for cosmetic surgery for men has disappeared, and men are excited to correct the size and shape of their breasts.

male breast reduction To the left is an example of a  25-year-old male patient that I performed gynecomastia surgery on about 3 months ago. The patient is very happy with the results, and his confidence is extremely high.

For men who feel self-conscious about their over  sized breasts, this procedure can help restore self-confidence and appearance. For more information, contact our office at 310-275-4513 or fill out our online contact form.


Unliateral Gynecomastia Procedure

Male Breast Reduction

I was presented a 22-year-old male that was complaining about enlargement and pain in his right breast area. During the consultation and examination, it was determined that he had a benign enlargement of the right breast resulting from a proliferation of the glandular component of the breast.

The surgery was scheduled, and the procedure was a unilateral gynecomastia performed with the patient under general anesthesia supervised by a board-certified anesthesiologist. The photo to the right shows four weeks post-op, and the enlarged breast has been reduced to balance with his left breast.

For more information or to schedule a consultation with Dr. Linder, you can call us at 310-275-4513 or fill out our online contact form.










Clarifying Expectations, View Before & After Photos

Plastic Surgery Before and After Photos

Before and after photos are an excellent way to understand and help clarify expectations when determining the type of plastic surgery procedure one may be considering. For the past 15 years in my practice, I have recognized the benefit of before and after photos and have been honored to have thousands of my patients choose to share their positive experiences with others on my website.

I encourage new patients that are considering plastic surgery to not only seek out a board-certified plastic surgeon, but also take the time to view the plastic surgeon’s before and after photos to get a realistic idea of possible outcomes from these photos.

Liposuction Before & After

Tummy Tuck Before & After

Gynecomastia Before & After


Breast Augmentation Before & After

Breast Augmentation Before & After


Gynecomastia is referred to as male breast reduction. It is associated with glandular tissue and fatty tissue found in the entire chest area. This extends from the infraclavicular, under the clavicle, along the parasternal to the inframammary fold and all the way laterally to the anterior axillary line. There are two different types of tissue that can be found in gynecomastia patients. They include glandular tissue and fibrofatty tissue. The fatty tissue can usually be sculpted around the chest area, while the gynecomastic tissue normally requires direct excision through a periareolar approach.

nipple areolar complex actual glandular tissue glandular tissue and fatty tissue

Our patients are normally placed under general anesthesia and an incision is made underneath the nipple areolar complex from approximately the 5:00 to 7:00 o’clock position. At this time infiltration of tumescent fluid with a Klein needle is performed and liposuctioning with a 3 mm triple lumen Mercedes cannula to 1 atmosphere of vacuum suction pressure is used to sculpt the chest area, again extending along the sternum to the infraclavicular at the anterior axillary line and down to the inframammary fold. A large wedge of tissue is then removed, usually it’s a wafer of tissue in the shape of a football, from the posterior retroareolar region. A platform of glandular tissue is however maintained with the undersurface of the nipple areolar complex to contour and depression deformities.

actual patient before and after gynecomastia surgery photos

After removing this large wedge of tissue, it is taken down to the fascia overlying the pectoralis major muscle. Hemostasis is acquired using electrocautery. Deep closure is performed to close the dead space, 2-0 Vicryl sutures and the simple subdermal and simple subcuticular sutures to close the skin.

Gynecomastia: Does Marijuana Use Promote It?

Given the establishment of a booming marijuana trade, plastic surgeons in Colorado are beginning to wonder if mile high guys may see more patients asking about gynecomastia to see if they can rid themselves of the hated “man boobs.”

Having gynecomastia surgery is not just ego. A guy’s fleshy chest can interfere with normal development because the typical patient does not want to take off his shirt or even wear a tee shirt. During the teen years, guys with man boobs are teased and ridiculed without mercy. Many have come to the their gym lockers and found a bra hanging on it.

(Look at some gynecomastia before and after pictures.)

Most men are as, or more, sensitive to the flatness of their chests as they are to the shape of their nose. As you may know, rhinoplasty was the leading facial procedure among men during 2013, according to the ASPS.

But where does the marijuana use enter the picture? The substance has been shown to lower the male hormone, testosterone, at least in animals.

(Learn more about the gynecomastia procedure and recovery.)

Doctors note that gynecomastia develops during the teen years when an imbalance takes place between the male and main female hormone, estrogen. But lowering an already low level of testosterone with marijuana is not the wisest move.

Other studies have shown high estrogen levels in many drinking water supplies. Other scientists have found some prescription drugs also linked to gynecomastia.

(Read more about the gynecomastia-pharmaceutical link.)

Still other scientists have found common products – like some hair shampoo – and too many female hormones in drinking water supplies responsible for the rise in “man boobs.”

(Read more about Man boobs and estrogen in drinking water.)

Moreover, the numbers of gynecomastia procedures are up, says the latest plastic surgery statistics. According to the American Society of Plastic Surgeons, (ASPS), 21,000 male breast reduction procedures were performed in 2013, a five percent increase over the previous years.

The American Society for Aesthetic Plastic Surgery (ASAPS) counted 22,638 gynecomastia procedures for 2013 and noted it was the 4th leading procedure for men among the members of their organization.

Gynecomastia Beverly Hills

We see patients weekly here in our Beverly Hills office presenting with gynecomastic symptoms, including feminizing breast problems, including increased retroareolar breast tissue, gynecomastic tissue, lipodystrophy and adiposity of the entire chest wall.  These men present with similar problems.  They are frustrated that they are unable to wear T-shirts without having prominent nipple areolar complex protrusion through the shirt.  They are very frustrated with also being unable to take off their shirts at the pool setting due to the increased breast tissue found.  Weight loss may be helpful, but in general is not able to completely resolve the problem of severe gynecomastia with gynecomastic feminized tissue production.  There is an increased predominance of gynecomastic tissue in patients who have taken several medications and steroids as well as marijuana use.  Our typical patients as seen in photo gynecomastic 170A frontal view, present with protrusion of the nipple areolar complex as well as increased fatty tissue extending from the anterior axillary line along the midline and down to the inframammary fold.  These patients do well with a combination of liposuctioning using tumescent technique as well as direct partial subcutaneous lumpectomy of tissue in the retroareolar region.  Notice on side view, Photo 190, that the patient actually has a conical pendulous appearance to the breast with protrusion of the nipple areolar complex due to herniation of the gynecomastic tissue causing an outpouching of the nipple.  This is very distressing to men especially wearing tighter T-shirts in that it appears that they have “breasts or male breasts.”

The after-photo from both of these patients presents at eight weeks.  The only incision made was through the periareolar from the 3 o’clock to 9 o’clock position at which the patient has had tumescent lipectomy of the entire chest wall with a small cannula, 2.5 mm, and then a partial subcutaneous mastectomy of retroareolar breast tissue with care not to form a depressive deformity under the nipple areolar complex by over-excision of the tissue.  It is important that the gynecomastic tissue is sent to pathology for diagnostic purpose to rule out any form of premalignancy or malignancy.

Gynecomastia presentation has increased significantly over the last decade.  These patients are extraordinarily happy with the results of removal of this breast tissue through a periareolar excision and are well accepting of that scar.