While reconstructive plastic surgery is obviously necessary for teenagers as this will improve their body’s function, treat physical difficulties, and help them live a normal life, this is not the case for cosmetic surgery which is solely performed to improve the physical appearance.

One of the most cited reasons why teenagers should delay cosmetic plastic surgery is that their level of emotional maturity may not be enough to understand its limitations and risks.  In addition, they are prone to social pressure compared to other age groups; in fact, a study conducted by the American Society of Plastic Surgeons (ASPS) has shown that teens view surgery as a way to fit into their community while adults see this as a way to stand out from the crowd.

Aside from emotional maturity, another important consideration is a patient’s physical development.  According to plastic surgeons, a teenager’s body is still growing which may affect the result of cosmetic procedure, and for this reason, she will most likely need a revision treatment in later years.

For example, if rhinoplasty or “nose job” is performed on patients aged younger than 14, there is a great chance that they will undergo a revision procedure several years after their initial treatment since their nasal structure is not yet fully developed.  It is important to note that subsequent surgery is usually more expensive and complicated and involve more risks.

Because the natural development of the body may affect the result of a particular cosmetic procedure, plastic surgeons consider the age of their patients and usually turn down anyone who will not meet this requirement.  For instance, breast augmentation surgery through the use of saline implants require a person to be at least 18, or 21 years old if she will have the silicone version.

In liposuction treatment, most doctors also require their patients to be at least older than 20 since some people just appear plump because of their “baby fats” which usually disappear in later years.  But in some cases, this procedure is given to male teenagers who are suffering from gynecomastia, a condition in which their breasts become enlarged due to the excess fats, skin, and/or tissue.

While the condition is not life threatening, this may have a negative impact to some men, particularly on their emotional health.  In fact, some sufferers have reported relationship problems with the opposite sex and low self-esteem.

Contrary to a popular belief, gynecomastia does not improve even with rigorous exercise and diet since the problem is primarily caused by excess breast tissue and skin rather than fats.  For this reason, plastic surgeons use breast reduction surgery that can remove the excess tissue through strategically placed incisions.

To start this procedure, plastic surgeons administer general anesthesia or intravenous sedation to their patients.  Once the drug has taken its effect, they may perform liposuction if there is a significant amount of fatty deposits in the breasts.

Breast liposuction involves the use of a cannula, a thin hollow tube attached to a vacuum pump.  This instrument is inserted to small incisions in the fatty area and is moved back and forth to dislodge the fats, which is then removed from the body.

Once the fats are removed, doctors in plastic surgery will create several incisions directly into the breasts.  In most cases, they use the almond-shaped incision (starting from the crease traveling to the upper part of the breast) together with a circular incision around the edge of areola.

However, there are cases in which the U-shaped incision provides a better result.  In this approach, the middle of the upper incision curves downward to allow doctors to relocate the areola to a higher position.

In the almond-shaped incision, the scar line travels horizontally in the middle of the areola, while in the U-shaped incision, the scar is placed along the breast crease which makes it look like a natural fold of skin.

If needed, some plastic surgeons also reduce the size of an enlarged areola to further make the male breasts appear smaller and more natural.

Because of the invasiveness of the procedure, most doctors in plastic surgery see this as the last resort to treat gynecomastia.  With this, they may require their patients to lose some weight (for those who are overweight) or change their medication if a certain drug is causing the problem before conducting any surgery.

Compression Vest

Guys who have large, female-like breast – a medical condition known as gynecomastia – spend a lot of time trying to hide their breasts which are cruelly nick-named man boobs.

Because teens and men are uniformly ashamed of having such prominent female characteristics, they think everybody is staring at their chests.

To hide bulging chests, the obvious things are tried first: baggy T-shirts and sweatshirts, hoodies and light weight jackets, even in the hottest weather.

It then becomes more creative. Some use yards of Ace bandages wrapped tightly around their torso to create a flatter chest.

And just about all guys with gynecomastia have discovered that black best conceals protruding, bulky or fleshy bulges.

Others gain as much weight as possible, thinking a guy with 60 extra pounds looks normal with man boobs.

On each guy’s verboten list are:

• Anything in white – too revealing
• Golf shirts – too clingy
• Never buying clothes without a try-on

A few graduate to wearing printed T-shirts and tops. Design or large lettering does wonders to mask the roundish chest and show-through nipples

Some really desperate very overweight gyno patients also buy a woman’s sports bra and then wear it under what else? A black button-down shirt.

Others try to hide their man boobs by developing large muscles.

