Gynecomastia patient has one breast larger than the other

Occasionally, a patient comes into my office with one breast larger than the other and, to appear normal, wants gynecomastia surgery on just that one breast.

It’s a condition known in medicine as unilateral (meaning, one side only) gynecomastia which requires a unilateral mastectomy.

First, we make sure nothing else is happening — like a tumor.

But here’s the fly in the ointment: it is very difficult to operate on one breast and make it identical to the other. About the only way to accomplish the task is to perform surgery on both.

Otherwise, the outcome can be one breast that looks normal (the operated breast) but now the untouched breast may look odd — or even bigger in comparison.  And usually some excess tissue on the other breast also exists, but obviously not as much as the larger side.

So, most plastic surgeons want to perform surgery on both sides as well.

I usually recommend that both sides be done to provide the best and most optimal results possible.

While virtually all gynecomastia patients report being unhappy with their large, female-like breasts, having one breast that is far larger than the other only makes the problem worse.

Some body builders are extremely frustrated when they devote endless hours to weight lifting and then discover the large chest muscles they have developed only make the breast fat and tissue – known as “bitch tits” to them — stick out farther.

The one larger breast problem also occurs in teens and non-bodybuilding men.

Overall, you may be wondering how many men have – or will develop – any form of gynecomastia. If you look at the articles that have been written about the topic, it often depends on who counts.
Four M.D.s writing in a 1961 issue of the Journal of the American Medical Association (JAMA) reported that 65 percent of boys may have the problem but that it “typically resolves on its own.” (Also, typically, many do not!)

A military doctor, counting Navy patients on active duty in 1944 found eight percent had enlarged male breasts, or “man boobs.”

Other researchers, counting hospitalized men and  those in pathology labs, found about 40 percent have the condition with almost 60 percent of men over 70 having it.

One of the statistics I like the best is by Merl Yost, a psychoanalyst, gynecomastia patient, author of a book on gynecomastia and operator of the excellent website, Gynecomastia.org.

Yost wrote in a 2006 article for Men’s Health that about 91 percent of gynecomastia surgery patients were happy and would recommend the procedure to a friend.

All of which brings us to our next post: of the nine percent who were not happy, some had revision gynecomastia surgery.

Same patient as above after gynecomastia surgery

We’ve already discussed how gynecomastia causes extreme embarrassment, social withdrawal and can ruin a person’s self-image, making him feel worthless.

Truth be told, there is plenty of pain to go around!

On one website supporting a petition asking insurance companies to cover gynecomastia surgery, you can see lives being held back.

For instance, Bruce blogged:

“I opted out of a promising military career because I would not disrobe…I suffer from depression and often isolate myself. (Health) insurance will pay for tummy tuck and breast reduction in women but not for gynecomastia. Would somebody explain why?”

Mark B. wrote:

“The emotional impact can lead to feelings of hopelessness, depression and thoughts of suicide…there is pain and tenderness when jogging..gynecomastia plastic surgery has nothing to do with cosmetics. All we want to do is live normal and productive lives.”

Giovanni V. added:

“It is not normal to have breast tissue if you are a man!”

Louis P shared:

“Having gynecomastia as a teen, I put on a lot of weight because I thought I could hide it…I’m now 40 and trying to lose the 100 pounds I put on…An adolescent boy should not have to suffer through what I did!”

Porta S. wrote:

“At age 15, my son’s breasts are larger than mine; he can easily fill a size B bra. This otherwise healthy, athletic boy has to deal with kids gasping in horror when changing clothes in gym.”

Chase, 18, blogged:

“I have not led a full life due to my gynecomastia and it kills me! I try not being depressed but I can’t help it. Insurance coverage would give me the second chance I so desperately need.”

Jim, 48 said:

“In high school, my girl friend said ‘What the hell is this?’ while we were swimming. To this day, I won’t take my shirt off in public.”

Dedan L. wrote:

“I developed gynecomastia at 13. Whether I was 135 or 235, it made no difference. Even at my largest and leanest, 215 and 8 percent body fat, I still wore a rash guard (a spandex athletic shirt) to the beach.”

Karen added:

“My 13-year-old son has gynecomastia; it’s heartbreaking to see him worry so much about how much breast shows through his shirt.”

56-year-old Paul blogged:

“I have considered taking razor blades and performing surgery on my man boobs. My entire life has been affected by gynecomastia.”