Enlarged breast tissue in men, a condition known as gynecomastia, affects a significant proportion of the male population at some point in their lives. Despite how common it is, many men feel significant embarrassment and avoid activities that require removing their shirt. Dr. Bram Kaufman, a board-certified plastic surgeon in Cleveland, provides both surgical and non-surgical evaluation and treatment for gynecomastia at MetroHealth Medical Center.

Understanding Gynecomastia

Gynecomastia is defined as the benign enlargement of male breast tissue, specifically the glandular tissue beneath the nipple, not just fatty tissue. It is caused by a relative imbalance between estrogen and testosterone and is distinct from chest fullness caused purely by fat accumulation (pseudogynecomastia). Many men have a combination of both glandular and fatty tissue.

True Gynecomastia vs. Pseudogynecomastia

• Pseudogynecomastia (fat only): Liposuction is highly effective
• True gynecomastia (glandular tissue): Requires direct surgical excision; liposuction alone will not adequately remove firm glandular tissue
• Mixed presentation: A combined approach addresses both components

Non-Surgical Evaluation: Ruling Out Underlying Causes

• Medication side effects (anabolic steroids, certain psychiatric and heart medications)
• Marijuana use
• Underlying endocrine conditions such as hypogonadism or hyperthyroidism
• Liver disease

Dr. Kaufman coordinates with patients’ primary care physicians when a medical workup is indicated. Addressing the underlying cause may resolve the gynecomastia without surgery in some cases.

Surgical Treatment: What the Procedure Involves

• Liposuction through small incisions to remove fatty tissue
• Gland excision through a small periareolar incision to remove the firm glandular disc
• In cases with significant skin excess, skin removal may be incorporated

Recovery and Results

Most patients return to desk work within one week. A compression vest is worn for four to six weeks. Physical activity resumes gradually, with full exercise clearance at four to six weeks. The final result, a flatter, more masculine chest contour, is fully visible at three to six months once swelling resolves.

Psychological Impact

The psychological benefit of gynecomastia surgery is often profound. Men who have avoided swimming, the gym, or any situation requiring removal of a shirt for years report dramatically improved confidence and quality of life following surgery.

Dr. Kaufman provides gynecomastia treatment to patients in Cleveland, Beachwood, Pepper Pike, and surrounding Northeast Ohio. To schedule a consultation, contact Dr. Kaufman’s office today.

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