There may be a gazillion ads for creams, elixirs and lotions “guaranteed” to make man boobs go away, but the only proven way to get rid of true gynecomastia is through surgery. (Read how male breast reduction surgery is done.)

Surgery is required because a thick, stubborn ring of rubber-like fat sits under the nipples. It can’t be liposuctioned away like other fat because it is just too tough.

Watch the following YouTube video in which a plastic surgeon pulls the gyno from a teen’s female-like breasts.

After gynecomastia surgery, a compression garment is worn 24/7 for a month to promote healing and reduce swelling.

But when some guys read about the garments which fit like girdles for the chest, they start wearing them daily, even though the vests are stifling.

A whole subset of body builder patients worry about a condition they rudely call “bitch tits.” It happens when weight lifters take steroids to develop muscles. Oh, they get big O.K., but their nipples swell and grow large, too.

Bottom line: no steroids, no swollen nipples.

But don’t hope for too much, too quickly.

Some teens outgrow gynecomastia and so insurance companies usually nix the request, saying the surgery is for cosmetic appearance.

But you may get coverage by showing the ways that your guy’s case of man boobs will cost the insurance company more money later on.

It can be a lot of work, but, hey, plastic surgeons aren’t cheap these days. At least, good ones!
Start with your plastic surgeon who will state, yes, surgery is required to remove the bulging breast tissue.

Then, see an endocrinologist and, after the appropriate tests, get a letter saying the condition is glandular, not hormonal. That doctor should also say the potential patient is not using drugs. (Some street drugs can worsen gynecomastia.)

After that, see a psychologist, or therapist, who will say the boy or man is not going to have a normal life, is already depressed and socially isolated and may later develop type II diabetes due to lack of exercise, eating disorders and other health problems.

Toss in a note from a school coach or Phys Ed teacher who says the guy is terrified  of social situations, uses a hunched over posture and wears many layers of clothes to try and hide his breasts. Include unclothed photos of the chest.

Make sure all the info is true! Health plans check and double check everything.

Don’t be surprised if the company asks the patient to see a gynecomastia expert of their own. That’s a good thing.

Many insurance firms automatically turn down any first request. That’s because most people will just forget about it. But if you follow up and add more ammo to your case, you may receive some coverage.

In the past, courts have ordered coverage, ruling that gynecomastia is a real deformity, more like a club foot than a broken nose.

Read about one court-ordered gynecomastia surgery.

To find out if your insurance company will cover a case go to: gynecomastia plastic surgery and fill out the form.

California Surgical Institute will start the process but you will probably have to do some heavy lifting later on through several, if not many, follow-ups with your insurer.

That’s because most guys with gynecomastia feel shame and embarrassment about the appearance of their chests and would not dream of going anywhere near the beach, a pool or any other public activity requiring them to shed their shirts.

But while fully clothed, quite a few become experts at cloaking their fleshy chests.

Almost all keep a large collection of baggy sweat shirts, big hoodies and T-shirts with some sort of large lettering. The color of the clothing is virtually always taken from a selection of the following:

• Midnight black
• Jet black
• Gothic black
• Inky black
• Coal mine black

Some even look for darker colors!

Before getting dressed, those  with especially large breasts and more sensitivity than usual will tightly bind their chests with a large Ace bandage.

As time goes on, those same guys will go online and discover the compression vest, a tight-fitting, elastic garment usually worn for a few weeks after gynecomastia surgery to flatten fatty areas. Those who have puffy nipples slap all sorts of tape over them. Then, they will don a shirt.

Some just wear a light jacket all year long.

And if you’re thinking that extra large clothing, skin tight vests, and tape may be okay for winter but is pretty miserable during in the summer, you’ve got the picture.

However, that is not the end of the cloaking and masking.

Some teens and men purposely adopt a poor, stooping posture with hunched shoulders to further mask prominent breasts.

Others think that if they must have large breasts, or “man boobs” as they are so often cruelly known, they might as well be fat all over and perhaps better hide the large breasts. So they purposely work on gaining a lot of unwanted, unhealthy weight.

Look at some before and after male breast reductions pictures and you can see how guys become more confident, relaxed and relieved with the flat, more masculine chest gained via gynecomastia surgery.

Many pediatricians and others vote for the most conservative action, saying just wait until the lad is close to his 20s because he may outgrow the condition. That does happen, sometimes. The large breasts just go away on their own.

In the meantime, though, a teen’s life can be hell-on-earth due to endless teasing, pestering and put-downs because of his fleshy, female-like chest.

