Almost everyone likes boobs, but most guys don’t want them on their own body. We are Beverly Hills breast surgeons who help men with "man-boobs" or gynecomastia. Ask Us Anything!

How often does a man come in and you think...That man does not have boobs that need fixing?

It's all what the GUY thinks. Not what we think. But we do have to manage expectations. A 350lb 5'3" guy isn't going to walk out looking like he was in the cast of 300 no matter what we do.

I'm sure as a medical professional cutting into a perfectly healthy body for no reason other then 'the patient wants me to' isn't something to take lightly.

Where is the line where you deny the procedure?

If you are coming from the place of "I can make that better" and the risk is low (remember, removing some fat and unwanted glandular tissue from their chest has almost no risk), then aside from their health being so precarious that the anesthesia risk alone is too high, there is pretty much no reason to deny someone this improvement if that is what they want. I would deny this to someone who thought that if they improved their chest's appearance that they could quit their job, leave their wife and kids, and make it as as a singer on the TODAY show backed by a band of girls dressed as angels. Because obviously, that's completely delusional and their expectations for the change in their appearance are not going to be met. It's the WHY they want it done that's the issue, not the danger in the procedure that would make me take pause.

Wait a minute... did Corey Feldman come to you looking for a boob job?

No, but even if he did, I'd still say have to say no. HIPPA.

Bro or Manzier?

I like Brozier.

What's the biggest boobs a guy has had that you have seen?

A large C cup. I was suitably impressed.

Can smoking pot lead to gynecomastia?

There have been several animal studies that have shown this to be the case, but there have been several studies in humans showed it did not appear to be the case. It may be a bit of chicken and egg thing... Some pot smokers are more sedentary than others and this may be more of the issue than the pot itself.

How do you determine if it's something exercise can, or cannot fix?

Examination and ultrasound is the best way- also history... If you looked great and had a normal chest before a weight gain, then more than likely weight loss with get you back to where you were. If you are a fairly normal weight, it takes an evaluation to see how much is fat VS glandular tissue- glandular tissue will not go away without surgery. It can be made smaller with some interventions, but usually is not taken all the way away.

Have you ever had patients have their man boobs reemerge after surgery or is this generally a one and done procedure?

Usually one and done.

What does a procedure like this cost?

it really depends on how old you are and why you have gynecomastia. Some cases are totally, or partially covered by insurance. Other times, it is considered completely cosmetic. The cost can range from a few thousand dollars to over 10 depending on your geographic location and what you need done.

Which cases are totally covered?

If there is nodularity or solid glandular tissue that could be classified as a mass, or an obvious mass present, then all or nearly all of the surgery should be justifiable as investigative and is basically a great big biopsy. If it's "purely cosmetic" (I.e. Just liposuction removing fat) then it's not going to get covered. Go to a breast surgeon who won't raise as many red flags from an insurer. A plastic surgeon can try to get coverage too, but sometimes insurers don't allow them to biopsy for disease as easily. Tissue should be sent to pathology as well.

As plastic surgeons, you spend some of your days slicing, dicing, and sewing human flesh back together!

When you leave the clinic/operating-theater, are you able to eat a meal (grab a bite to eat) immediately without any overwhelming nauseous feelings and visions ruining your appetite?

Or do you have to have some downtime before you can eat?

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The reason I ask is because once during my college days I had to dissect a baby fetal pig (before lunch hour). When I got to lunch, I had a ham/tomato/lettuce sandwich, and caught a faint wisp of formaldehyde scent on my finger tips (even though I had worn gloves)...

And let's just say I didn't eat lunch that day!

And let's just say I found myself running towards the bathroom, on the verge of vomiting!

One of my friends who was a dentistry student at the time (and had to dissect human heads) also had considerable trouble eating anything after dissection classes!

So ya... essentially I'm wondering if those types of feelings ever fully go away?

