Treatment Options For Gynecomastia, Also Known As Puffy Nipples Or Man Boobs

Gynecomastia is the term to describe male breast enlargement. Enlargement can take different forms from enlargement of the nipple with descriptions such as “puffy nipple,” to large excesses of the entire breast.

Gynecomastia is seen most commonly in boys in their early teens as well as in older men and is usually due to hormonal changes that can occur at these times. Most cases that develop at the time of puberty improve or resolve over the next few years. This enlargement, at any age, can cause emotional discomfort and impair self-confidence. It often makes it difficult for males to participate in certain physical activities or find clothing that doesn’t reveal their prominent chest.

Males with gynecomastia may benefit from breast reduction surgery. Operations to reduce the male breast vary based on whether the excess tissue is dense glandular tissue or more loose fatty tissue. Liposuction alone is appropriate for primarily fatty tissue excess while open excision will address the more dense glandular tissue. Sometimes a combined approach of liposuction and open excision is appropriate. If the enlargement is significant, some portion of skin may also need to be removed, thereby restoring the masculine contour of the chest.

The amount of excess tissue also helps determine whether the procedure can be done in the office under local anesthetic or if general anesthetic in the surgery center would be recommended. Either way the operation is a same-day surgery, taking approximately one hour to complete.

Postoperative restrictions are minimal, with a return to work within one to two days, and strenuous activities in two to three weeks. Patients are asked to maintain a compressive garment in place over two to three weeks to encourage the swelling to decrease. Other recommendations are to avoid direct sun exposure for at least six months.

The average cost of gynecomastia surgery is $3,196. That is the national average surgeon/physician fee according to 2013 statistics from American Society of Plastic Surgery.

Schedule a free consultation with Dr. Marion to discuss your specific options, get answers to your questions, and get to know Dr. Marion and his staff.


You may also click here to see before and after pictures of Dr. Marion’s gynecomastia patients.

What Can Liposuction Do For Me?

Liposuction removes unwanted fat which improves the overal shape and contour of the body.

The target areas most common in men include abdomen, waist and flanks (love handles). In women the areas are abdomen, hips, thighs (saddle bags) and buttocks.

Other possible sites include: upper arms, back, chest, cheek, chin, neck, calves and ankles.

What Can’t Liposuction Do For Me?

Liposuction can take care of excessive fat in most areas, but it is important to realize it is not a substitute for diet and exercise. It has limitations on how much fat can safely removed and sometimes another procedure, i.e. abdominoplasty, may provide better contours. Liposuction is not a tool to remove dimpling or cellulite and it does not affect skin laxity. Many body types can improve with liposuction, but we see the ideal candidate as those who are otherwise healthy, active but have certain areas (love handles, saddle, bags, etc) that don’t seem to improve despite hard work.

How Is Liposuction Performed?

Liposuction has several forms but essential to all devices and types are a few key points. All liposuction procedures use a small wand type device is used to introduce fluid that helps to break up the fat cells, reduce the amount of bleeding and discomfort from the procedure. Once the fluid has been introduced a similar wand or cannula is introduced to remove excess fat from trouble spots. The cannula insertion requires a small incision, usually less than 1/4″ long, which is placed so as to not be noticeable with healing. For best results, each area is usually approached from two different insertion sites. Once healed these scars are often difficult to even find.

After surgery you will be fitted with a tight fitting garment to promote resolution of the swelling and quicker recovery. This is generally worn for at least 2 weeks.

Expected Results/Recovery

Results from liposuction procedures takes patience. Early on there is some fluid retention in these areas and the swelling can take weeks to resolve. Look for improvement in the following weeks, with continued improvement in the areas suctioned over several months. Provided one’s weight remains stable, the results may be very long-term.

Before & After Photos HERE

Is Liposuction Safe?
Complications from liposuction are usually mild and avoidable if the plastic surgeon is well trained. More common downsides of the procedure can be asymmetries or contour irregularities where the fat was removed or bruising as a result of removing fat. Less common and more severe complications involve injury to other tissues in the area such as the deeper organs or the overlying skin, infection, blot clots. Most concerning are reports of small pieces of fat or blood clots entering the blood stream and fatally traveling to the lungs or heart.

How Much Does Liposuction Cost?

The average cost of liposuction is $2,866, according to 2013 statistics from the American Society of Plastic Surgeons. The average fee referenced above does not include anesthesia, operating room facilities or other releated expenses. What is the cost of liposuction?

Dr. Marion’s prices generally start around $2400 with additional areas around $750 each. (Fee are approximate)

Questions About Botox

Botox has been called the single most revolutionary “beauty treatment” in the past century. People are familiar with the name Botox and the idea that it may stop or help slow aging or turn back the hands of time and improve one’s youthful appearance. But still, many do not know a lot about it.

Let’s answer some important questions commonly asked about Botox:

Where does the name Botox come from, and what is it?

Botox is the trade name for the original medication developed from botulinum toxin, the active neurotoxin found to produce temporary muscle relaxation. The FDA has two other companies that make drugs with similar effects – namely, Dysport and Xeomin.

What Can Botox / Dysport / Xeomin do For Me?

There are lists of areas that cosmetic botulinum toxin has been used to treat, including crows feet (periocular wrinkles), vertical or 11 lines (glabellar) frown, Horizontal (frontalis) frown, Bunny Lines (nose wrinkles), Upper Lip, angle of the mouth, jaw line (platysma), venus rings (horizontal neck rhytids), Turkey neck (vertical platysmal bands), amongst others. Many of these are off-label, meaning the FDA has not provided specific indication for those areas.

Beyond the cosmetic results seen with botulinum toxin injection, other uses include, reducing excessive sweating (hyperhidrosis), painful teeth clenching (bruxism), migraine headaches, neck muscle spasm (cervical dystonia), blepharospasms, etc.