Youngsters report to Gyecomasita.org that others gave the lads cruel nicknames like “Breasts”, “Chesty,” and even “Boobula”.

(Read more about the situations that teens and boys with gynecomastia must endure.)

It’s so hard on teens because they naturally want to fit in well with other teens and not be singled out for bearing some odd defect.

And if the lad happens to be overweight, many experts have yet another reason to deny the chest-flattening surgery: they say the lad should wait until his weight is closer to normal.

But recently, a group of plastic surgeons and experts in adolescent medicine in Boston and at Harvard studied the medical records of 69 teen patients who had gynecomastia surgery sometime between 1997 and 2008.

The physicians, writing in Annuals of Plastic Surgery noted that some experts think obesity is a root cause of gynecomastia. They also noted that the gynecomastia can cause extreme psychological distress with men in their 30s and 40s remaining single because they have no experience with – or fear — females.

Nonetheless, because plastic surgeons are also scientists they also said the role of obesity on male breast reduction surgery is not understood very well.

The study subjects included:

• 51 percent obese lads

• 16 percent overweight boys

• 33 percent normal weight youngsters

Results? The researchers found that major complications happened after the surgery to four patients, with minor complications happening to 19.

The obese patients required more extensive operations and suffered more impact from friends’ teasing than the other groups.

However, the obese group was just as delighted with the results of surgery and – most importantly – suffered no more complications than the normal weight patients.

Declared the surgeons: “We conclude that obesity should not be used as an absolute contradication (meaning: surgery should not be done) to gynecomastia surgery.” (Learn more about the gynecomastia surgery study.)

For 2009, the rate of male breast reduction increased 80 percent over the previous year. And for 2008, that rate had increased over 2007.

According to the British Association of Aesthetic Plastic Surgeons (BAAPS), 581 gynecomastia surgeries were counted in 2009 while 2008 saw 328.

Compare that with half a decade ago, when only 22 such surgeries were performed.

By comparison, male breast reduction in the U.S. was down 5.7 percent for 2008 when compared to the number of similar surgeries done in 2007. The American Society of Plastic Surgeons (ASPS) –believe it or not! – says the decline was due to the economy.

Actually, readers of the CSI blog were already clued into some of the story. Back in January, 2009, the CSI blog reported on some suspected causes. (Read our blog about why gynecomastia has increased.)

The BAAPS also points out that, for British men, the following procedures increased 21 percent over last year’s rates, including:

• Rhinoplasty
• Eyelid lift surgery
• Liposuction
• Pinning back of large ears (otoplasty)

What could be going on?

According to some plastic surgery analysts and prognosticators, it’s the “Sarkozy effect” – a mini boom in male plastic surgery.

Sarkozy? (In New Orleans, they would say “Who dat?”)

 Nicolas Sarkozy, the 50-ish president of France, married former supermodel Carla Bruni who is 13 years his junior.

Meanwhile, back in England, a cosmetic plastic surgery chain, The Harley Medical Group claims 50 percent more men than last year between 35 and 55 coming in for Botox.

Also, male microdermabrasion – a procedure much loved by women – is up 43 percent.

Face lifts are up 17 percent while chin lifts have increased 43 percent.

The new group of patients are being called FAMs (Forty or Fifty-year-old Alpha Males) by British plastic surgeons.

In addition to looking good, another trend is working when a FAM marries a woman young enough to be his daughter: he must be willing to start another family!

He is then known as a “Recycled Father”.

After a few years of diaper changing and the terrible twos, our FAM will then be ready for every rejuvenation procedure known to plastic surgeons!

Gynecomastia

It’s especially tough on teens who, above all, want to fit in with their friends. But with breasts can that can rival those of prepubescent girls, a lot of cruel teasing takes place.

One of the first questions teen boys ask plastic surgeons when they arrive to ask what can be done about their growing breast  is “Do I have cancer?”

Usually not. Statistics reveal that for every 100 cases of female breast cancer, about one teen or man is stricken with the same malady.

Teens then want to know why they have enlarged breasts. Most cosmetic plastic surgeons will explain that the lad:

• Has too much female hormone, estrogen
• Is too sensitive to the amount of estrogen in his system
• Has obesity as a contributing factor.

Many pediatricians and family doctors suggest waiting until the lad’s 18th or 19th birthday before considering gynecomastia surgery. Sometimes, the condition  just goes away on its own.

But many plastic surgeons think teens should be allowed to have gynecomastia surgery – given a proper diagnosis – because a lot of what happens in the teen years determines the type of men patients become.

Just read the concerned letter from a very worried mom of a teen gynecomastia patient.

