Sagging Male Chest treated with Gynecomastia by Mastectomy , Raleigh, NC*

This 21-year-old man developed breast enlargement in youth associated with weight gain. Through diet and exercise, he had lost over 60 lbs and noted extreme sagging of his breasts. He was very self-conscious and couldn't even hide his "man boobs" with his clothing. He underwent treatment of the gynecomastia with mastectomy and replacement of his nipples as free grafts. Although he had pretty significant scars, he realized that to be as flat as possible, he required skin removal. He now is much happier with his appearance. He can go to the gym with a tight-fitting shirt and not be embarrassed. Male gynecomastia surgery has to be tailored to the patient's deformity. With good skin tone and no skin excess or sagging- liposuction or direct removal via small incisions is possible. When the breast begins to sag and has excess skin - the breast looks like a woman's breast. The nipples have to be repositioned and excess skin removed. In severe cases, Dr. Lyle will sometimes remove breast and excess skin and replace the nipple as a "free graft' which means it has to reestablish its blood supply. This allows for a more contoured chest with no need to preserve breast tissue. Patients have to accept a longer scar to achieve a more contoured chest. This technique is not used that commonly but when it is utilized - it can correct drooping breast tissue better than many other techniques