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Factors Affecting Gynecomastia Surgery Results

Deciding whether a gynecomastia surgery is right for you will depend on your expectations and how likely the outcomes will match that. This question will be the primary focus of the consultation process with your surgeon. With the information obtained from an ultrasound scan, she will be able to tell you how much fat and glandular tissue needs to be removed to flatten your chest, and how well she expects your skin to smoothly retract afterwards. Hopefully, armed with this information, you will be able to better decide whether the discomfort, inconvenience, and costs of a procedure are worth it.

Some additional factors that will influence the quality of the results from your gynecomastia surgery include age, weight, skin type, and lifestyle. These will also be discussed during your consultation. The key points are explained in the boxed segments below.

Outcomes vs. age

There are three important influences on outcomes as a function of age. First, after the age of 40, there is a gradual decrease in muscle tone. This will play a role in the overall aesthetic result of a gynecomastia surgery; however, this can be counteracted through regular strength training. Another point to consider is that skin thickness and elasticity diminishes with age, and this will have an effect on the overall retraction and redraping of the skin after surgery. There are some treatments that can help thicken the skin, and in some circumstances, it will be worthwhile to have these prior to surgery. Finally, the body recovers less rapidly as we age, and so the recovery period after the procedure will likely take longer for older patients.


Men who are overweight carry a lot of subdermal fat.  Over time, this fat stretches out the skin, which is exacerbated in the chest region by a condition of gynecomastia. This makes it much more difficult for the skin to retract smoothly after surgery.  Moreover, for these cases, it is more likely that the nipples and areolas will have significant ptosis (drooping).

These aesthetic issues can be addressed during the surgery through the excision of excess skin and the repositioning of the nipples.  This will significantly reduce the severity of post-operative folds and wrinkles in the skin for overweight men, but it will not redrape as smoothly and as evenly as for men who are more fit.  There will also be additional scarring for these types of cases.

Skin Type

The spectrum of different skin types (Afro-Caribbean, Mediterranean, Asian, Caucasian, and so on) are not just differentiated by their pigmentation, but also by the amount of collagen and connective tissue they contain. Skin with more connective tissue is more elastic, and tends to retract better after surgery, however, it also tends to produce more pronounced scarring.

Men with darker levels of pigmentation have higher levels of collagen and connective tissue than for those with lighter skin. It is for this reason that their skin tends to wrinkle less with age. However, their scars from cuts and wounds also tend to be broader with a more noticeable change in coloration. These factors have a bearing on the final aesthetic result of a procedure. Your surgeon will be able to discuss both of these characteristics with you, and will show you before and after photos that will help you understand what are the likely outcomes for your particular case.

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Managing Expectations

It is important to understand that gynecomastia surgery is a process that delivers generalized results. The volumes of fat and glandular tissue will be reduced, and the chest will become flatter and less pronounced. However, the final aesthetic outcome is determined by a variety of factors that are not specifically under the control of the surgeon. For one, it is incumbent on the patient to assiduously follow the post-operative care protocols with regards to the use of the compression garment. Moreover, as discussed above, there will be variations in outcomes as a function of the patient’s age, weight, and skin type. But also, there will be unforeseeable factors specific to the biochemistry of each patient that will have a bearing on the healing process and, as such, the final results. Patients must be prepared to accept some risk that surgery does not produce their perfect result.

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