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What is gynecomastia?

Gynecomastia is the abnormal growth of male breast tissue.  It can be due to several factors.  It most commonly occurs during puberty. In most males, this resolves by itself, however in 10% of the population,the condition does not resolve by itself and residual breast tissue is left behind.  

This can make it uncomfortable to go shirtless at the beach/pool, you may feel self conscious in tighter shirts, or in some cases patients have sensitivity or pain from this condition.  Gynecomastia can also be due to weight gain, certain medications, endocrine conditions or due to marijuana or anabolic steroid use. Some patients just have breast or fatty tissue and some patients also have extra skin.

Who is a good candidate for surgery?

Anyone who is healthy and desires a reduction of their breast size is a candidate.  For patients that have the condition due to either medication use or marijuana/steroid use, we would want to stop these prior to surgery to avoid recurrence.  Some patients may need a hormone workup to determine if an endocrine problem is the cause.

How is this procedure performed?

The surgical technique can vary depending on whether the breast growth is due to fatty or glandular (breast) tissue.  In patients that have fatty tissue or loose glandular tissue, liposuction can be performed to remove the excess tissue.  In patients with hard glandular tissue, a direct excision with an incision at the areolar border (from 3 to 9 o’clock) may need to be performed.  For patients with a large amount of excess skin, a chest scar along the lower border of the pectoralis muscle may be needed.


After surgery, you will be placed in a compression vest to help with swelling.  In some cases, drains are needed for a few days to avoid fluid build up.  Vest use is encouraged for a month and most patients are back to work/school within a few days and back to the gym in 2 weeks (liposuction patients can return immediately).  Swelling can last 6 weeks and scar care is performed for the first few months.


  1. Nipple sensation changes – Due to the removal of tissue under the nipple, sensation changes can happen including total loss of nipple sensation. This is uncommon in liposuction techniques
  2. Nipple loss – very uncommon, but due to blood supply loss 
  3. Recurrence/residual tissue. In surgery the excess tissue is removed, however a small amount has to be left behind to avoid the nipple/areola sinking in/inverting. In rare cases, this tissue can regrow
  4. Need for revision – in some cases a touch up may be needed for optimal aesthetics
  5. Loose skin – In liposuction techniques and simple excision, there is no skin removed. Generally this skin contracts by itself, however in some cases the skin may not retract.
  6. Fluid buildup – buildup of blood or serous (plasma) fluid is possible, if this happens, drainage may be needed – usually this is performed with a needle and syringe 
  7. Suboptimal results – although everything is done to minimize the risk, sometimes asymmetries and contour abnormalities/dents may result.  These may require a touch up.

Your Gynecomastia will be performed in Dr. Praful Ramineni‘s surgery center located in Washington, DC.

This has been an amazing experience from the consultation to post-surgery!!! I honestly can’t even express how happy & grateful I am with the results. Everyone….Dr. Ramineni and his whole team are impeccable, to say the least. A very thoughtful, professional, kind, and knowledgable team. I will 100% always refer anyone I know to this amazing team…Dr. Ramineni had a challenge when I came to see him with my issue but he 1000% went above & beyond to achieve perfection with my results. I can’t thank this team enough!! I genuinely want to thank you so much!

- Sally T.

Dr. Ramineni was recommended to me by my plastic surgeon as a masterful surgeon who could figure out why I was having complications. He diagnosed the problem correctly and fixed it. I am grateful for his openness, his honesty, and skill.

- Saiyyaed A.

Life-altering surgeon. He helped make my dreams come true with the most flawless surgery I’d been waiting my whole life to get. Healing and recovery has been almost disturbingly easy and pain-free. I could not recommend enough. Everyone there is so sweet as well!

- Katie C.

Before & After

Male Breast Reduction Before & After

Dr. Praful Ramineni



Dr. Ramineni is the founder of District Plastic Surgery. He is board certified and has over 15 years of experience in plastic and reconstructive surgery. He started his career as one of the busiest surgeons at Medstar Washington Hospital Center with a focus on complex reconstructive surgery including cancer and trauma reconstruction, microsurgery and aesthetic surgery.

Dr. Praful Ramineni

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