Question: Are tuberous breasts on males the most difficult to deal with?

[ineedsurgery]

Just seems like it's the most rare of the male breast deformities. Especially if the male is not overweight. Is it the most difficult to operate on? I really need mine removed

[George Pope, M.D.]

Tuberous breasts are a challenge in gynecomastia surgery, but the correction can be done.  Women can have the same issue, and their repair, usually involving breast implants, can be challenging as well.

Be sure to ask your plastic surgeon about his/her experience with tuberous breast deformity.

Dr. Pope, MD

[Dr. Elliot Jacobs]

Tuberous breasts on a male are an extreme example of a puffy nipple.  In these circumstances, all of the breast tissue is concentrated directly under the areola, so the breast becomes long and narrowed with a rounded areola at the end.

I have treated this condition successfully with a combination of lipo and direct excision.  The lipo is important not only to remove excess fat and gland, but also to help re-distribute the excess skin over the entire expanse of the chest wall. 

You can see examples of this in the photo gallery of my gynecomastia website (see below) -- see patients 68, 71 and 77.

Yes, there is hope.

Dr Jacobs

[ineedsurgery]

Thanks for giving me some hope Dr's.

[ineedsurgery]

Is the price usually more because of how rare it is?

[Dr. Elliot Jacobs]

To a certain extent, the fee is determined by the anticipated length and complexity of the planned operation.

Why don't you post some photos??

Dr Jacobs

[DrBermant]

Just seems like it's the most rare of the male breast deformities. Especially if the male is not overweight. Is it the most difficult to operate on? I really need mine removed

There are many such challenges, none can be labeled the "most difficult." Tuberous breasts come in many different variations and degrees of difficulty. An individual with good skin tension skin will be easier than someone with stretchy skin and stretch marks in how that skin of the tuberous breast will adapt. A patient with a one sided tuberous breast will be so much harder to make look good that having it on both sides.

The patient after hundred of pounds of weight loss loose skin around the entire body is another example of a problem difficulty requiring compromise. Another example is the individual with growing breasts with no cause that can be found and corrected. Without such stabilizing, that is another extremely difficult problem to some. Another extremely difficult case, may be revision surgery with a deformity that makes the operation a compromise.

Realizing such limitations before the operation and then living with that compromise can be a task for both patient and surgeon.

The single most rare deformity I have ever seen was the case of Congenital Adrenal Hyperplasia XX individual that should have been diagnosed as a female early in life that I published on my website. Hopefully that individual was unique, the entire medical system in failure for so many years. When I discussed that case at my presentation to the National Meeting of Endocrinologists, none had seen a similar problem. Yet, I was able to find a therapist who had seen several such missed diagnoses who helped find that patient a local resource to deal with issues of finding out his life as a male was really of a body with XX chromosomes and a defect in his adrenal glands.

Tuberous breasts, I have seen many and sculpted many. Yes it is demanding and solutions will require demonstrations of how well that loose skin adapted over the new contour. That is why I added bending over views to that problem and solution pictures. One of my last cases was such a deformity and the documenting Standard Male Mastopexy Pictures and Video were very revealing of the power of the sculpture. Look for that technique of documentation when learning about a surgeon's methods with that problem. Looking at how good loose skin sits on the male chest is better with more critical methods than just standing upright arms at the sides no flexing of muscle views.

Hope this helps,

Michael Bermant, M.D.

[Dr. Elliot Jacobs]

Why not post some photos so we can be of specific help for you?

Dr Jacobs

[ineedsurgery]

These are the only pictures I am able to upload at this moment. Sorry I do not have more pictures. https://www.gynecomastia.org/smf/index.php?topic=16389.msg114150#msg114150

[Dr. Elliot Jacobs]

Yours are small tuberous breasts with a very large areola.  The remainder of your chest appears fine.

In patients similar to you, surgery has been directed to removing the excess tissue beneath the areola. Then, attention is directed to the surrounding skin to loosen it and allow the skin to re-distribute across the entire chest.  When the skin re-distributes, the areola shrinks to some extent.  Sometimes, even after appropriate healing, the areola is still too large.  Then it can be reduced in size through a second, smaller procedure.

Sometimes the surgery can be performed in only one operation, but there will probably be more scars on the chest.

Dr Jacobs