Dallas, Fort Worth Plastic Surgeon Dr. David Azouz Busts Several Gynecomastia Myths

Gynecomastia is a common condition that can be disturbing to many men.  Unfortunately many myths still persist today that cause men to be discouraged when seeking treatment for gynecomastia.

Myth: ‘Pseudogynecomastia, Man boobs, Male Breasts, Gynecomastia are mutually exclusive (you have one or the other)”

Dr. Azouz:  Most men have a combination of fatty tissue and gynecomastia.  It is not uncommon for men to have massive weight loss and have true gynecomastia (pure breast tissue).  Similarly men who are at their ideal weight may have significant fatty tissue in their chest.  Most men will have a combination of gynecomastia (breast tissue) and fatty tissue.

Myth: ‘Nipple Size is independent of gynecomastia’

Dr. Azouz: Enlarged male Nipples are most often associated with underlying gynecomastia.  Patients undergoing gynecomastia surgery can often expect their nipple areola to reduce by half to one third of the size.

Myth:  ‘You will have Drains with Gynecomastia Surgery’

Dr. Azouz: We do not use drains in gynecomastia surgery.  This allows a more comfortable recovery without additional scarring from drain sites.

Scar with Gynecomastia Surgery “The scar is most often imperceptible and camouflaged in the areola.”  

Myth: Scarring with Gynecomastia surgery: ‘scars are multiple, large and visible’

Dr. Azouz: We only place one scar on each breast in our procedure.  The scar is most often imperceptible and camouflaged in the areola.

Myth: ‘Older men are not candidates for gynecomastia surgery’.

Dr. Azouz: Older men can have wonderful results with gynecomastia surgery.  We operate on men in their 70s and 80s routinely and have many older patients who are very happy after male breast reduction surgery.

Myth: ’Teenagers and pre teens are not candidates for gynecomastia surgery’.

Dr. Azouz: Young adults and teens can have wonderful results with gynecomastia surgery.  We operate on boys as young as 10 and 12.  There are patients who have severe gynecomastia even before they are teenagers.  Gynecomastia surgery can be performed in even growing boys.

Myth: ’Male breast reduction is very painful’.

Dr. Azouz: Many of our patients do not take any pain pills after male breast reduction surgery.  Some patients only take Tylenol and advil.  It is rare for a patient to ever need a refill of their pain prescription after surgery.

Contacting Us

Patients who experience gynecomastia are encouraged to contact us. We can perform a thorough examination and offer advice on the appropriate method of treatment. For more information and to schedule your consultation with Dr. Azouz at 972-702-8888, contact our office.

Will Gynecomastia Go Away Naturally or On It’s Own?

Although you commonly hear of breast reductions for women, male breast reduction is not as commonly discussed. Gynecomastia is a condition that can cause breast tissue in men to swell or enlarge. Gynecomastia presents from puffy nipples to large female appearing breasts. Approximately sixty percent of men have this condition, and many have it to the point that they choose surgical correction.  In adults when gynecomastia persists for 12 months, surgical excision and body contouring is the definitive treatment of choice.

What is gynecomastia?


Gynecomastia is a condition that can first present in puberty or after infancy, as the young man is encountering many different changes in his body. An imbalance between testosterone and estrogen can cause breast tissue to develop and grow in a male. Although the exact etiology of this condition is not always clear, steroids, recreational cannabis and other medications are believed to contribute to gynecomastia. Other factors like weight and age can also influence the development of gynecomastia.  The overwhelming cause of gynecomastia is a genetic predisposition inherited from a male relative.


To many males, especially as a young teen, this is a source of embarrassment. Many young men report not wanting to participate in sports or any team activities that require changing in front of other young men or women. Patients often report being very self-conscious of their bodies and try to hide it in various ways. Older men may also experience difficulty with self esteem and avoid going shirtless, playing sports or wearing tight fitting clothing. There are also men who intentionally gain weight in order to camouflage their gynecomastia.  Gynecomastia may be minor and fade away past puberty, or it may be excessive and not reduce or disappear.


Gynecomastia is also referred to as male breast tissue, gyno or “man boobs”.  Gynecomastia is different from pseudogynecomastia which involves lipodystrophy or abnormal fat distribution in the chest.  Most men who are afflicted with gynecomastia have a combination of both lipodystrophy and true gynecomastia.


Will gynecomastia go away naturally?


Males affected by this condition often want to know the answer to this question: Will gynecomastia go away naturally? The simple answer is it depends. For young boys, gynecomastia often goes away after puberty. However, for many children, young adults, and adults the appearance of gynecomastia may be permanent. In fact, the only proven treatment for this condition is male breast reduction, a surgical procedure. When a skilled plastic surgeon performs this procedure, it creates a permanent change in the male’s physical appearance.  The gynecomastia removal can often be achieved with one outpatient surgical procedure.


How do you choose a good plastic surgeon for liposuction and removal of gynecomastia (male breast reduction)?


Most importantly, you need a plastic surgeon you can trust and feel comfortable with. A plastic surgeon is a surgeon who has completed a minimum of 3 years of general surgery and 3 years of plastic surgery.  It is advisable to directly inquire if your plastic surgeon completed a residency in plastic surgery.


