For many years, cosmetic surgery was a very private affair. Some people would even wear disguises when visiting their plastic surgeon. Now it is very open, and even common in the male population.

The most common procedures in the male are liposuction of the “love-handles,” followed by face and eyelid procedures. Results are uniformly satisfactory. Of course, other procedures, such as nose jobs, chin implants, liposuction of the neck and elsewhere are also common-place.

Unknown to most people is the problem of gynecomastia, or oversized male breasts. I find that men truly hate having excess breast tissue. They can’t wear T-shirts and are often embarrassed, and the treatment is unknown to most people. Typically, this problem usually begins around puberty but usually goes away in the late teens. It also develops with weight gain and during andropause, the male menopause. This is because the enzyme that converts testosterone into estrogen is more abundant. This is also why body builders who take large doses of anabolic steroids, forms of testosterone, get large breasts. Excess testosterone makes more estrogen, which stimulates formation of breasts tissue.

Regardless of the cause, the treatment is to remove the breast tissue. This is usually through a small incision at the bottom end of the nipple-areola complex, where there is a skin color change. In addition, liposuction is usually performed. These procedures must be individualized according to the gland/fat ratio, as the surgical excision removes the “core” breast tissue and the liposuction removes the fat. If a patient is significantly overweight, some skin may have to be removed as well, leaving scars which must be discussed with your plastic surgeon.

Recovery usually takes a few days requiring an Ace bandage around the chest. This procedure can be performed under general or local anesthesia.