Correction of the male chest in Sindelfingen
The chest region also plays an important role for men. In particular, a well-trained and defined male chest is almost a kind of status symbol among athletically ambitious men and stands for strength and masculinity. Responsible for the typical broad and arched contour of the upper male torso are above all the large pectoral muscle (pectoralis major) and the smaller lateral part lying beneath it, the small pectoral muscle (pectoralis minor). The superficial pectoralis major in particular, depending on predisposition and training level, contributes significantly to the overall appearance of the male chest with its fan-shaped course and its broad attachment to the breastbone.
Small and rather horizontally oval areolas are also part of the image of an attractive male chest.
If this ideal image of the male chest is disturbed by excessive fat deposits (pseudogynecomastia/lipomastia) or by enlargement/growth of the glandular tissue (gynecomastia), this leads, for many affected men and regardless of their training level, to sometimes considerable restrictions in sports and leisure, at work and in their social environment, up to psychological strain. In extreme cases, the appearance resembles a female breast, which often damages the self-confidence of the men affected.
In addition to an increase in chest volume and a feminization of the chest shape, the formation of a strongly accentuated inframammary fold or enlarged and round areolas are also perceived as very bothersome. If enlarged and/or elongated nipples are also present, these changes often mean that the affected, usually younger men wear only loose clothing and avoid swimming pools, saunas and other places and situations where the upper body cannot be covered. It is therefore easy to understand that, depending on the extent of the gynecomastia, problems in relationships or restrictions in sexuality can also occur.
With the help of gentle surgical procedures such as water-jet-assisted liposuction and, if necessary, complementary gland removal (subcutaneous mastectomy), your chest can be restored to an aesthetically pleasing and, above all, masculine shape. You will find more details on the various forms of treatment and important information in the FAQ.
The difference between pseudogynecomastia and gynecomastia
To understand why different treatment methods are used to correct the male chest, I would first like to explain the differences between the two most important forms in more detail.
Pseudogynecomastia consists exclusively of fat deposits in front of the chest muscles, the most common cause of which is being overweight and an associated increased estrogen level in the blood, which in turn can encourage feminization of the chest, including the areolas. In many cases, this form of male breast can be influenced very favorably by targeted strength training, a healthy low-fat diet or weight loss.
In “true” gynecomastia, or in mixed forms between this and the form mentioned above, on the other hand, there is an actual increase in the volume of the mammary glands. It should be noted here that men also always have glandular tissue, albeit small and hormonally suppressed. The growth of the glandular tissue is usually caused by a hormonal disorder or imbalance between the male sex hormone testosterone and the female sex hormone estrogen.
Especially during puberty, corresponding changes with glandular growth can occur (pubertal gynecomastia). Unlike the other forms, which usually occur later, these are, however, usually temporary and generally regress on their own if the state of glandular enlargement does not last too long. Studies show that after a period of more than 1 year, spontaneous regression is observed much less frequently, as connective tissue remodeling of the glands (fibrosis) can then occur, which makes such regression more difficult.
Persistent disturbances of the hormone balance, in particular reduced testosterone production and increased estrogen production, and external factors such as certain medications (certain blood pressure medications such as calcium antagonists or digitalis, antidepressants), excessive alcohol consumption, drugs (cannabis, heroin) or the abuse of steroids for muscle building (anabolic steroids), on the other hand, encourage courses that can no longer be reversed after a certain “exposure time” to these factors, in that here too the mammary gland tissue has already changed under the constant stimulus to such an extent that it hardens into connective tissue (fibrosis) and can no longer regress even after the supply has stopped (cf. pubertal gynecomastia).
Rare hormonal causes include diseases such as Klinefelter syndrome, but undetected disorders of liver, kidney or thyroid function as well as hormone-producing tumors may also be considered, which can be ruled out by targeted blood analysis and special examinations.
One-sided enlargement of the male chest (usually in older men) must always be examined more closely in order to rule out serious diseases such as male breast cancer.
