Gynecomastia Removal Surgery

Mens Health
Cosmetic Surgery

Treatment Overview

Our Price: $4,000 - $6,000

Table Of Contents

  1. Introduction
  2. What is Gynecomastia?
  3. Man Boob Anatomy
  4. Confidence & Self Esteem
  5. Diagnosing Gynecomastia
  6. Causes
  7. Non-surgical Gynecomastia Treatment
  8. Surgical Gynecomastia Treatment
  9. Gynecomastia Surgery Recovery
  10. Gynecomastia Surgery Complications
  11. FAQs

1. Introduction

Gynecomastia is a common problem affecting the self confidence and self esteem of many men.

gynecomastia affects roughly 1 in 4 men between the ages of 15 - 35
estimated incidence of gynecomastia in young men

2. What is Gynecomastia?

It is the appearance of female breast characteristics on a man's chest.

a younger man with bilateral gynecomastia. more prominent on the left
a younger man with bilateral gynecomastia more prominent on the left

3. Man Boob Anatomy

Gynecomastia Glands - Puffy Nipples

Nipple "puffiness" is caused by gynecomastia glands directly behind the nipple pushing it outwards. The size of the gynecomastia glands stretches out the areola making it appear lighter. After gynecomastia removal surgery, the skin retracts and the areolar becomes darker

man boob puffy nipples before and after gynecomastia surgery
notice how the nipple areola complex shrinks and darkens once the glands are gone
The gynecomastia glands themselves are made up of a tough fibrous tissue that cannot be removed with liposuction. They must be surgically removed.
gynecomastia glands - gross specimen. Notice the difference in color and quality in these glands versus the image above.


stubborn fat deposits on the lower/side chest

When it's mostly superficial chest fat causing a breast like appearance, we call it pseudo-gynecomastia.

Quick Facts - Pseudo gynecomastia

  • Diet and exercise are the 1st line treatment option.
  • men with normal BMI and good muscle tone can still have stubborn fat deposits at the lower and lateral chest area

A Combination of Both

surgically removed large gynecomastia gland with some anatomic labels. on close inspection one can see some yellow fat globules surrounding the glandular tissue.

4. Conidence and Self Esteem

The Ideal Male Chest

Usually described as: broad shouldered, symmetric, minimal fat, well developed muscles, proportional nipple-areola complexes.

5. Diagnosing Gynecomastia

Physical Exam - What are some signs that you may have gynecomastia?

  • a mass you can feel behind the nipple(s)
  • pointed/puffy nipple(s)
  • lower chest volume
persistent gynecomastia despite significant weight loss
persistent gynecomastia despite significant weight loss and good muscle tone

Imaging - CT, MRI and Ultrasound

Depending on the quality of the fibrous tissue, we can see it really well on CTs and MRIs.

CT of the chest with gynecomastia glands labeled

MRI of the chest with gynecomastia glands, superficial chest fat, pectoralis muscles and the heart labeled


6. Causes

Causes of Gynecomastia in 786 adult men. European Journal of Endocrinology.
What causes gynecomastia? most cases have no identifiable cause because gynecomastia is a naturally occurring phenomena

Genetics - Nature vs Nurture

Most cases of gynecomastia are caused by our natural genetics and physiology. A quarter of cases are associated with medical problems and about one in five are cause by medications/drugs.  

the balance of testosterone and estrogen is determined by our genetics and our environment. These hormones have a big impact on our physical appearance

Physiologic Gynecomastia
Gynecomastia is a naturally occuring phenomena. It ebbs and flows in man's lifetime. It peaks during 3 periods of life. Infancy, during puberty and in our senior years. Prevalence rates as reported by Johnson et al: 
  • transient neonatal gynecomastia: 60-90%
  • transient pubertal gynecomastia: 50-60%
  • age related gynecomastia: up to 70%
Figure 1. Gynecomastia of puberty: (A) at the age of 14 years and (B) at the age of 15.5 years. Spontaneous regression of breast enlargement is observedwith associated progression of virilization (courtesy of Dr. G. Kanakis).780Andrology, 2019, 7, 778–793©2019 American Society of Andrology and European Academy of AndrologyG. A. Kanakisetal.ANDROLOGY
spontaneous regression of gynecomastia from age 14 (a) to age 15.5 (b)
Pathologic Gynecomastia

Gynecomastia can also be caused by medical problems such as: 

  • testicular dysfunction (gonadal failure)
  • kidney dysfunction (renal insufficiency)
  • liver dysfunction (cirrhosis)
  • thyroid dysfunction
  • hormone secreting tumors
  • obesity - more likely to cause pseudo-gynecomastia
  • other - cystic fibrosis, ulcerative colitis, etc
Medication/Drug Induced Gynecomastia

Although drugs are responsible for less than 20% of all cases of gynecomastia, there is a long list of medications that have been identified as potential causes of this condition.

