As many as six out of every 10 men are affected by gynecomastia, or male breasts.

• Do you wear a T-shirt, even at the beach?
• Do you have loose, sagging skin on your chest after massive weight loss?
• Have your breasts enlarged with age?

If enlarged breasts have made you embarrassed in social or intimate situations, plastic surgery can give your chest a more masculine contour.

What is gynecomastia?

Gynecomastia is a condition where the male breast is enlarged by excessive glandular tissue. It may affect only one breast or both. The American Society of Plastic Surgeons reports that in 2006, 20,000 American men underwent male breast reduction surgery to treat this all-too-common condition.

What is pseudo-gynecomastia?

Pseudo-gynecomastia is a condition characterized by enlarged male breasts caused by excessive fat tissue. Unlike gynecomastia patients, men with pseudo-gynecomastia have a normal amount of glandular breast tissue. Pseudo-gynecomastia commonly occurs in:

• Older men
• Younger men who are overweight
• Men who have lost a massive amount of weight following bariatric surgery

What is male breast reduction?

“Male breast reduction is plastic surgery to give a man a chest that is flatter, firmer and better contoured.”

How can massive weight loss affect a man's chest?

“Men who have sagging skin after massive weight loss don't typically have excess breast tissue, as in gynecomastia. They have loose skin and nipples that dangle. I call this condition PAWLS: pseudo-gynecomastia after weight loss surgery.”

How do you recommend treating gynecomastia?

“The typical treatment for gynecomastia is to do liposuction first. Then, if necessary, a year later I will do a procedure to take away excess skin.

“Sometimes, the problem is actually breast tissue, which all men have, but some more than others. In these cases, I make an incision under the nipple and remove the excess breast tissue. It's important to understand that liposuction can remove fat, but not breast tissue.”

How is men's breast reduction surgery different from women's?

“Breast reduction procedures for women are not necessarily good for men because they ‘cone’ the breasts to make them stick out more. And frankly, men don't want to accept the scarring that women are willing to accept—nor do they necessarily need it.

“Other breast reduction procedures for men involve performing a free-nipple graft, where the nipples are removed and grafted back in place—which causes a complete loss of nipple sensation. I do not do this.”

How do you perform breast reduction in men after bariatric surgery?

“I've developed my own procedure for men who have lost a significant amount of weight after bariatric surgery. This surgery limits scarring to the crease where the chest meets the belly; there is no vertical scar. In many cases, I perform male breast reduction as part of an upper body lift