This 36-year-old man had struggled with gynecomastia since puberty. While he had maintained a healthy weight and active lifestyle, he continued to experience puffy nipples that worsened in warm conditions, along with occasional tenderness in the chest area. These symptoms were not just cosmetic. They affected how he dressed, how he felt about his appearance, and even how he trained at the gym.
He came to the Charlotte Gynecomastia Center hoping to resolve this long-standing issue without interrupting his routine too much.
His main goals were to flatten the nipple projection, eliminate the underlying gland, and be able to return to full workouts without hesitation or discomfort.
Surgical Evaluation and Custom Treatment Plan
During our consultation and exam, we found that this patient’s gynecomastia was caused by a combination of fat and dense breast gland tissue. His chest volume was disproportionate to the rest of his build, especially around the nipple area.
To address this, we recommended a combined procedure using both VASER liposuction and direct glandular excision. This approach would remove the unwanted tissue while preserving the natural slope of his chest.
Awake Procedure with Targeted Results
We performed the surgery under local anesthesia while the patient was awake and relaxed. This allowed for a quicker recovery and more precise contouring.
Breakdown of Tissue Removed
- Fat removed with VASER: We extracted 475cc of fatty tissue using ultrasound-assisted liposuction for smooth, even sculpting.
- Gland excised: A total of 90 grams of firm glandular tissue was removed from beneath the areola to eliminate nipple projection.
By addressing both the fatty and glandular components, we were able to create a flatter, firmer chest that looks completely natural.
Rapid Recovery and Weight Loss Progress
Thanks to the awake technique and minimal trauma during surgery, his recovery was smooth and quick.
Post-Op Recovery Timeline
- Back to cardio in 2 weeks: He resumed light exercise shortly after surgery without complications.
- Bench pressing again by week 3 or 4: He returned to full upper body workouts with no limitations.
- Dropped 25 pounds in 4 months: His weight went from 195 to 170, further enhancing his results.
This combination of surgical correction and personal commitment allowed his chest to take on a more athletic, sculpted look in just a few months.
Invisible Scarring and Aesthetic Detail
The patient was particularly concerned about scar visibility. With his lighter skin tone and active lifestyle, he wanted to ensure that there were no obvious surgical signs.
Where Scars Were Placed
- Areola border incision: The primary incision was placed at the lower edge of the areola, blending perfectly into the natural color transition.
- Underarm access point: A secondary incision hidden in the armpit allowed for lipo access without a scar on the chest wall.
Now at four months post-op, both incision sites are nearly impossible to detect, even when shirtless.
These subtle, well-planned incisions allowed for a complete transformation without leaving behind a visual reminder of surgery.
Final Thoughts
This case highlights how much can change with a focused, minimally invasive approach. This patient had lived with puffy nipples, tenderness, and self-consciousness for years. With one outpatient procedure and a brief recovery, he now has a flat, defined chest and the confidence to match.
At the Charlotte Gynecomastia Center, our goal is always the same. We give patients natural-looking results that align with the body they’ve worked hard to build.
Contact us today to schedule your consult and fix your gynecomastia!
