This 37-year-old man came to the Charlotte Gynecomastia Center with a concern he had lived with for decades.
He had developed gynecomastia during puberty and carried it into adulthood, despite remaining active and fit. As a former swimmer and now a father of two young children, he had become increasingly uncomfortable taking his kids to the pool or removing his shirt in public.
What bothered him most wasn’t just the appearance of his chest. It was how disconnected he felt from the confident, athletic person he used to be. He wanted to feel comfortable in his body again, especially during meaningful family moments.
A Thoughtful, Personalized Approach
After his consultation, it was clear this patient had true gynecomastia. A firm glandular buildup beneath the nipple had remained unchanged for over 20 years. There was no significant fat, no sagging skin, and no structural issue beyond the presence of the gland.
Since he had an excellent skin tone and lean frame, he was a perfect candidate for a quick, highly targeted procedure. He wanted a result that looked untouched, not overdone, and he wanted to avoid downtime that would disrupt life with two young kids.
We created a surgical plan focused on discreet correction and minimal recovery.
Awake Surgery with Zero Downtime
We performed his procedure under local anesthesia. There was no general anesthesia, no IV sedation, and no recovery room stay. He remained awake, relaxed, and pain-free throughout the procedure, and he drove himself home afterward.
This approach offered several benefits:
Reduced recovery time
He was able to return to family responsibilities almost immediately without extended downtime.
No risks from general anesthesia
Since he remained awake, we avoided many of the typical side effects and risks associated with sedation.
Increased precision during surgery
Operating while the patient is awake allowed us to confirm contour and symmetry in real time, ensuring a clean, natural result.
This type of awake surgery is an ideal option for healthy, motivated patients looking for real results with minimal disruption.
Surgical Technique: Remove the Gland
Our goal was simple. Remove the breast tissue, preserve the masculine contour, and leave no visible signs that surgery had ever been performed.
Direct glandular excision
We made a small incision along the lower border of the areola, carefully hidden at the six o’clock position. Through this discreet access point, we removed the dense glandular tissue causing nipple projection and distortion.
Targeted removal of the gland
The tissue was carefully sculpted to correct puffiness while maintaining the chest’s natural muscle slope.
No liposuction needed
Since the issue was entirely glandular and there was no excess fat, we avoided unnecessary steps and focused only on the problem area.
By using a direct yet minimal approach, we preserved the integrity of the chest while addressing the core issue effectively.
Scar Concealment and Healing
This patient’s only scar is at the bottom edge of the areola. It is small, flat, and blends naturally into the pigment transition between areola and skin.
No visible sutures
The incision was closed with dissolvable stitches placed underneath the skin to avoid surface marks.
No drains or bulky dressings
His recovery was simple and straightforward, with no need for special wound care or follow-up procedures.
Scar nearly invisible at 4 months
As shown in the magnified image, even close-up, the scar is barely detectable.
The subtle nature of the incision and his rapid healing meant that even under close inspection, there is no obvious sign that surgery occurred.
4 Months Later
At just four months post-op, this patient had already experienced a major shift, both physically and emotionally.
Chest is flatter and more balanced
The glandular fullness has been eliminated, and the overall shape of the chest is masculine and proportional.
Nipples now rest naturally on the chest wall
Without the underlying tissue pushing them forward, the nipples now sit flat without distortion.
No evidence of surgery
The result looks completely natural with no sharp edges, depressions, or surgical indicators.
Improved confidence around his family
He reported feeling comfortable taking his kids swimming again, something he hadn’t done in years.
The transformation was subtle but meaningful, restoring a sense of freedom in his day-to-day life and interactions with his children.
Final Thoughts
This case reflects the power of subtle, precise gynecomastia surgery. We didn’t need to transform this patient’s chest, just remove what didn’t belong and restore what had always been there beneath it.
The patient trusted us with a concern that had impacted his life for decades. In return, he got results that gave him his confidence back without disrupting his daily routine.
At the Charlotte Gynecomastia Center, we believe every patient deserves to feel comfortable in their skin. Whether you’re 17 or 57, we’re here to help you achieve lasting, natural results.
Contact us today to get started on your gynecomastia surgery journey.
