More men are getting breast reductions. What to know about gynecomastia and how it’s impacting male body image.

In 2023, more than 1.6 million men had cosmetic procedures, a significant portion of which were breast reductions.

Gynecomastia surgery — a procedure that removes excess breast tissue from males specifically — was the “most sought-after procedure for men,” according to the latest report from the American Society of Plastic Surgeons (ASPS). Liposuction followed closely behind.

“Men are becoming more aware and much more in tune with wellness and their physical appearance,” Dr. Michele Shermak, a Baltimore-based plastic surgeon, tells Yahoo Life. “There’s a big awareness of plastic surgery and less of a stigma about it. And men are kind of the last frontier of stigma.”

But while she theorizes that men are getting “on board” with surgical cosmetic procedures, it’s still curious that breast reductions are among the most popular, as both the data and anecdotal evidence from surgeons suggest.

What is gynecomastia?

Both men and women have glandular tissue in their chests. For men, it is typically more involute than for women, says Shermak, meaning that it doesn’t contribute to breast growth. However, that is not always the case. In fact, 50% of people assigned male at birth will be affected by gynecomastia at some point in their lives, according to the Cleveland Clinic.

Dr. Joshua Jacobson of Jacobson Plastic Surgery in Beverly Hills, Calif., tells Yahoo Life that he’s not only seen an increase in patients seeking gynecomastia removal surgery in his practice, but he has undergone the procedure himself.

“It runs in some families and can be genetic or due to endocrine disorders, medications such as testosterone, spironolactone, some antacids and some HIV medications, just to name a few. Also, cannabis and alcohol have been associated with it,” says Jacobson. “Some tumors, like from testicular cancer, can also have this effect, due to increased estrogen production.”

Natural hormonal changes and weight fluctuations also play a role. In any case, the condition can cause excess skin, in addition to fat and tissue. Most importantly, it’s not harmful to physical health.

How is it removed?

The specific procedure depends on the extent of a person’s gynecomastia and the type of tissue in the breast. Most often, it requires a small incision around the areola for the tissue to be cut out. “That is usually paired with liposuction of the chest,” says Shermak. “With that type of surgery, it’s really small scars, barely visible, but really impressive results.”

More severe procedures are required for excess skin. “A bigger need for more skin removal tends to require some bigger incisions and scars,” she says. The type of gynecomastia a person has, and therefore the surgery they’ll need, are graded from one to three.

Cleveland Clinic reports that aftercare usually consists of wearing a supportive garment around the chest to reduce swelling and taking medication for pain, swelling and for lowering the risk of infection. In some cases, tubes are temporarily placed under the skin to drain fluid and blood during the healing process.

Why are so many men getting the surgery?

The number of gynecomastia surgeries performed each year indicates how common the condition is. However, a general rise in male plastic surgery and in conversations about body image among men appear to be the chief reason for the 23,831 gynecomastia surgeries for men recorded for 2023.

“Men are more in the mix of having surgical procedures done. They’re seeing it on social media and are open to more information just as participants in social media,” says Shermak. “And the whole wellness, physical exercise space is huge for men.”

Boys, in particular, are becoming more exposed to unrealistic body standards, which is influencing their body image. Shermak says that teenagers who come to her feeling self-conscious about asymmetrical breasts or full chests make up a good proportion of her cases. “I had one young man who came in presenting [gynecomastia], and it really was impacting his body image. … And he’d been on some antidepressants,” she says. “When he came to see me a year later, he was off almost every single medication and had lost weight on his own. He just looks like a different person. And I say a big part of this difference is more his just confidence and the way he presents himself. He’s now a lot more comfortable with who he is.”

Communities of men with gynecomastia on social media illustrate that phenomenon. A subreddit dedicated to questions and discussions about the condition sees active members of all ages sharing their experiences.

“I developed grade 2 gyno [shorthand for gynecomastia] when I was 12. I hated how it looked and got bullied a ton for it, mostly in locker rooms. Twenty years later, I am comfortable in my own skin. But I hit a point in training (weightlifting and running) where the thought that I can’t improve on something because it is outside of my control put me over the edge,” one user wrote. “I remember promising myself when I was 14 that once I will make enough money, I will do it. Well, today is the day. I am so stressed though, hope the day goes OK and that the results won’t cause another insecurity.”

“I’m 1 hour out of surgery, wildly sore, but already mentally, I feel incredible,” wrote another. “This sub[reddit] has helped me tremendously in making this decision for myself. I’m 36M, I’ve had gyno since high school, and for the last 20 years have put off surgery for every reason under the sun, until this summer, when I realized on a deep, deep level that it was either get the surgery, or live with it for the rest of my life. It’s not like we get a second chance at this.”

Trends like the “ballet body” and the rise of weight loss medications promote the ideal of aesthetic, proportion and athletic physiques in women and men, according to the ASPS report. So as breast reductions rise in women, the organization suggests that the subsequent rise among men makes sense.

“Men wanted to feel confident in clothing, [including] fitted shirts that accentuated the contours of their chest. Also, they likely wanted to be at ease with their chests when not wearing a top either at the beach in a swimsuit or in a game of shirts against skins,” states the ASPS report. “Other favored procedures for both men and women toned and tightened their cores by getting rid of stubborn fat or sagging skin that diet and exercise couldn’t target.”

Shermak says that weight loss accounts for a subsection of the group getting gynecomastia-removal surgery. “Weight loss is again part of the whole wellness movement. And so there’s a group of people who can do their CrossFit and can do their weight loss, but they’re still left with something that might need a little surgical management to kind of get them over the hump,” she says.

Changing attitudes about weight and weight loss also contribute to the rise, according to Jacobson.

“In the past, people would blame the individual for being overweight and therefore make them believe the only answer is diet and exercise. But as plastic surgeons have been showcasing gynecomastia surgeries, bringing more awareness of it and displaying before/afters, the general public has become more aware of it and has realized it can be present even in skinny individuals — and in a lot of cases the only way to treat it is surgery,” he says.

The average cost of gynecomastia surgery is $5,587, according to the ASPS, which is lower than that of aesthetic breast reductions in female patients, at $7,800. Both numbers exclude the cost of anesthesia, operating room facilities and other related expenses, which are typically not covered by insurance. All things considered, Shermak says “the price point is appealing” for men, especially considering the life-long results.

The bottom line

Men’s new willingness to undergo elective plastic surgery to address aesthetic needs is worth noting, says Dr. Jerry Chidester, a Utah-based surgeon. “The increasing demand for this procedure underscores a larger trend,” he tells Yahoo Life. “Men are taking charge of their health and aesthetics, leveraging advances in medicine and surgery to enhance their overall quality of life.”