Those feelings go away, you would never be able to eat as a surgeon if you required downtime after the OR. I could probably eat during the operation if it was acceptable. Not the patient of course.

Not the patient of course.

Then what are you making out of all that excess tissue? Soap?

Who doesn't love a good Fight Club reference?

I had a hard time in anatomy class in Med school, but others didn't. I had a professor who was trained in a foreign country say they were forbidden to wear gloves during their dissections because it was an "insult to the person who donated their body". Don't think I could have done that. Sometimes you get a whiff of something all too familiar. It serves as a reminder that we are all animals and that makes me happy to stick to a plant based diet as much as possible

Have you ever had a client who had a pair which you'd consider to be a nice pair on a woman?

Not to put too fine a point on it, I know women who've paid to have what some men would pay to get rid of.

I saw a dude with a perfect rack, it was weird. Not arousing at all though. (And he was straight, just overweight)

I wonder what he thought about it...

If I were to fill a swimming pool with all the moobs you have extracted, how large of a swimming pool would I need?

It's more of a newer issue that people are acting on. So I'll go with a hotel sized jacuzzi. I expect we will get to a good lap pool, but there are only so many hours in the day for us.

Is there a large proportion of your clients getting surgery to sort out the gynecomastia due to taking anabolic steroids? I ask because it seems there are quite a large number of bodybuilders that aren't quite sure what to do in regards to their PCT, and often end up with pretty noticeable gyno by the end of it.

Good question! I have absolutely dealt with this. For those guys absolutely set on continued steroid use (which we don't recommend), we can pretty easily rid them of this tissue with an out patient procedure. The results depend on the end goals- looks versus symptoms such as lumps or pain.

Are there any successful treatments for stretch marks (weight gain)?

Stretch marks are because of breaks in collagen in the dermal layer... You can't knit that back together. There are some skin treatments that can improve their appearance, but like ripping your jeans and sewing a patch underneath, it's never the same as when as when it was first made.

Yes, do guys with gynecomastia make mutant jokes like they're X-Men or something a lot?

Haven't heard that yet. Willing to suggest it to the next one I see.

What's the common age for us males to acquire these "man-boobs" (I prefer the term "moobs", personally)? I'm 35 ... am I out of the woods - or "over the hills" - yet?

70% of men over 50 have gynecomastia!! The other common times are neonatal and adolescent- because of the sudden hormonal changes. So if you are in the 35s, it would be a good idea to look at your medicine cabinet, how your relatives look (can be somewhat familial, like your hair texture or height) or any other contributing medical conditions

How young was the youngest person you've worked on? How old was the oldest?

Youngest: early 20s / oldest: 60s

What do you think about the ethics of excepting a request for plastic surgery even though it may be harmful, unnecessary or a result of a mental illness?

I'm curious to know if you have a specific reason for asking? IMHO Anyone with unreasonable expectations, that is, anyone who thinks that their life/job/relationship status will change based on something they do to their body should be vetted to appreciate the impact of what they want and what they can expect from their procedure.

Well we have all seen plastic surgery horror stories like M.J (rip) or that human barbie that removed her ribs, the japanese superman guy with metal plates and it seems unethical to me that a plastic surgeon would agree to such procedures knowing how harmful it is.

I wouldn't offer those extreme procedures to patients. But what about piercers or tattoo artists that put permanent crazy and maybe even questionable things on people's bodies? At some point, adults that want to do stupid and/or risky things to them selves (no matter what it is... Skydiving/unprotected sex/wearing crocs) are free to do so and sometimes need to be left alone to learn from their mistakes. I've had colleagues argue that if they don't do what the patient wants, the patient will just find someone else who will. So at least if THEY are the ones to do it, the patient may have a better chance of having a safer outcome than if he or she went to an unreputable doctor. I think the bigger issue is listening to the patient to find out the "WHYs" of their choices and making sure they truly understand the risks and benefits. I have been able to talk sense into a few people in the past.