What CAN’T Botox / Dysport / Xeomin Do For Me?

Botulinum toxin injection may improve the appearance of fine lines and wrinkles, especially those only present with motion. For deeper wrinkles or those present even while the facial muscles are at rest, recommendations in addition to botulinum toxin injection may be of benefit. Also, because of how these medications work, they are not to be injected in people with certain neuromuscular disorders, taking certain medications or those that are pregnant or breast feeding.

How Is Botox / Dysport / Xeomin Administered?

The medication is injected directly to the areas of concern during a simple office procedure that takes a few minutes. The needle used is one of the smallest made and there is no pain after the injections are complete. Patients often will have a raised area at the injection site that quickly disappears. Patients are cautioned against laying down, doing strenuous activity/exercise, or wearing tight hats immediately following injection.

How Does Botox/Dysport/Xeomin Work?

At a basic level, the botulinum toxin works by blocking the release of chemicals that normally act between the nerves and muscles which cause the muscle to contract. The time period between injection into the muscle and decreased muscle function is between 24 hours and five days. With this block in place the muscle does not contract and as a result of non-use it tends to become weak and small. Think keeping your arm in a cast for a few weeks, then noticing how small the arm looks once the cast is removed. This effect is reversible, however, as with time new chemicals act from the nerve to the muscle to allow it to contract again. This is why the effects of cosmetic botulinum toxin are not permanent and require repeated injection for continued effect.

How Long Will It Last?

As explained above, the effects of Botox / Dysport / Xeomin are limited in their duration and last on average around 14 weeks, with the full effects seen by the first 4 weeks. There is some evidence that the muscle remains relatively less bulky even beyond this time.

It has also been reported that patients may become resistant or develop decreased effectiveness to the drugs over time. In those cases, switching to one of the other muscle relaxing agents usually resolves the issue.

Is Botox / Dysport / Xeomine Safe?

Botox has been FDA approved for treatment of glabellar lines since May 2002, with recent new approval for the treatment of the periocular or “crow’s feet” area in September 2013 Beyond this, the same medication has been used for non-cosmetic reasons since the late 70’s. The American Society of Plastic Surgeons has reported Botulinum Toxin injection has become one of the most performed non-surgical cosmetic procedures in the world at 6.3 million procedures in 2013 alone. This is up 3 percent from the previous year. With millions of patients being injected each year, the safety and effectiveness of Botox / Dysport / Xeomin is unquestioned.

Having established its safety, it is important to also know that there can be side effects to injection with botulinum toxin. The most common being mild bruising, swelling, temporary headache, asymetries, or ptosis.

How Much Does Botox / Dysport / Xeomin Cost?

Cost is usually discussed in terms of “units” of the medication injected to treat specifically areas. Because specific areas require different amounts of the botulinum toxin costs can range significantly. The cost per unit is $12 (Fees are approximate).

What are Gummy Bear Implants?

Gummy Bear implants is a marketing term or nickname for cohesive gel implants. Cohesive silicone implants are form stable, meaning the implants hold their shape like jello or their nickname, gummy bears. Standard silicone implant consistency is similar to honey. Because “gummy bear” implants are form stable they are less likely to leak if the implant shell fails and keep their shape over time.

Gummy bear implants form stable shape mimic the natural shape of the breast, they are thicker at the bottom and tapered towards the top. For this reason they are a popular implant choice with woman for breast reconstruction. Other advantages are less wrinkling of the implant and studies are reporting less capsular contracture around implant. Some reported disadvantages of the gummy bear implant are dissatisfaction with the firmer gel, shape and sometimes larger incision.

The FDA recently approved a third manufacturer to sell form stable implants: Mentor, Sientra and Allergen.

Luscious Lips and Dermal Fillers

Even if you were not born with Angelina’s plump pout, there are ways to achieve the luscious lips you have always desired. The path for creating beautiful lips all begins with skin care, but your transformation can be enhanced with dermal fillers.

Exfoliating removes dead skin while stimulating blood flow to the lips. “You’ll get a rosy, juicier-looking mouth that looks great untouched or with a slick of gloss,” says celebrity makeup artist Charlie Green. Next, apply a simple moisturizer to create a smooth canvas for lip color application. If you want an added bonus, look for a lip balm that contains hyaluronic acid, a powerful natural humectant that binds water to lips for a fuller look. Choosing a light lip color and using a smooth brush for application will help the lips appear fuller. Choose light shades over darker ones; it is a basic color theory that light colors magnify. To make your pout pop even more, brush a nude eye shadow along the cupids bow of your upper lip, says Wende Zomnir, executive creative director of Urban Decay Cosmetics. Most women have a bigger bottom lip, and this trick helps create proportion. Finally, applying a dab of lip gloss to the center of the mouth will complete your look for fuller and more luscious lips!

If these simple make-up tricks do not work for you, medical fillers are the best option to achieve beautiful, long-lasting results.There are a number of commercially available injectable fillers (i.e. Juvederm, Perlane, Restylane, Scupltra, Radiesse, etc), and the best choice for any patient should be discussed with your plastic surgeon. Choosing the right injectable filler is based on understanding where they can be placed, the risk of side effects, how long they will last and how much they will cost. Natural collagen is what gives the skin a supple and youthful appearance. As we all age, wrinkles and loss of volume comes from the break down of our natural collagen. One of the best ways to achieve more youthful skin is to replenish the volume your skin has lost. Medical fillers can enhance fullness within minutes all while stimulating the production of your natural collagen.

We offer free consultations to discuss these issues and personalize your treatment plan. Call us 801.331.8554 or contact us to set up your consultation.

More detailed information and answers to common questions can be found here: