Over the last 20 years, I have devoted considerable time and effort treating gynecomastia patients. I have performed over 8,000 procedures. According to the latest statistics, last year there were 18,000 male breast removal procedures performed in the United States alone.
Gynecomastia or male breast reduction can be a very sensitive and highly emotional experience for male patients regardless of age. Unlike the breast of a woman, the male chest is expected to be flat and muscular. For an aesthetically pleasing pectoral muscle, or the "ideal" male chest, fat or breast tissue should be minimal above the muscle (similar to "six pack" abs). Realistically only very few athletes will have this kind of "ideal" chest.
For body builders, once we remove the gynecomastia tissue, we usually can create an ideal chest due to the developed pectoral muscle that is shown under the skin. In most of the male population, we aim to achieve optimum results by removing as much breast and fat tissue as possible.
The patient who is not a professional athlete may also achieve a "muscular, athletic-looking chest" after this procedure is performed by working out and physical training.
As with any surgery, realistic expectations are important and vary from patient to patient. As a result of gynecomastia, some male patients feel a sense of embarrassment, withdrawal, and self-pity, those patients tend to refrain from certain social activities, unfortunately those are precisely the patients who tend to delay treatment. These emotional and physical factors are taken into consideration and are treated with the utmost respect and professional confidentiality.
One of the major problems in body building, due to the use of anabolic steroids, is the existence of real gynecomastia tissue. This is a real impediment during competition and also in extremely rare cases, breast cancer can be found. By enhancing the shape of the pectoral muscle (removing the existing gynecomastia tissue), the likelihood of achieving their goals increases.
These body builders who have very low body fat and real gynecomastia should be treated by excision of most of the breast tissue. In the same athletes, maximal removal of breast tissue is possible due to the fact that the skin will immediately drape nicely over the developed pectoral muscle, and as a result, it is extremely rare to experience recurrence of the problem or any irregularities. In my practice, I have encountered less than a 1% recurrence rate of the male breast condition (compared to studies that show 10% or more recurrence rate).