Gynecomastia in Longueuil: Liposuction or Gland Excision for Male Breast Reduction?

A prominent male chest does not always have the same underlying cause.

It may be primarily related to an accumulation of fat, an increase in glandular breast tissue or a combination of both. This distinction matters because it directly influences which type of surgery may be considered.

Liposuction can be effective when fat is the main component. However, it cannot always correct firm breast tissue located behind the areola.

This is why gynecomastia surgery is not limited to a single technique.

Fat or glandular breast tissue?

An increase in chest volume caused mainly by fat is sometimes called pseudogynecomastia.

It can occur with weight gain and may be accompanied by fat deposits elsewhere on the torso.

Glandular gynecomastia is different. The tissue beneath or around the areola may feel firmer and create a localized projection of the nipple and chest.

In many men, fat and glandular tissue are present at the same time.

A physical examination helps determine what is actually creating the volume.

When can liposuction be enough?

When the concern is primarily excess fat and the skin has adequate elasticity, liposuction may reduce the thickness of the chest and improve the contour of the torso.

Small incisions allow a cannula to be introduced so that some of the subcutaneous fat can be removed.

The objective is not necessarily to create a completely flat chest. Some volume generally needs to be preserved to maintain a balanced transition between the chest, shoulders and abdomen.

This planning is particularly important in a man with developed musculature. Removing fat uniformly without accounting for the contours of the pectoral muscle may produce an unbalanced appearance.

Why is gland excision sometimes necessary?

Glandular tissue is denser than fat and does not necessarily respond to liposuction.

When a substantial amount of glandular tissue creates a firm mass behind the areola, direct excision may be required. A discreet incision can then be made near the areola to access the tissue.

Excision and liposuction are used together in many cases.

The gland responsible for the central projection can be reduced, while liposuction helps smooth the surrounding chest contour.

What if the skin is loose?

Skin quality becomes particularly important after major weight loss or when pronounced gynecomastia has been present for a long time.

Once volume is removed, the skin must be able to adapt to the new contour.

In some patients, it contracts sufficiently. In others, excess skin may remain and require a different surgical approach.

This helps explain why two men who appear to have a similar amount of chest volume may require different procedures.

Why does gynecomastia develop?

Gynecomastia can develop at different stages of life, including adolescence and adulthood.

Hormonal changes, certain medications and various medical conditions can contribute to it. In many cases, no single cause is identified.

A recent, painful or unusual change in the chest deserves an appropriate medical assessment before it is treated solely as a cosmetic concern.

Treatment based on the structure of the chest

The term “gynecomastia surgery” therefore covers several possibilities.

For some men, liposuction is the main component of surgery. For others, gland excision is the determining step. A combination may be required when fat and glandular tissue both contribute to the volume.

In Longueuil, Dr Alain Gagnon sees patients from Brossard, Saint-Lambert, Boucherville, Saint-Bruno-de-Montarville and communities across Montréal’s South Shore who wish to discuss male breast reduction.