But speaking of crocs, don't surgeons and nurses wear crocs because they're so comfortable for how long they are on their feet? I know I've seen them in hospitals.

They are a necessary evil for some.

Have you ever had an MTF transgender who came to you regretting their previous decision to get breast?

I haven't seen that yet... I'm sure those are very complicated decisions. I have worked with FTM with small to no scars and amazing outcomes.

I know the drug risperidal is a known grower of man boobs, is there a lawsuit against that? If so, do you testify for people?

It's one of the bad actors that is known to cause gynecomastia. But- if it's necessary to treat more pressing conditions, then it's necessary. The gynecomastia is a side product.

What is the biggest confidence change you've seen happen in a guy after a treatment?

I've seen lots of guys become more active- take on exercise challenges, loose weight, be shirtless without concern. No one has regretted it. But I haven't gotten anyone into the NBA or the space program yet because of it. Still though, there is time.

I haven't had that yet- but there are certainly ways to handle that, just like a breast reduction in any female. Since we all have the same potential for breast growth from an embryo logic standpoint, there would be no different from a fissure/cellular standpoint for someone MTF on hormones vs a XX female who was allowed to develop normally.

Hi Docs,

I've dealt with this for awhile now and never asked a Dr. about surgery. I take Advair for asthma and I believe they warned me that this would be a side effect. I'm in Chicago. How do I proceed with finding a Dr. who can navigate insurance and perform the surgery?

Thanks,

If the insurance coverage is an issue, you can start with a doc that is a breast specialist. That may be more likely to qualify. They may or may not have the expertise. If they don't, try a plastic surgeon. Most have info on websites and before and after pictures. Ask to talk with other patients they have treated too.

Why did The Rock wrestle with a shirt on for awhile?

Shirt companies paid him extra? I don't know. If anyone knows the Rock, they should ask.

He had gynecomastia for about 6 months during his wrestling career. He was too big of a star to take off tv, so he wreslted with a shirt for 6 months.

I think that is how a lot of men wrestle with it, day to day.

Does diet have anything to do with it getting rid of them?

Nope! You can't eat or starve it away. It's mostly genetics and occasionally medicines/hormones.

What's the breast thing about your job?

Ba-dum dum, ching.

In your opinion, do any supplements (in particular Indole-3-carbinol) have any effect on reducing breast size in men?

(Yes I had to look up what that is...) the key is balancing the hormone ratios, and there are many ways to do that. I don't routinely recommend supplements for managing gynecomastia, but it may be worth a try. It looks like the jury is still out on the effectiveness of that particular supplement of hormone balancing and may do more to reduce cellular proliferation/inflammation that is associated with neoplasia/cancer changes.

Can you make mine huge?

Kelly can.

I hear eating Tofu can lead to gynecomastia, right? How much tofu is too much tofu?

Not usually... Phytoestrogens in tofu are pretty weak. I'd look to other sources unless you are chowing down metric tonnages.

What about endocrine disruptors in plastics? Also, the antibacterial soaps, isn't this a potential side effect of those too?

Perhaps not tofu by itself, but maybe if you add up tofu, plastics, antibacterial agents, etc. etc. Basically a range of environmental triggers could be causing the issue for some of your patients with no known trigger maybe?

Absolutely! If you know how to rid the world of those things without the vast majority of people turning into giant whiny babies I would be all for it. We can do a randomized controlled study and find out. Those endocrine disrupters are in the slick printer papers that receipts are printed on, too.

How painful is recovery? Is there loss of sensation?

There is almost always temporary decreased sensation and we warn patients of the possibility of permanent numbness. There are also tingly and shooting sensations as he feeing comes back after surgery. I've been told it's less painful than expected almost all the time. Recovery can be a week or so vs soreness for about a month, depending on how much we are doing.

How often to you find that "man boobs" contain cancerous tissue? I've heard that uneven male breasts can be due to malignancy. Do you regularly send out the excised tissues to pathology?

