Causes and contributing factors
Gynecomastia is enlargement of male breast tissue caused most often by a hormonal imbalance between estrogen and testosterone. It can affect one or both sides and commonly appears during puberty, with aging, or after exposure to certain medications, endocrine disorders, or recreational substances. The mix of fatty and glandular tissue varies, shaping symptoms and treatment choices.
In many adolescents gynecomastia resolves without intervention; likewise, treating an underlying medical issue or stopping a causative medication or substance can be sufficient. Diagnosis begins with a focused physical exam, medical history review, and selective testing to exclude other causes. Identifying whether tissue is predominantly fatty or glandular helps determine whether liposuction or surgical excision will be recommended.
Evaluation and surgical decision-making
Evaluation at our Beverly Hills practice emphasizes precise assessment rather than routine assumptions. A surgeon will assess breast size, the relative contribution of fat versus glandular tissue, skin quality, and any asymmetric findings. Tests and history aim to rule out endocrine causes or medication effects. That clinical picture directly guides whether a less invasive liposuction approach or formal excision is preferable.
Surgical planning considers incision placement, contour goals, and scar visibility balanced against the volume and density of the tissue. Liposuction treats primarily fatty enlargement with contouring through small access points, while excision removes firm glandular tissue and may include shaping under direct vision. Trade-offs include scar location and the amount of direct tissue removal required for a smooth chest contour.
What to expect after surgery
Recovery varies with the procedure chosen: patients can expect temporary swelling, bruising, and changes in sensation as tissues settle. Follow-up care involves incision checks and monitoring healing; sometimes compression garments are recommended to support contouring. Because our office is in Beverly Hills, many patients find it convenient to schedule follow-ups around work, shopping, or hotel stays in the Golden Triangle area.
Long-term results are shaped by skin elasticity, the balance of residual fat and gland, and whether an underlying hormonal or medication cause is addressed. Recurrence is possible if causative factors persist, so part of care includes reviewing medications, endocrine follow-up, and substance counseling when appropriate. A candid discussion about realistic outcomes helps set expectations before any commitment to surgery.
