Patient Overview
This young adult male came to the Palm Beach Gynecomastia Center after years of struggling with chest fullness that had persisted since adolescence. His chest had a distinctly puffy appearance, with rounded, prominent areolas that projected outward, which is a classic sign of gland-dominant gynecomastia.
Despite maintaining a slim to average build, the protrusion created a look that felt out of place with the rest of his frame. The condition was especially noticeable when shirtless, leading to years of emotional discomfort, social self-consciousness, and a hesitance to participate in activities like swimming or going to the gym.
This was not a case of generalized fat accumulation. His chest shape did not change with exercise or weight fluctuations. It was clear that the tissue present was glandular in nature: dense, fibrous, and unresponsive to lifestyle modifications.
Physical Presentation
During the consultation, the patient showed:
- A lean torso with minimal abdominal fat
- Significant projection of both nipples and the surrounding areola
- Firm subareolar masses palpable under the skin
- Symmetrical gynecomastia with no signs of hormonal imbalance
There was no associated skin laxity or ptosis. His skin tone and elasticity were excellent, which made him an ideal candidate for gland excision without the need for skin removal or liposuction.
Surgical Plan and Technique
The plan for this case was straightforward and focused. We recommended direct glandular excision,
performed through a small incision placed inconspicuously along the lower border of the areola. This approach would:
- Remove the dense, fibrous breast tissue responsible for the projection
- Restore a flat, masculine contour to the chest wall
- Preserve surrounding structures for a smooth and natural shape
- Leave behind a well-hidden scar that would become nearly invisible over time
The procedure was completed under local anesthesia with oral sedation. The incisions were minimal, and no drains were required. The entire surgery was performed in an outpatient setting, and the patient returned home the same day.
Recovery Experience
Recovery progressed smoothly. The patient wore a compression garment for several weeks to control swelling and support healing. While mild soreness was present in the first few days, he was able to return to light activity almost immediately. By the end of the second week, the swelling had reduced significantly, and the results were already becoming visible.
The most noticeable difference appeared in the profile view, where the nipple and areola no longer projected forward. The chest had flattened and blended naturally with the rest of his torso. At four weeks post-op, the incisions were healing well, and the patient was cleared to resume moderate physical activity.
By six weeks, the chest contour had stabilized. There were no contour irregularities, indentations, or
asymmetries. The final shape appeared smooth, balanced, and athletic.
Outcome and Final Appearance
Postoperative outcome for this patient were both physically and emotionally notable.
This included:
- Full resolution of glandular prominence
- No residual puffiness or bulging beneath the areola
- A nearly imperceptible scar at the lower edge of the areola
- Excellent skin retraction due to the patient’s natural tone and elasticity
The patient reported a significant boost in confidence and body image. He began wearing clothing that he had previously avoided and resumed activities he had long been hesitant to participate in.
While the physical result was excellent, it was the emotional impact that stood out most clearly in follow-up conversations.
Surgeon’s Note
This case is a textbook example of how gynecomastia surgery can completely transform a patient’s
experience in their own body. In cases where the glandular tissue is the primary cause of contour irregularity, direct excision is both curative and permanent.
At the Palm Beach Gynecomastia Center, we specialize in identifying the correct cause of gynecomastia and tailoring treatment accordingly. For this patient, just one carefully executed surgery, performed with precision and an eye for natural anatomy, was all it took.
If you are looking to get rid of your gyno, be sure to reach out to our male breast reduction center today!