We do send tissue samples of the gland part for pathology in almost all cases. It's very rare for men to have breast cancer- I've seen only two cases in my 15 year career. The changes associated with make breast cancer are usually fairly striking and noticeable. Safe unevenness is very common. We typically have clear signs to suspect cancer before any surgery and investigate/biopsy any irregularities and know well before any procedure is performed. Obviously, treatment for male breast cancer and a procedure for appearances' sake are two very different surgeries.

Have you seen any man boobs that...look better than a woman's?

Depends on the woman! But yes. Some guys with gynecomastia have more developed breasts than some smaller-breasted women.

Is your job diffrent from female breast reduction?

It is- there are different goals in mind even though the technical aspects of tissue removal are the same... What we want to get rid of and what we leave behind is very different for men and women.

Do the excercises themselves help, or is it the weight loss that does it?

It's the weight loss more than the exercise. Weight lifting and pectoralis and latisimus muscle development can visually distract from having a more feminine nipple appearance or camouflage some of the fullness, but it's still "there".

It's relieving to know I am going in the right direction with starting to work out lol. Honestly I didn't know that someone actually specialized in this study, I thought I was just a random case of weird.

I've seen many guys with your same concerns! And it's always a relief to be able to tell patients we have ways to make things better, it's just a question of how much

Does it hurt?

The minimally invasive approach is usually the least bothersome with some of the guys complaint of feeling sore for a few days to a week. The more we have to do, the more there is to recover from. We also recommend a compression best for a month or so afterwards to improve healing and reduce swelling. Some patients feel like that gets pretty old, but many wear minimizing garments before those surgery anyway...

If the gynecomastia is caused primarily by weight, do you recommend some sort of either nutritional or psychological support after the procedure so that the patient doesn't end up back to see you in a couple years?

Once the fat and glandular tissue is removed, it doesn't grow back. Everything can get generally larger everywhere, but if people gain weight, they tend to get it in other places- belly, love handles. The biggest complaints/comments we get after successfully treating this is that people then notice other problem areas that didn't bother them before... But we recommend generally that people have a low sugar, whole foods diet, and regular exercise to maintain an optimal BMI

What does the scarring look like on someone from whom you've removed a lot of tissue?

It depends on how much extra skin we think there may be afterwards. Most of the time, the skin retracts nicely and we can 1) just make small nicks and insert probes that do the work from sites like natural skin creases, where the effect is almost scar-free 2) on the edge of the areola where the scar is well hidden or fairly rarely 3) a larger scar sometimes is necessary along where a "bra line" would be. That's for people with skin that need removal or a situation like FTM transgender surgery situation.

Does anyone ever ask to make the scarring worse or more noticeable? I could see someone wanting a wicked scar to make up a story rather than some questionable looking nicks or lines.

Some dudes say they don't care about the scars, but mostly if is too clinical/symmetrical it is hard to pull off any cool stabbing story or cougar attack reminiscence.

Have you treated with Nick Saban? He needs a gift certificate or something.

Feel free to send him our contact info: www.bedforbreastcenter.com & Roll Tide! (FYI: I went to Wake Forest, so I don't have a dog in that fight) Dr Kelly may feel differently... I dunno

Could part of what is causing this in men be from the hormones fed to animals to increase milk and meat tissue?

That is absolutely possible. But I've seen this in vegans too.

How important is having a Beverly Hills address? Is it something you can monetize?

I've practiced here and in Atlanta. I prefer life here, and practice with the same high standards as I did in Atlanta, but for some reason there is "instant credibility" that comes with a Beverly Hills address. There are some craptastic MDs in this area, which goes to show that all you need to be a Beverly Hills MD is a lease and a medical degree. There is no entrance exam or selection process. But, it's an expensive area. So to a degree, if you can't make it, you will likely get weeded out.

Is it gynecomastia if a guy Is in lean fit shape but the nipple is larger than normal? And if so can that be treated with surgery? Would appreciate any feedback!

