Gynecomastia San Diego

San Diego Cosmetic Surgeon Dr. Tom Pousti Talks About Gynecomastia



Gynecomastia is defined as the visible or palpable development of breast tissue in boys or men. Gynecomastia is a condition in which males develop enlargement of the breast. This is quite common in adolescents and is often first noted at the onset of puberty. Gynecomastia affects an estimated 40% to 60% of men. It may affect only one breast or both. When gynecomastia is severe, when it persists, and in those cases where there is suspicion of malignancy surgical treatment may be indicated. For men who feel self-conscious about their appearance, breast-reduction surgery can help. The procedure removes fat and or glandular tissue from the breasts, and in extreme cases removes excess skin, resulting in a chest that is flatter, firmer, and better contoured. In most cases, the incisions for this operation can be placed just inside the areolar border where they are less likely to be conspicuous.

The Surgical Procedures

The glandular tissue must be removed. This firm fibrous tissue extends from the nipple areolar complex down to the surface of the pectoral muscle beneath. In some cases, it is helpful to use liposuction to remove some of the fatty tissue which always surrounds this ductal tissue. Without this liposuction some patients would have a “donut” shaped defect after removal of the ductal tissue.

The most common complication following surgical removal of the ductal tissue is hematoma. When severe this could lead to a second operation to drain the collection of blood. Some residual deformity of the nipple areolar area may remain despite the best efforts of the surgeon. As with any operation, a wound infection could occur. Inadvertent injury to the blood supply of the nipple areolar region could result in loss of skin in the nipple areolar area. There would be the usual anesthetic risks associated with any surgical procedure. These complications and other even rarer complications do not occur often and the vast majority of patients undergoing this operation are very pleased and adopt a more normal life style with regard to exposure of the chest in normal social situations such as the beach.

What to Expect After Surgery

Whether you’ve had excision with a scalpel or liposuction, you will feel some discomfort for a few days after surgery. However, discomfort can be controlled with medications prescribed by Dr. Pousti. In any case, you should arrange to have someone drive you home after surgery and to help you out for a day or two if needed.

You’ll be swollen and bruised for a while–in fact, you may wonder if there’s been any improvement at all. To help reduce swelling, you’ll probably be instructed to wear an elastic pressure garment continuously for a week or two, and for a few weeks longer at night. Although the worst of your swelling will dissipate in the first few weeks, it may be three months or more before the final results of your surgery are apparent.

In the meantime, it is important to begin getting back to normal. Any stitches will generally be removed about 1 to 2 weeks following the procedure.

Resumption of Physical Activities

You’ll be encouraged to begin walking around on the day of surgery, and can return to work when you feel well enough–which could be as early as a day or two after surgery. Your surgeon may advise you to avoid sexual activity for a week or two, and heavy exercise for about three weeks. You’ll be told to stay away from any sport or job that risks a blow to the chest area for at least four weeks. In general, it will take about a month before you’re back to all of your normal activities.

You should also avoid exposing the resulting scars to the sun for at least six months. Sunlight can permanently affect the skin’s pigmentation, causing the scar to turn dark. If sun exposure is unavoidable, use a strong sun block.


My decision to pursue the surgery was very spur of the moment. Although I had been wanting it for quite some time, I never really had the opportunity to pursue it; year around I was involved in sports, more specifically football. Anywho, to make a long story short, upon arriving back to San Diego after a whirlwind of a time in Europe following college graduation, I decided it was time to do something for myself. I did a little research and found Dr. Pousti with the help of the internet. The thing that attracted me to Dr. Pousti, besides his excellent resume (Harvard Grad), was the fact that he was a pioneer in the particular surgery that I was looking for, and was an innovator in his procedures.

Dr. Pousti’s office was the first I visited, and the last. From the very beginning, I felt as if I was not only ‘a’ patient of his, but ‘THE’ patient. Walking into to a plastic surgeon’s office filled with a female staff and a mostly female cliental could be a little frightening, especially for a big, meathead, egotistical football player like myself. However, from the very beginning, the staff welcomed me with open arms. Each and every one of them had an endearing smile and always greeted me with a friendly hello. Every time I called to make or reschedule an appointment, they always remembered my name, were always interested in how I was doing, and always responded with a , ‘No problem Mike, we can do that.” Being in the business world myself, this is the MOST important characteristic to possess: client service. And with client service comes sincerity, a great attitude, working hard, exceeding expectations; I feel that Dr. Pousti and his staff possess all of these things and more.

I am very happy with my results. I still have some healing to do, but it is such a blessing to have such a great Doctor and office to rely and fall back on.

After living with gynecomastia for several years I decided that I would start looking for a plastic surgeon to take care of my issue. I did extensive research on the subject and found that Dr. Pousti would be the correct choice to perform my surgery. Going into the surgery I was very nervous of the outcome, but Dr. Pousti assured me that I would be pleased with my results and explained in detail of how the procedure would work. The day of the surgery came and it was over in a flash. I’m now three weeks post-op and looking back on the experience I can actually say that the anxiety of finding a plastic surgeon and worrying about the results was far worse than the actual surgery itself. The results of the surgery were what I hoped it would be! I now have a huge sense of relief and feel that a weight has been lifted off my shoulders since the procedure. Dr. Pousti, his office staff, and hospital staff were all very professional and made for a pleasant experience and I recommend Dr. Pousti to anyone thinking about the procedure.