Gynecomastia, a condition that causes firm, female-sized breast tissue to develop in males, most commonly begins during the teenage years. In fact, up to 65% of 14-year-old boys in America have gynecomastia. Teenage boys are particularly vulnerable to this condition because of the hormone changes associated with puberty; however, medical conditions, prescription medications and marijuana use also play a role.
If medications or drug use are the cause of the disorder, simply stopping use may solve the problem. The treatment for hormone-related gynecomastia, though, entails more of a watch-and-wait approach as most cases simply go away on their own. Approximately 33% of cases resolve within the first year, with the majority of cases disappearing within 2 years.3,4 Any case of gynecomastia lasting for more than 2 years is eligible for surgery.
Although surgery may seem like a drastic solution, gynecomastia can cause life-long psychological, emotional and social issues. The teenage years are a particularly sensitive time in the development of body image. Being subjected to taunting and mockery as a result of gynecomastia can lead to avoidance of social situations, negative adaptive behavior and low self-esteem that lasts far beyond the teenage years. However, studies have shown that teenagers’ self-image undergoes a rapid transformation following plastic surgery, which leads to lasting positive changes in their behavior and social interactions. That is one of the main reasons why surgery to correct gynecomastia accounted for approximately 20% of the cosmetic surgical procedures done on patients between the ages of 13 and 19 in 2008 in America (a total of more than 14,000 procedures nationwide).
Surgery to correct teenage gynecomastia is done on an outpatient basis. While the patient is under general anesthesia, the surgeon uses ultrasonic liposuction over the entire chest to break down some of the glandular and fatty tissue. She then makes an incision under the nipple and removes excess glandular and fatty tissue from the breast area. The entire procedure usually takes about 2 to 3 hours to complete.
After the surgery, a patient is home from school in bed for the first week and recovered enough to return to playing sports after 1 month. For the first 2 weeks after surgery, the patient has to apply antibiotic cream over the incision and wear cotton pads over the incision along with a compression vest. For the next 2 weeks, only the compression vest is worn. After the first month, Mederma is used to shrink the scar.
To find out if this type of surgery might be right for you or your son, consult with a board-certified plastic surgeon like Dr. Rajagopal in San Francisco, who performs a few of these procedures each week. This is an especially delicate issue, especially for teenage boys, so it is important this decision is made with the advice of an experienced surgeon.