This patient is a 28-year-old male, 5’11” and 170 pounds, who has struggled with gynecomastia since puberty.
Despite maintaining a healthy weight and active lifestyle, he continued to see prominent glandular tissue beneath his nipples. The condition made him feel self-conscious in fitted shirts, and he avoided situations where he would need to be shirtless.
He reached out to the Charlotte Gynecomastia Center, hoping for a solution that would deliver permanent results without looking overdone. After a detailed consultation and assessment, we confirmed he had true gynecomastia, not just fatty tissue.
Understanding the Patient’s Concerns
From the beginning, this patient was clear about his goals. He wanted:
- A flatter, more defined chest that looked natural
- A procedure with minimal downtime
- To avoid general anesthesia
- A result that did not look “surgical” or obvious
Due to his overall lean frame, even a small amount of extra volume was noticeable. His case was an ideal match for our awake gynecomastia procedure using VASERlipo and glandular excision.
Why We Chose Local Anesthesia
This patient underwent his procedure entirely under local anesthesia. There were no IVs, no general anesthesia, and no grogginess afterward. He walked into our accredited surgical suite, had the procedure while fully awake and comfortable, and walked out the same day.
Awake gynecomastia surgery is a game changer for men who want real results without the extended recovery or risks associated with traditional surgery. It is also ideal for patients who are highly motivated but hesitant about going under general anesthesia.
What Makes Gynecomastia Surgery Successful
The key to a good result is not just removing tissue. It is how the chest is sculpted during the procedure.
We used a two-part approach:
Step 1: VASERlipo to Sculpt and Define
VASERlipo uses ultrasound energy to break up fat while preserving the surrounding tissue. It allows us to:
- Loosen and remove fatty tissue with precision
- Create clean, even contours across the chest
- Minimize trauma to blood vessels and connective tissue
For this patient, we used VASERlipo across the lateral chest wall and under the arms to help blend the chest into the upper abdomen. This provided a smooth transition and avoided the “donut” effect you sometimes see when only the central gland is treated.
Step 2: Glandular Excision for Permanent Removal
Once the surrounding fat was removed and sculpted, we made a small incision at the lower edge of the areola to directly excise the dense glandular tissue. This step is essential when treating true gynecomastia. Without removing the gland, the fullness will return.
We carefully controlled the depth and shape of the excision to avoid a crater deformity or sharp indentation under the nipple. Our goal is always a flat but natural slope that restores a masculine contour.
Recovery and Results: What to Expect
At five months post-op, his results are stable and well healed.
- The chest appears firm and proportionate with the rest of his body
- The nipple now sits flush against the chest wall without protrusion
- There is no visible scarring or distortion of the areola
- The transition from chest to abdomen is smooth and athletic-looking
He returned to light activity within a few days and resumed his normal workouts after about three weeks. There was mild swelling for the first few weeks, but by the two-month mark his results were already very close to final.
What Makes This Result Stand Out
This case highlights why combining advanced liposuction technology with surgical technique is so important. If we had only performed an excision, he might have ended up with an unnatural contour. If we had only done lipo, the gland would have remained.
Using both VASERlipo and excision together provided the best of both worlds:
- Sculpting and shaping across the chest
- Permanent removal of the gland
- A balanced, natural result that simply looks like a healthy male chest
A Lasting Outcome
For this patient, the procedure was not just about aesthetics. It allowed him to finally let go of years of self-consciousness and feel comfortable in his own body. His confidence, posture, and demeanor all improved in the months following surgery.
At the Charlotte Gynecomastia Center, we aim to deliver more than just physical change. We want each patient to walk away feeling like the best version of themselves, and in this case, that is exactly what happened.
If you are looking to improve your chest, reach out to our gynecomastia practice today!