If is full and feminine looking, the best thing to do is reduce/remove the glandular tissue adherent to the back. If it's very large when it's erect/when the muscle is squeezing, it may need to be actually made smaller by removing skin/tissue from the front.

Scars can be revised, or there are treatments to improve the appearance if they heal and become too thick or overgrown, and we can plump up any sunken in or uneven spots with fat injections or filler fairly easily. But a scar can't be un-made, only canada auger or improved. The best thing is to have a good surgeon with careful scar placement so that they are small and not noticeable.

Are pointy nipples a form of gynecomastia? A man of normal weight without a fatty chest, but nipples that could cut glass, all the time? Is it the same thing, and is it something that can be fixed?

For some men, they don't relax very much and the nipple portion is much more prominent. It's not so much a feature of gynecomastia, where the tissue has a softer, fuller, more feminine appearance, usually. It's a variant of normal for men, but if it's something that is really, really bothersome, or if you are a professional window cleaner and you keep damaging buildings with your nipples, then it certainly is possible to reduce them and make them less noticeable/hazardous.

We have pictures here: gynecomastia link

Most people have a pretty dramatic immediate result. But, it takes a loooong time (2-6 months) for all the healing to settle in, toughness to dissolve, and swelling to go down. It can be frustrating to see how much better it's going to get, and people get impatient. I haven't had anyone have any regrets. And as time goes on, they forget how bad it was and start to focus on other areas they are unhappy with. But that's typical for most things. You finish remodeling the kitchen and the living room looks dated and you feel like you need a new couch.

What about a hormone treatment? And what could be the side effects?

The non-surgical treatment primarily focuses on anti-estrogen treatment. Alternatively, if you were found to have a testosterone deficiency and need that repleted that is possible too. The issue is that testosterone can be converted by enzymes via the aromatase pathway into an estrogen like hormone. So the more successful route is the anti-estrogen pathway of treatment. Other than a less feminized appearance, there's really no need for an abundance of estrogen a man so there is very few side effects to note. If it has been a long-standing issue for many many years with significant glandular development and an abundance of skin, the nonsurgical pathway is usually less successful. If it's a fairly acute, short-term situation with concentrated glandular tissue that is sensitive and tender with a more feminized appearing nipple, this is where medical treatment has the most impact.

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It is possible to try medicines that block estrogens and to check testosterone balances. It's important not to overlook any other medical conditions in the case where it's bilateral. If there is an underlying cause that can be remedied, then surgery may not be needed. If it's a pretty severe case with lots of enlargement, medical treatment may not have enough of an effect.

Right now it's a three way tie between "f*cking perfect" (pink) , "the middle" (jimmy eat world) and "whole lotta love" Yours?

RAWR. Go Kelly!

LMAO Man boobs are funny. Although not so funny when your 1 year old son is sitting on your lap and suddenly stares bewildered at daddy's "man-boobs" and says, "Mommy?"..... Eye opener maybe? Now I've definitely been super relaxed on working out and well eating not as healthy as I should. What is the surgery you speak of? Now is the surgery only for people with gynecomastia or can any Joe Shmo get it? And do I need to try exercise first?

Exercise is ALWAYS a good start! It can help melt body fat which contributes to the imbalance of testosterone and estrogen like hormones (fat has aromatase which turns testosterone into estradiol). It may decrease some of the size, but even giant gym rats can still be plagued with glandular tissue that just won't budge and makes the areola/nipples look large and feminine and can be tender and uncomfortable. And bumpy. Ugh. Surgery can consist of liposuction, if it's mostly fat, but a really successful surgery gets rid of the glandular tissue too. That requires an incision, or we use a probe that can take out the tissue in pieces that doesn't require an incision larger than a liposuction probe (3mm).

