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Dr. Linder's Blog

Gynecomastia Beverly Hills

Posted On: November 03, 2013 Author: Dr. Stuart Linder Posted In: Gynecomastia, Uncategorized

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.