Medications Implicated in Gynecomastia
medications implicated in causing gynecomastia

7. Non-Surgical Treatment:

Diet & Exercise

  • Maintaining a low body fat percentage with high muscle mass is the best chance one has at minimizing the appearance of their gynecomastia.
  • This makes a bigger difference for pseudo-gynecomastia than glandular gynecomastia


Tamoxifen 10mg. Brand name: Nolvadex

  • the primary medication used to treat gynecomastia is Tamoxifen
  • the main indication for Tamoxifen is breast pain in gynecomastia smaller than 4cm.
  • unfortunately Tamoxifen can have a variety of side effects including: blood clots, loss of libido, bone pain, mental fog, leg cramps

8. Surgical Gynecomastia Treatment


We use a 4 step approach

  1. Anesthesia - the patient receives sedative medications to relax them, then we pump in a large volume of anesthetic into the superficial chest
  2. VASER - we liquify the fat surrounding the gynecomastia glands and liquify surrounding chest wall fat as needed
  3. Liposuction - we suction out the liquified fat
  4. Surgical gland removal - we carefully resect the gland(s) with a scalpel, scissors, electrocautery or via blunt dissection.

Cost of Gynecomastia Surgery

Cost of Gynecomastia Surgery includes facility fees,  surgeon's fees, anesthesia fees and miscellaneous expensesthe
our TOTAL price is $4,000-$6,000

Financing Options

Does Insurance Cover Gynecomastia Surgery?

  • credit card and cash payments online at this time

Payment Plans for Gynecomastia Surgery at 2 Palms Medical Center

Payment Plans for Gynecomastia Surgery at 2 Palms Medical Center

Getting Surgery at 2 Palms Medical Center

Are you a candidate for gynecomastia surgery?

Yes IF:

  • If you've had gynecomastia for more than 2 years despite a healthy lifestyle
  • are relatively healthy (no serious medical problems)
  • you are NOT obese (BMI less than 32 unless you are very muscular or have made a lot of progress in your weight loss journey).
Contact us for a FREE video consultation with Dr. Hersi
  • Text 956-315-2851 to schedule a free phone or video call with Dr. Hersi.
  • If you are a candidate, then we will schedule you an in-person consultation.
Requirements for Surgery
Requirements for gynecomastia surgery at 2 Palms Medical Center
Why do we request require blood work?

A few reasons:

  • to make sure you're not anemic
  • have no organ problems
  • no bleeding problems
  • to get a baseline in case we need to compare future labs results should you have any complications
How much does blood work usually cost?
  • there are multiple facilities in the RGV that charge less than $40 for 3 labs we require (cbc, cmp, pt/ptt/INR).
In Person Consultation
How long will the appointment last
  • 50 minutes
What will we go through?
  • goals of the surgery
  • pre operative photos (you will receive a copy) and
  • check your vital signs (blood pressure, heart rate, etc)
Deposit: ½ the price of surgery
  • payments can be made by either credit card or cash.
  • Required to schedule surgical date


Prescriptions medications will be ordered once deposit is paid.
prescriptions called into your local pharmacy of choice

Prescriptions will be sent to you pharmacy of choice

Direct number to Dr. Hersi.

Day of Male Breast Reduction Surgery

Arriving at the office

what to expect when arriving to the office the morning of surgery

Mild Sedation & Local Anesthesia

Numb the Target area

Access Incisions


Gland Removal

9. Recovery

Book an In-Person or Virtual Consultation

Phone/Video consultations are FREE. In person consultations are $200 and count towards the cost of medication/surgery.

600 E Griffin Pkwy Suite D Mission, TX 78572