Overall, the cruelest remarks are: “No girl wants to go out with a boy who has bigger breasts!”

Later in life, the grown gynecomastia sufferer will hear remarks about his “man boob” or “moobs.”

Other patients ask why the excess tissue can’t just be liposuctioned away.

While some fat in the chest can be liposuctioned, the actual fibrous breast tissue formed in the guy’s breast is far too dense to be taken out with suction.

Male breast reduction must be surgically removed. (Read more about gynecomastia surgery.)

For guys who are concerned about the Big C in their chests and breasts, the tell-tale symptoms to look for include:

• Being over 40
• Having growth on one side only
• Breast cancer in women relatives
• Discomfort in a breast
• Anything leaking from a nipple
• A nipple that retracts

That man would then have a very tiny piece of internal tissue taken from the affected breast and then biopsied by a lab.

Rarely has there been a more noteworthy example than a recent Ezine article about gynecomastia, the procedure that provides male breast reduction.

It could be that the author is merely confused. Or, trying to use satire to sell his products. Either way, the piece contains a ton of bogus info.

First (and most serious) red warning flag: the author glibly informs us that patients undergoing gynecomastia surgery are “euthanized.”

Ah, where to start?

The author obviously is trying to use the word, “anesthetized.” In most places in the U.S., euthanasia is against the law. Moreover, plastic surgeons who “euthanized” their patients would probably not enjoy any patient referrals! Imagine what the before and after plastic surgery pictures would look like!

Second major flub: the author says that gynecomastia surgery “has to be done once every few years.” Given a competent plastic surgeon working in a certified surgical center, the procedure is done once and lasts the lifetime of the patient.

Try and follow the logic: you euthanize the patient and then repeat the operation? How would that work exactly? Grave robbing?

Anyhow, moving on through this mountain of misinformation, we are next told that if the embarrassed patient would only skip the gynecomastia surgery, he can get by nicely wearing a compression garment – full time. That’s an extremely snug device that fits like a vest and acts like a corset to holds the patient’s excess breast tissue down.

Compression garments are worn after gynecomastia surgery to promote healing.

But, yes, that could also be one way to hide man boobs.

In the very next breath, our hit-and-miss author recommends wearing the compression vest while “sun bathing, playing basketball, and in swimming pools.”

But wait, there’s more!

With the aforementioned compression vest, you’ll do better at work and “get through daily activities normally.” Although you might sweat like a waterfall.

If you’re shy about the overly fleshy shape of your breasts in intimate moments? After all, no woman wants a guy with breasts larger than hers! The proposed solution? Wear the vest during love making!

After all this, we find the purpose of the article is to send you to a website that sells – surprise! – gynecomastia vests. Who woulda thought?

Now that you’ve been forewarned, go ahead and read the gynecomastia article – just for laughs.

Wikipedia says the male bra, or the “bro” as some wags have named it, is only used by men who are potential gynecomastia surgery patients.

But most of the wearers seen in videos — like this male Japanese bra wearer on YouTube — really have nothing to put into the virtually flat cups of made-in-Japan male bras.

Other wags have suggested calling the garment, a “Manssiere.”

It really started with a T.V. sitcom from the 1980s and ’90s, Seinfeld. One character had a very fleshy chest so the lead character, Kramer, came up with the male bra concept as a comedy routine.

That may have been the first mention of men’s large, fleshy breasts, which is still something of a taboo subject.  Medically, the condition is known as gynecomastia.

Many, many teens and young men are embarrassed to the point of tears due to female-like chests. Locker rooms, beaches, swimming pools, shirts-and-skins basketball teams and public showers are a literal nightmare for these guys.

But a way around the embarrassment is through gynecomastia surgery. Working through a small incision in the nipple area, surgeons:

• Remove excess breast tissue
• Use liposuction to remove fat deposits
• Prescribe a chest compression garment for two weeks

Elliott Jacobs, M.D., a board-certified New York City plastic surgeon has always advocated breast reduction surgery for teen boys with fleshy breasts.

Although conventional surgery wisdom says to wait — because the lad may outgrow the condition — Dr. Jacobs (who himself has gynecomastia) says the teen years are so precious, they should not be given over to the constant ridicule that goes hand-in-hand with gynecomastia.

Dr. Jacobs has never forgotten the pain of high school when he returned to his gym locker and found a woman’s bra waiting for him.

View some gynecomastia before and after pictures of men who had their large breasts surgically changed into a more flat and masculine chest

Would you let your 15-year-old son have the surgery?