Treatment of lipomastia – Everything you need to know
Lipomastia, also known as pseudogynecomastia, refers to an increase in fatty tissue that leads to the formation of a man’s breast. In contrast, it is a “true gynecomastia” when excessive glandular tissue is present. In both cases there is the same problem, which can lead to psychological stress. Many men hide their feminine-looking breasts under a loose-fitting T-shirt in order to look “normal” and conceal the enlargement. Do you suffer from your breast shape and use loose-fitting shirts and sweatshirts to cover it up? Do you feel uncomfortable when you see yourself in pictures or in shop windows? Would you like to feel comfortable in your own skin again?
Opt for a man’s chest that you no longer have to hide:
- Feel good even in body-hugging T-shirts
- Bringing the body into balance through the right proportions
- Increase attractiveness
- Barely visible scars, rapid regeneration and firmer breasts
What our patients say
Information at a glance
Operation duration
1 hour
Anesthesia
Twilight sleep
Hospitalization
Outpatient
Costs
Aftercare
6 weeks
Thread tension
Self-dissolving threads
Socially acceptable
after 5 days
Additions or alternatives
What are the causes of lipomastia?
One of the known and most common causes of pseudogynecomastia is obesity, i.e. a high body fat percentage. After significant weight loss, skin elasticity is reduced and excess skin may remain. The sagging skin can give the impression of a female breast. This is why the term lipomastia or pseudo-gynecomastia is also used in these cases of enlarged breasts. To restore a masculine upper body contour, it is also necessary to tighten the skin on the chest and the sides of the upper body.
However, a man’s chest can also develop without being overweight or severely overweight (obesity). In most cases, male breasts are caused by both an increase in fat (adipose tissue) and an increase in mammary gland tissue. This is also referred to as lipo-gynecomastia.
It is a myth that gynecomastia can be linked to a large pectoral muscle (pectoralis major muscle). In addition, the widespread misconception that gynecomastia can always be eliminated simply by changing your diet and doing sufficient breast training (sport) must be denied: as mentioned, in many cases the cause is not obesity.
Tissue proliferation of the male mammary gland can be caused by medication or, for example, changes in the hormone balance (physiological gynecomastia). An imbalance between the hormone testosterone (male hormone) and the hormone oestrogen (female sex hormone) is associated with enlarged mammary glands. In many cases, however, there is often no clear and precise cause.
Triggers or causes of enlarged male breasts include male and female hormones and their interaction. In addition, specific medications can be associated with the occurrence of the various forms of gynecomastia.
What to do about lipomastia?
The main page on gynecomastia provides particularly detailed information on the known methods used for the non-surgical treatment of female-looking male breasts. You will find out to what extent they are actually medically effective against male breasts in comparison to plastic surgery. Gynecomastia surgery performed by a specialist in aesthetic surgery is the most effective method of reducing the size of the breasts of affected men. Nevertheless, a brief comparison is also made here so that you can find out to what extent the suffering of the men affected can be reduced by these measures.
The body fat percentage can be reduced with sport and diet or a healthy diet (low in calories and fat and balanced). In some areas of the body, fat is broken down faster in the form of pads than in others. However, as mentioned above, lipomastia can also be present without obesity, so this solution is not possible for the same problem. Depending on the changes in your upper body, the goals cannot be achieved by losing weight. Fat deposits can be reduced to a small extent using the technique of cryolipolysis (targeted, temporary cooling of the affected body area). Cryolipolysis can reduce the fat in the treated areas of the man to a very limited extent after at least three treatments. However, cryolipolysis and fat removal injections are not seriously considered as indicated or common alternatives to gynecomastia treatment. The success of treatment with medication (aromatase inhibitors) is doubtful and only has a chance of success – if at all – in the first few months after the onset of gynecomastia during puberty (www.awmf.de).
The following goals can be achieved by surgery on the patient:
- Creating a flat and masculine chest
- The removal of an underbust fold
- Correcting the size and position of the areola
- Reduction of the nipple
- Removing excess skin
- Removing excess fat through liposuction
- Matching the size and shape of both breasts
How is lipomastia treatment carried out?
The excess fatty tissue of the breast is gently removed using a special liposuction technique. Depending on the findings and treatment goals, other surgical techniques may be used. With moderate excess fatty tissue and good skin elasticity, the skin mantle adapts to the new contours. If the skin is severely sagging or the fatty tissue is significantly reduced, additional tightening of the skin may be advisable. HD liposuction can be used to emphasize the contours of the muscles of the chest, abdomen or shoulder.
What skin tightening techniques are available for lipomastia?
With the technique of vibratory liposuction (SAFE-Lipo) as part of the procedure, a certain shrinkage of the skin is observed over the months. The extent to which the skin shrinks after liposuction of the fat breast varies from person to person and cannot be calculated. The aim of a skin tightening is to remove excess skin and correct the size and position of the nipples. With moderate excess skin, a scar-saving technique leaves a scar around the male areola. This so-called O-shaped tightening can be accompanied by a displacement and reduction of the areola. Careful consideration is required beforehand, as scars on the front of the upper body cannot be hidden during the procedure.
