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 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.

Breast Augmentation Funnel

Patients seeking breast augmentation invariably ask about scars. Will I have them? Where will they be located? How big or noticeable will they be? One of the advantages saline implants have over silicone is the ability to place the implant (which is initially deflated) through a small incision, then to inflate them once they are in position. This is not possible with silicone implants because they are fully filled prior to insertion, which requires a larger incision. One method to decrease the length of the incision, and in turn, the scar, is to use a funnel device.

The funnel device, known as the Keller Funnel, is shaped similar to a pipping bag a pastry chef would use to put icing on a cake. Here the implant is placed into the large portion of the funnel and the smaller end is placed into the incision. The implant is then delivered out of the bag through the small opening and into the pocket created in the breast. The funnel itself is a sterile device that is used for a single patient and then discarded.

This device was recently updated, now known as the Funnel 2, the new iteration is clear which allows for better positioning of the implant within the pocket. Along with better positioning of the implant and a smaller scar for most patients, the funnel also aids in potentially reducing the risk of infection. The implant is not directly touched when being placed it in its position, which means it doesn’t come in contact with the bacteria on one’s hands. In addition, it has a low friction surface which allows for easier, quicker insertion than manually pushing the implant into place. This method also reduces the trauma placed on implant and therefore reduces the risk of rupture.

A final potential advantage to using the funnel is reducing the overall time of the operation. The implant is quickly delivered, reducing risk to the patient related to anesthesia time, as well as the added benefit of reducing operating room cost.

I am happy with the use of the Keller Funnel and employ it in my breast augmentations without increased cost to my patients.