Azouz Plastic Surgery has two such plastic surgeons, who are sympathetic to your problem and skilled in performing male breast reductions. Both plastic surgeons perform gynecomastia surgery (male breast reduction) on a regular basis.  Dr. Azouz routinely does not use drains, performs gynecomastia surgery as a day surgery and often is able to achieve the desired results with imperceptible scars.  Dr. Azouz performs Aesthetic (Cosmetic) and Reconstructive surgeries of the chest and has experience in treating patient with advanced gynecomastia, Poland syndrome, placement of pectoral implants, nipple/areola reduction and chest asymmetry.


If you are affected with gynecomastia, schedule a plastic surgery consult and call 972-702-8888 today.

Gynecomastia in Teens – Azouz MD

What is gynecomastia?

Although breasts do not develop in males like they do for females, most men are born with a small amount of breast tissue. A male’s body makes the testosterone hormone which guides his sexual growth and development with puberty. However, males also produce the female sexual growth hormone, estrogen. Endocrine studies have demonstrated a hormonal imbalance with an increase in estrogen, leading to a swelling and hypertrophy of male breast tissue. Almost 50 percent of adolescent boys develop gynecomastia to some degree and some will develop permanent gynecomastia presenting as a female appearing breast or as puffy nipples.  Some men will also present with lipodystrophy, which is an abnormal distribution of fat overlying the pectoralis muscles. Many men have a combination of both abnormal fat distribution and gynecomastia (breast tissue) appearing to be female breasts.

Gynecomastia in young adults and teens – Azouz MD

With puberty comes a number of changes to the body.  The appearance of facial hair and deepening of the voice are part of healthy male development. Sometimes, teenage boys may experience another change that comes in the form of breast tissue enlargement which is distressing and cause self-consciousness with tight-fitting clothing or when shirtless.

What causes gynecomastia?

There can be a number of factors that that can cause gynecomastia in men and teens, however, the exact cause can be difficult to determine. Most cases of gynecomastia are no fault of the patient and run in families being genetic. Some factors that are felt to contribute to gynecomastia are as follows:

  • An injury to the testicles which make testosterone or disease affecting it.
  • Problems of the liver, thyroid or kidneys
  • Obesity which leads to an increase in estrogen.
  • Certain medications like those for depression, cancer, ulcers or heart disease.
  • Drugs like marijuana or steroids.
  • Dietary or herbal supplements

What are the symptoms and treatment?

Gynecomastia can initially present as a lump of fatty tissue under the nipple. The swelling in the breasts may be even or uneven.  Most patients have some asymmetry between the two breasts.

Dr. Azouz evaluates each patient with a history and physical exam.  When indicated Dr. Azouz is able to contour the chest with liposuction and removal of gynecomastia and fatty tissue.  Dr. Azouz routinely camouflages small incisions around the areola and does not use drains.  Liposuction and removal of gynecomastia is routinely performed as a day surgery and many patients report experiencing little pain after surgery.  Dr. Azouz will guide aftercare and advise patients on when to return to light and heavy physical activity.

How Old Should I Be for Gynecomastia Treatment?

Although most men experience gynecomastia, or enlarged male breasts, at some point in their lives, not every patient fits the criteria for a good candidate. This is because gynecomastia can change over time or resolve on its own, so life stage is a very important factor when looking at your options with gynecomastia treatment. As you plan your consultation for male breast reduction, here are some things to consider.

Considerations for Puberty

Because gynecomastia is most commonly caused by hormones during the body’s development, puberty can be a huge factor in deciding whether surgery is appropriate for candidates. Most men experience gynecomastia during their teenage years to some degree, but this usually resolves as the body exits puberty. For this reason, male breast reduction may be detrimental to the body as it continues to change. If you’re still within your teenage years, you should be sure to discuss your options with Dr. Azouz and explore other options if you’re still experiencing this important phase.

Considerations for Maturity

Plastic surgery is no small choice, so most plastic surgeons will be sure to discuss with their patients the repercussions of choosing their procedure. Male breast reduction can be an effective, long-term solution, but it’s not a permanent fix. Despite treatment, gynecomastia can still reoccur without the proper life changes to ensure it stays away. These can include avoiding weight gain and certain medications. Overall, patients for any plastic surgery procedure should be mature enough to understand the procedure and its ramifications on their body and their lifestyle.

What Age is Best?

This question can be difficult to answer, since every patient presents a unique case. Male breast reduction is best for patients who have outgrown puberty and still have enlarged breasts. However, many male breast reduction patients are middle-aged or older and experience enlarged breasts as a result of aging or weight gain. In any case, ideal patients have tried lifestyle adjustments to reduce their gynecomastia and are able to consent to and undergo surgery to correct it. The best way to determine whether you can benefit from gynecomastia treatment is through a consultation with Dr. Azouz.

Dr. David Azouz is a top gynecomastia plastic surgeon in the Dallas area who performs effective male breast reduction techniques at our state-of-the-art practice. To schedule a consultation to discuss your gynecomastia treatment options, contact our office by calling or filling out our online form.