Despite all caution, the formation of bulging and reddened scars must be taken into account if the patient is predisposed to this. If the patient has a lot of excess skin after losing a lot of weight, resulting in a fold of skin under the breast, it may be necessary to tighten the entire chest. The removal of sagging skin may require an incision from the side of the chest under the upper arm to the man’s breastbone.
Our before and after pictures of a lipomastia
A comprehensive consultation is of the utmost importance for successful treatment. The consultation will give your plastic and aesthetic surgeon a clear understanding of your goals and give you an idea of the possible treatment results. Before and after pictures can be very helpful to illustrate the possibilities and limitations of the respective techniques. Since not every technique is suitable for every man, a certain amount of prior knowledge is required to be able to evaluate the images. Surgical techniques differ in terms of results, effort and therefore risks. Treatment is only appropriate if the expected results outweigh the possible risks. The legislator has decided that the presentation of before and after images outside of the informed consent discussion is not permitted. Because we attach great importance to providing you with the best possible information, we are happy to show you before and after pictures during a consultation.
Frequently asked questions
A man’s breast is caused by excess fatty tissue and an enlarged mammary gland. The disease can also develop during puberty. If excess fatty tissue predominates, this is referred to as pseudogynecomastia. However, it has been shown that both the glandular tissue and the tissue consisting of fat usually need to be treated for an optimal result. The distinction between gynecomastia and pseudogynecomastia therefore has little practical relevance in relation to gynecomastia surgery in men.
The combination of liposuction and removal of the mammary gland to treat gynecomastia was first described in 1983 1 . The advantage of using both techniques at the same time is an attractive contour of the breast with fewer irregularities and greater patient satisfaction than either technique alone can achieve. In the case of low-grade gynecomastia in young patients of normal weight (body mass index: 18.5-21.5 kg/m2) between the ages of 18 and 43, 5 to 80 grams of breast tissue can be removed from each side of the body and around 100 to 200 milliliters of fatty tissue removed by liposuction 2 . Vibratory liposuction for the treatment of gynecomastia was first used in 1999 3 . The fine deflections of the vibrating suction cannula remove the fat from a larger area. Vibration support is particularly helpful in the treatment of dense tissue rich in fibers 4 . In addition, there is a tendency for the skin to shrink after vibratory liposuction, which has a positive effect on the aesthetic result. As a result, patients are ultimately more satisfied with the shape of their body.
This is one of the most frequently asked questions in this context. In most cases, male breasts are caused by both increased glandular tissue and excess fat. The excess tissue of the gland can usually be easily felt under the nipple. It feels harder than the surrounding fatty tissue. The doctor can assess and measure the mammary gland tissue in an ultrasound examination.
The risk of breast cancer in men is very low compared to women. Lipomastia is not associated with increased breast cancer. Detailed, quantified information on this can be found on the main page on gynecomastia.
Our cost page gives an impression of the costs of surgery for lipomastia. If you are unable to determine the cost of lipomastia surgery or if you are not sure which form of the disease is present in your case, you have the option of having a physical examination carried out by the doctor treating you. This takes place as part of the personal consultation. The plastic surgery specialist can analyze the symptoms and make a clear diagnosis. As many different surgical techniques are used, an exact price can only be given after a consultation and examination by the plastic surgeon. As part of the consultation mentioned above, you will receive an individual offer with a transparent cost overview.
The assumption of costs depends on several factors. In any case, health insurance will only pay for gynecomastia treatment or the procedure if there is a medical necessity. If you would like to find out in advance whether your health insurance company will reimburse or cover the costs of gynecomastia surgery to reduce large breasts in men, please visit our informative page on health insurance coverage.
AUTHOR
Dr. Stéphane Stahl
We provide you with extensive expert knowledge in order to select the best possible treatment path together with you.
Privatdozent Dr. med. Stéphane Stahl is the former Director of the Clinic for Plastic, Reconstructive and Aesthetic Surgery / Hand Surgery at Lüdenscheid Hospital. Dr. Stahl studied medicine at the Universities of Freiburg and Berlin.
He passed the European specialist examination for plastic and aesthetic surgery in 2011 and the German specialist examination in 2012. This was followed by further specialist qualifications and additional qualifications (including quality management, medical didactics, physical therapy, emergency medicine, laser protection officer, hand surgery) as well as prizes and awards.
In 2015, he completed his habilitation in plastic and aesthetic surgery in Tübingen. He is an experienced microsurgeon, sought-after expert witness and regular speaker at specialist congresses. Following a multi-stage selection process, Stéphane Stahl became a member of the American Society for Aesthetic Plastic Surgery (ASAPS), one of the world’s largest and most influential specialist societies for aesthetic surgery.
His authorship includes numerous articles in prestigious peer review journals and standard surgical textbooks.
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