This 27-year-old male came to us after years of struggling with persistent gynecomastia.
At 6 feet tall and 195 pounds with a muscular, athletic build, he had done everything right. Clean diet, consistent training, and discipline developed during his military service. Still, the glandular fullness beneath his chest never went away.
For someone who takes pride in his fitness, the prominence of gynecomastia was not just frustrating. It impacted how he viewed himself, especially in settings where he would otherwise feel confident like the gym or beach. He was ready for a long-term solution.
Assessing His Chest Anatomy
This patient had a unique challenge. His pectoral muscles were well developed, which made the glandular tissue appear even more pronounced. His skin quality was excellent, and he had minimal fat, but the hard, dense glandular tissue directly under the nipple created noticeable protrusion from all angles.
Due to the density and visibility of the gland, surgical excision was necessary. But to ensure a natural blend with the surrounding chest wall and prevent any harsh contour lines, we also performed VASERlipo.
A Fully Awake Procedure with Minimal Downtime
He underwent the procedure entirely under local anesthesia, remaining awake throughout.
Benefits of Local Anesthesia
This approach provides several advantages:
- No general anesthesia or IV sedation
- Faster recovery and fewer risks
- The ability to stand and assess symmetry mid-procedure if needed
At the Charlotte Gynecomastia Center, we often use this technique for men who want great results without the added recovery time of traditional surgery.
Surgical Technique
This case required a dual-modality approach to achieve a flat, masculine chest contour.
Step 1: Precision VASERlipo
We started with VASERlipo, an advanced ultrasound-assisted liposuction technique. This allowed us to:
- Gently emulsify and remove small pockets of fat surrounding the gland
- Shape and contour the edges of the chest
- Maintain the definition of the underlying muscle
Since his fat content was already low, this step was focused on fine-tuning the shape and improving the transition between the nipple area and the rest of the chest wall.
Step 2: Glandular Excision
We followed with direct glandular excision through a small, hidden incision at the edge of the areola. In his case, the gland was particularly firm and fibrous, making this step essential.
The goal was to remove the gland without flattening the chest unnaturally or creating a sunken area under the nipple. Balancing how much tissue to remove and how much to leave behind is a delicate part of this surgery and requires close attention.
Addressing Scar Tissue with Kenalog Injection
At his three-month follow-up, the patient had developed some firmness under the nipple. This is not uncommon and typically represents a buildup of internal scar tissue, not the return of gynecomastia.
We administered a low-dose Kenalog injection directly to the area. By his five-month photos, you can see that the scar tissue had softened and the contour evened out beautifully. The result is smooth, symmetrical, and natural in appearance.
Five Months Later: Results and Recovery
At five months post-op, his outcome reflects the power of a targeted, awake gynecomastia procedure. His chest now appears flatter and tighter, without any disruption to the muscular definition he had worked hard to build.
Visible Results
- Nipple projection has been fully corrected
- Chest contours blend cleanly into the upper abdomen
- No visible scars or contour irregularities
- No compromise in muscle definition or function
He resumed light physical activity within a week and was back to full workouts by the end of the first month.
A Personalized Solution for Physically Fit Men
This case is a great example of how gynecomastia can affect even the most athletic men. It also shows how important it is to approach each chest with a tailored strategy. In this case, the combination of VASERlipo, gland excision, and post-op follow-up care produced a chest that matches the patient’s physique and confidence level.
At the Charlotte Gynecomastia Center, we treat each case with the care and precision it deserves. Whether the patient is a bodybuilder, former military, or simply tired of living with unwanted chest fullness, we are here to help.
Contact us today to schedule your consultation and meet with our gynecomastia specialist!