Key facts about male breast treatment
| Duration of surgery: | 1.5–2 hours |
|---|---|
| Special features: | Very gentle suction technique (water-jet method / BodyJet), open removal of the mammary gland if necessary |
| Type of anesthesia: | local anesthesia (tumescent anesthesia), general anesthesia if necessary (for large suction volumes or open gland removal) |
| Hospital stay: | outpatient, 1 overnight stay if needed (for large-volume liposuction or combined surgery) |
| Aftercare: | Physical rest for approx. 1–2 weeks, compression garments for 6 weeks, scar care, sun protection, regular follow-up examinations for 1 year, |
| Suture removal: | none, usually not necessary as the sutures are self-dissolving |
| Back to social life: | immediately |
| Back to work: | after approx. 1 week for light office work, after approx. 4 weeks for heavy work |
| Sports activities: | after 1–6 weeks (depending on the sport) |
| Treatment costs: | from €3,500 (depending on volume and for liposuction alone; higher if open gland removal is necessary) |
* The costs of anesthesia and accommodation are invoiced to you transparently and separately by the private clinic.
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Frequently asked questions (FAQs) about male breast correction
Which treatment methods are used for male breast correction?
Drug treatments, for example involving estrogen inhibition or the direct administration of testosterone, rarely lead to satisfactory results and are reserved for the growing or changing chest during puberty. However, premature drug treatment is expressly not recommended, as changes during puberty can regulate themselves, and various hormone levels in the blood and urine should first be determined and further examinations carried out beforehand.
In pseudogynecomastia (a pure increase in fatty tissue), once conservative measures, i.e. lifestyle improvements (diet and exercise), have been exhausted, liposuction is recommended as the method of choice, with which the male chest contour can be restored or specifically improved. If necessary, complementary surgical methods such as reducing the areolas or shortening the nipples are used, but these can also be carried out at a later date and under local anesthesia.
In “true” gynecomastia, liposuction is supplemented by targeted removal of the enlarged mammary glands (so-called subcutaneous mastectomy), in which the glandular tissue is surgically removed gently and as completely as possible through a small incision at the lower edge, exactly along the line of the areola. The transitions to the adjacent chest contour are then harmonized again with liposuction.
How is male breast correction surgery performed?
In theory, liposuction alone can be performed under local anesthesia or twilight sedation, although general anesthesia offers significantly more comfort for patient and surgeon and should therefore be favored, especially for larger findings. If surgical removal of the glands is necessary or expected (in gynecomastia), the procedure is always performed under general anesthesia. As my standard liposuction procedure, I use so-called water-jet-assisted liposuction (WAL) with the bodyjet. This is a particularly tissue-friendly yet effective method of removing excess fat cells. Blunt cannulas are inserted multidimensionally into the tissue through very small incisions just a few millimeters long, and the fat cells are released from the surrounding tissue by a lateral, fan-shaped water jet at the end of the cannula and simultaneously suctioned off through side openings in the cannula.
Subcutaneous mastectomy
(surgical removal of the glandular tissue)
If glandular tissue also needs to be removed, this is done through a semicircular incision at the lower edge within the pigmented areola. The whitish glandular body, which can be very clearly distinguished from the surrounding fatty tissue, can be surgically removed gradually and usually in one piece, and the wound is then sutured in a cosmetically favorable way according to the principles of aesthetic plastic surgery.
How can I prepare for the operation?
Good preparation for the operation begins with letting your partner, your family and friends know in good time that you will have to take things very easy for around a week after the operation and that physical exertion must be avoided for 6 weeks after surgery. As we cannot issue you a sick note ourselves, you will usually have to take vacation days. So plan in good time to be able to take some time out.
When you can return to work depends largely on your occupation. Light administrative work can usually be resumed a few days after the operation; strenuous activities such as skilled trades, elderly care and nursing require a longer break. Ideally, schedule your preferred date at the beginning of a planned vacation during which you can simply relax.