I'm a 37 year old male who has had man boobs my entire life. For whatever reason, when I was 10 I gained a ton of weight and a bunch of boob. When I was in high school, I became an athlete, got in shape, was at a normal weight but still had man boobs. I recently lost 50lbs and still going, the heavier I am the bigger my boobs are so consequently, they've gotten smaller again since I've lost weight but they are still there and I think, always will be. I'm at the point in my life that I'm capable of paying for surgery.

My man boobs are seriously about the only thing I'm self conscious of and oddly enough, I'm afraid to have surgery because I'm afraid people will notice the scars. Yes, as stupid as this sounds I want to have this surgery without anybody knowing. So, I ask this, is there any way that a surgeon can give me a manly scar across my chest or something that will mask the scars? Maybe something I can say was caused by a knife fight or a fight with a wild animal?

Well the good (or bad news, depending on how you look at it...). Is that if it's primarily fatty tissue and a smaller amount of glandular tissue, the scars for the life of suction probes can be placed in natural creases and are only 3 to 4 mm in length. If they're visible at all, it could easily be mistaken for a mole that was removed. If it's a larger area glandular tissue or skin needs to be removed, we can often hide the scar in the edge of the colored circle (areola) so that it is not that obvious. So basically, we really don't need big or terrible scars so you'll have to think of another reason to tell that story about the zombie knife battle. Or whatever.

With FTM top surgery, there is (usually) a much larger skin envelope to consider and much more glandular tissue that must be cut out. So there are more design elements to consider. The minimally invasive approach is more conducive to gynecomastia because a higher percentage is fat that can be sucked out through a liposuction probe. We support the LGBT community and feel they should have the best access and support to achieve an appearance that allows them an authentic life. I have not had an opportunity to work with many trans patients, but I would love to. I'm very interested to see how far we can get with the techniques we have developed for gynecomastia with top FTM surgery to improve scars and prevent the need for nipple grafting.

I don't know who suggested three months off for recovery... We don't even recommend that for double mastectomy cancer patients. This is a very superficial process that does not alter any major blood vessels, nerves, muscles, or tendons. Imagine you had a really, really big mole... or a birthmark... that needed removal. It is hard to speak for cash costs in different regions of the country. A Google search that brings up a few area breast specialists or plastic surgeons is a good place to start. A phone call to their office will probably get you ballpark amounts pretty quickly. The question is how aggressive are they and how much experience do they have with different techniques and different sizes issues. You also want symmetry addressed. Even though this is only one side, you may want the other side evaluated so that dormant tissue doesn't "wake up" as you get older. But insofar as needing to be off work for three months? Nope. I wouldn't say that to anyone I plan on treating.

The chest shape issue is called "pectus excavatum" . If it's diagnosed in the pre-teens, they can put a bar across the chest (Nuss bar...) that flips it out and then it's removed a few years later after the cartilages harden so it doesn't cave back in. If it's an older person, the surgery is more extensive. So, yea... Less than ideal. Depending on the severity, it may be possible to fill in some of the space with fatty injections, and a plastic surgeon may be able to deal with the gynecomastia at the same time. If you can document mental hardship/anxiety due to the condition, it IS possible that insurance may cover it. It may take work with documentation and several appeals to get it done. All jn all, it may be life changing for you..

Lemme guess, pro bodybuilders are you biggest client??

edit. go check out /r/bodybuilding - so many cases of gyno.

No, usually really smart guys who exercise and just don't look as good as they would like to look.

Hi, my names not Dave. I have tried to go to the doctor many times to get devices, most likely put in me by the government and/or aliens, removed. I believe these devices are used to track my every movement, and possibly my thoughts, and as you can probably tell, that is restricting in my line of work... which is not a conspiracy theorist trying to unravel the secret powers of the world. The reason I haven't gone to my doctor is out of fear that he is one of them. I was wondering if you have any tips on someone finding and removing foreign objects from their own body?

Just like its hard to cut your own hair, it's hard to remove foreign bodies from yourself (alien implanted or otherwise). I recommend finding a physician/surgeon with an implant in their own body and you two do each other.