The Plastic Surgery Clinic

Got moobs? Male enlarged breasts are on the increase, so much so that they’re now referred to as moobs, a combination of men and boobs. It brings to mind the Seinfeld episode when Kramer invented the “manssiere” – a bra for men with big boobs.

Most men just live with their moobs, but others choose to have them reduced. In fact, male breast reduction is a growing part of the plastic surgery business. “I went from doing one to two a year to last year between 200 and 300 cases,” says Dr. Frank Lista of The Plastic Surgery Clinic in Mississauga, Ontario. “My colleagues are seeing the same thing. It’s one of the most rapidly increasing areas of surgery for men.”

Statistics from the British Association of Aesthetic Plastic Surgeons indicate that there were 323 male breast reduction procedures in 2008, up 44 percent from the year before. Dr. Lista also points to a WWII military journal which reported the incidence of enlarged breasts in single digits. A contemporary journal recently suggested that between 60 to 80% of men suffer enlarged breast tissue growth beginning in childhood, he says.

Of course, moobs is not the medical term. It’s gynecomastia. A few years ago, the Annals of Human Biology published a Greek study that looked at 954 healthy young men aged 18 to 26. Gynecomastia was found in just over 40 percent of the subjects, leading the co-authors to suggest that obesity and/or an earlier maturation may play a role in the development in breast tissue.

Whatever it is, it’s pretty common. Internet photos of moobs abound and include breast shots of notables such as Tom Cruise, Simon Cowell and former British P.M. Tony Blair – attractive men, none of whom are fat.

But breast tissue can also be affected by hormones. Men who have an excess of estrogen floating in their body (men have both androgen and estrogen in their bodies) may have larger breasts. There are some ten other causes, including exposure to anabolic steroid hormones, kidney or liver disease, testosterone deficiency, obesity and aging.

But most of the cases seen by Dr. Lista are not due to aging or obesity, he says. “Most of the men I see say they developed it during puberty when they were 13 to 15 years old. My average patient would be a guy in his 20s or 30s who tells me he has been struggling since his teen years. They say they’re self-conscious and that their big breasts are really bugging them.”

Dr. Lista says that several of the younger men he has seen have assumed that a bit more exercise would minimize their moobs. Not so, he says: “Some men think if they go to the gym and lift weights it will make it better, but it actually makes it look worse because they develop more pectoral muscles which only pushes forward the gynecomastia.”

On the other hand, if you’re an older guy with decreasing testosterone, the unopposed estrogen in your body might be causing the breast tissue to swell a bit. Medication that older men may be prescribed could also have side-effects that subtly change hormonal balance.

Male breast reduction is not covered by provincial health insurance; the average cost is between $4,000 and $8,000, depending on the complexity of the case. Men usually return to work within three or four days but have to abstain from sports and wear an elastic undershirt for six weeks. The risks are minimal and the satisfaction is maximal: “Their goal is very simple,” says Dr. Lista. “Men just want to be able to take off their shirt. It’s not about achieving perfection; it’s about meeting a patient’s expectations.”

Less scarring, more satisfaction

Male breast reduction can now be done with minimally invasive techniques which work better than old methods that left scarring that could be seen. “A woman wants her breasts to look better with her clothes on,” says Dr. Frank Lista. “A man wants his chest to look better with his clothes off.” The new surgeries include a tiny four-millimetre incision under the armpit or at the side of the chest.

'Breast' to be cautious!

Most men who are bothered by their enlarged breasts feel that way for cosmetic reasons. But breast enlargement should always be checked out by a physician as it could be a sign of breast cancer (yes, men get it too) or other conditions. Don’t hesitate if you have any of the following symptoms:

* A breast lump

* An ulcer over the breast

* Discharge from the nipples

* Recent swelling, pain or enlargement in one or both breasts

Dr. Lista's POV on:

"Man Boobs" a Growing Problem

I was recently interviewed for this article to discuss the problem of male breasts, otherwise known as gynecomastia. The article arises from the increasing interest in breast reduction surgery for men. Usually the only way to correct this problem is surgery. The operation takes about an hour, is relatively painless and is very safe to perform. Most men are back to work in a few days. The most frequent comment I hear is, “Why didn’t I do this earlier?”


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