Be sure to stop taking blood-thinning medications such as aspirin (ASA, acetylsalicylic acid), e.g. for headaches, in good time before the date of the operation. In good time means from at least 14 days before (!) until 7 days after the date of surgery. Other blood-thinning medications such as heparin or Marcumar must also be stopped or, if necessary, switched in good time in consultation with your family doctor. If in doubt, ask.
It is just as important to be certain that everything is in order with your chest. That is why, at the slightest doubt during your initial consultation or if there are noticeable findings on palpation, I may ask you to provide an ultrasound examination of the chest from your urologist or family doctor close to the date of your operation.
Current blood values and various hormone levels from your family doctor or urologist are also indispensable for the operation to go ahead.
If you smoke, you should stop your nicotine consumption completely for at least 4 weeks before and 4 weeks after the operation, as nicotine can have a very unfavorable effect on the healing process.
How can I prepare my home for the first few days after the operation?
- Have a few comfortable pillows ready so that you can lie and sleep with your upper body raised for the first few days
- Get a few soft, commercially available cooling pads that you can place around the lower part of your breasts after the operation. In many cases, this relieves any feeling of tightness and helps prevent swelling
- Severe pain is very rare, but nevertheless make sure you have enough painkillers at home so that, in the unlikely event of stronger pain, you are not “chasing the pain” but can give your body the rest it needs. Paracetamol 500 mg for the first few days and ibuprofen 400 mg from the third day are both available without a prescription and are usually completely sufficient. (I will of course give you specific dosage instructions)
- Arrange in advance for someone to walk your heavy and energetic dog, for example, as you should keep your arms and thus your chest muscles away from major pulling strain and exertion for at least the first few weeks.
- The most important thing is and remains physical rest, which also prevents painful swelling and unnecessary muscle irritation, for example. Give your body this time – after all, you want to be fit again quickly
- You will receive further recommendations in our personal consultation
What should I bring for the operation?
For what is usually an outpatient stay, it is best to pack a sports bag or a small trolley with the most important things such as personal hygiene items, dark, loose, non-tight clothing, your smartphone and whatever else you need to get by. It is best to leave other valuables at home; please remove any piercings and, in times of coronavirus, please do not forget your face mask. A rapid coronavirus test is usually carried out on site. If necessary, shave your chest 1–2 days beforehand and please do not apply lotion or other care products on the day of the operation. This would make it unnecessarily difficult to apply the planning markings on the day of surgery.
What does aftercare involve for male breast correction?
Both in the correction of pseudogynecomastia (liposuction) and in the correction of gynecomastia (with additional gland removal), the chest is placed under compression with a suitable garment for 6 weeks so that no cavities and thus accumulations of wound fluid (seromas) form, the tissue layers reunite and the final shape of the chest contour is positively supported. This garment is ordered exclusively for you in the correct size before the planned operation and put on immediately after the operation.
Regular wound and progress check-ups follow, at which the success of wound healing and the cosmetic result of the chest correction are documented. You will also receive valuable and important advice on the necessary scar care and scar and tissue massage.
What should I bear in mind after my operation?
For the next 6 weeks, you should wear your support garment consistently around the clock, except during personal hygiene. It counteracts swelling and also contributes significantly to the subsequent shaping and thus to your result.
For the next 6 weeks, you must also refrain from sporting activities such as jogging, swimming, climbing, strength training and especially chest muscle training. You should also strictly avoid lifting heavy loads >5 kg or strenuous overhead work.
However, you can quickly resume activities such as walking or isolated exercises for the lower half of the body such as squats, as well as non-strenuous everyday activities. So you are not confined to bed – on the contrary – your body and circulation will be glad after the anesthesia if you gradually get them going again with fresh air and gentle activities.
How are the costs of male breast correction made up?
The final treatment costs depend on whether we perform only liposuction or additionally surgical removal of the glandular tissue on your chest.
The price for liposuction alone is approx. €2,500–3,500 depending on the expected surgical effort, plus anesthesia services and the costs of the optional overnight stay in the private clinic. With simultaneous gland removal, the treatment costs are correspondingly higher due to the longer operating time and the greater surgical effort. The question of the recommended treatment concept and thus the costs can be answered during your consultation.
