I am currently 24 yrs old, and have had gynecomastia since around 13. I decided to post my stories here to maybe better inform others in my shoes about what they're up against and to maybe find good advice myself that I didn't expect to find.
My case is not typical at all, except that it seems to be related to puberty. I was a skinny boy all growing up and started developing gynecomastia in only my right breast at 13. It grew slowly until about age 16 by which point it was a b cup in size, while the left breast was still perfectly normal and flat. The mass under my skin composing my gynecomastia was different than I see it described in most medical articles. Mine was as hard as a rock where most articles describe it as being soft like a woman's breast. Additionally, mine brought me pain when any amount of pressure was applied, so things such as playing a guitar with the back of the guitar on my chest would hurt. It would also occasionally hurt on its own, as a slight pinching.
I was a reasonably active student involved in wrestling and track. I avoided swimming and tight clothing, and when I showered after practice at school I just pretended like it wasn't there, never paid attention to whether or not anybody was looking. But outside of being shirtless, I often walked with my back slightly hunched so that it wouldn't protrude and be visible from under my shirt. Ah to stand up straight in public, I can only imagine how good it must feel.
In 2007 after two years of college, my dad decided to get surgery for it. We consulted with a local plastic surgeon by the name of Andrew Mandery on the kinds of surgical procedures available and likelyhood of insurance coverage. He said there are two procedure options. Liposuction- with two holes for the tubes one one the side of my breast closest my armpit and the other on the bottom. And what I believe was called mastectomy with a semicircle cut around the edge of the nipple to directly cut out the tissue. He said lipo would not be covered and mastectomy may or may not be. He also said that lipo leaves less visible scarring than mastectomy. My dad wanted to get the best results and opted for the lipo with a $3,000 price tag.
The surgery was done under anesthesia and took several hours for them to suck out what they did. When I was told the amount they removed it was given to me in liquid volume units (cc). I said nothing but was wondering to myself how this painful brick inside of me could have been converted into liquid. I was weak during the recovery, even nauseous at times and when I removed the compression bandage wrap a week later my chest was very bruised all over, my breast still protruded, and there was a divot above my gynecomastia where the hard tissue had never even been in the first place. They had apparently decided it was taking too long to break the rock and suct it out that they went for my adipose tissue (fat) all the way to my muscle, which explains the liquid measurement units. The divot indicates a spot where there is virtually nothing between my muscle and my skin, it's as thin as paper. Luckily the divot isn't very large and with my arms at my side or in front, it isn't noticable.
We went back to see the doctor for a checkup a month later and he said they didn't accomplish what they set out to and since my dad paid $3,000 out of pocket or it he would perform another surgery in his office free of charge. Doing it in his office meant that there was no hospital staff or anesthesiologist, just local anesthetic injection, one assistant, and a mastectomy. During the procedure he was having a hard time and said "No wonder we had such a hard time liposucting." After that procedure, I wasn't weak or nauseous which indicates that my body didn't miss the gynecomastia tissue removed, it was weak the first time due to real damage and losing legitimate body tissue.
However, even after this second breast reduction, I was still left with an easily visible lump of gynecomstia in my right breast, still hard as a rock, still painful to pressure, still occasional pinching, and a few scars and a divot to boot. I was supposed to schedule a checkup with the doctor after that but I was not a proactive 19 yr old, and my father wasn't either so the appointment was simply never made and the doctor never got to see the product of failure himself. That was five years ago and I'm still a back-hunching, loose-shirt-wearing, never-swimming gyne victim dreaming of someday having enough money to find a good surgeon who can make me look normal.
Feel free to ask for additional details.