As a man, the development of fat in the pectoral area can be embarrassing and inhibit you from engaging in physical exercise and social events.

Hormone imbalances or adipose maldistribution that leads to the development of excess breast tissue is called gynecomastia. Thankfully, gynecomastia can be treated with a handful of surgical techniques.

At the Cosmetic Plastic Surgery and Laser Center of Maryland, we believe everyone should be comfortable and proud of their bodies. We strive to give everyone the results they desire. With cutting-edge technology and current techniques, Dr. Salman Ashruf performs surgeries with efficiency and precision to produce your best outcome.

What is Gynecomastia?

Gynecomastia is the excess or swelling of breast tissue in boys or men that is typically caused by an imbalance of the hormones estrogen and testosterone. Men with gynecomastia have a higher level of estrogen than testosterone, which results in increased breast tissue. Commonly both breasts are affected, but asymmetry may develop. Gynecomastia frequently affects males who are entering into an age where the hormones fluctuate. This includes newborn boys, boys going through puberty and older men.

Gynecomastia is not a serious condition but it can negatively affect men and boys both physically and mentally.

Discomfort is common as the individual may experience breast pain, as well as embarrassment from the condition. Sometimes, gynecomastia subsides on its own but medication and surgery can help correct it. Several factors that can cause hormone imbalance include:

Natural Hormone Changes

Testosterone and estrogen control the development of characteristics found in men and women. Testosterone controls male traits and estrogen controls female traits, such as the development of breasts. An imbalance can cause men or boys to develop breasts. Puberty can trigger Gynecomastia in younger men, which often goes away without treatment in six months to two years. Whether the hormones in older male patients return to a balanced state and reduce the appearance of breasts will vary by each patient.

Unbalanced Hormones

Estrogen and testosterone are healthy hormones for any man to have. The male body normally produces estrogen in smaller quantities than women. However, when male estrogen levels are too high and are out of balance with their testosterone levels, this can cause gynecomastia.

Gynecomastia in Infants

Over 50% of male infants are born with increased breast tissue due to the effects of the estrogen they ingest from their mother’s breast milk. The swollen breast tissue will commonly diminish within two to three weeks after birth.

Gynecomastia in Men

Gynecomastia peaks between the ages of 50 and 69. At least 1 in 4 men in this age group will develop excessive breast tissue.


What Can Cause Gynecomastia?

Many factors outside of the natural changing of hormones can cause men to develop gynecomastia. Medications that can cause gynecomastia include:

  • Anti-androgens
  • Anabolic steroids and androgens
  • AIDS medications
  • Anti-anxiety medications
  • Tricyclic antidepressants
  • Antibiotics
  • Ulcer medications
  • Cancer treatment
  • Heart medications

Extensive use of alcohol and marijuana can also cause gynecomastia

Health conditions that can cause gynecomastia include:

  • Hypogonadism, or any conditions that interfere with normal testosterone production
  • Aging
  • Tumors
  • Hyperthyroidism, a condition where the thyroid gland produces too much of the hormone thyroxine

Commonly used herbal products such as plant oils like tea tree or lavender oil, used in shampoos, soaps or lotions have been known to increase the likelihood of gynecomastia. Gynecomastia can be caused by many factors, both external and internal. Before pursuing a cosmetic procedure we recommend you receive a physical examination from your regular doctor to ensure plastic surgery is the correct solution for you.

Treatments for Gynecomastia

A common treatment for gynecomastia is a reductive surgery that removes excess breast tissue. Gynecomastia, or reductive mammoplasty surgery reduces the breast size in men and flattens the chest while maintaining masculine, natural contours. Sometimes the drooping breast tissue affects the areola, causing it to stretch. In these cases, the areola can be reduced in size and re-positioned to improve the aesthetic of the chest.

Before you decide to undergo surgery, we recommend you review your medications to see if they may be causing a hormone imbalance. Halting the consumption of alcohol may also produce results that diminish gynecomastia.


Dr. Ashruf can help return your masculine frame in one procedure. If you have excess breast tissue, you may qualify as a candidate for a gynecomastia procedure if you experience:

  • Excessive breast tissue in one or both breasts
  • Tenderness in the breasts
  • Breast pain
  • Nipple discharge

Men who are interested in a gynecomastia procedure should be of a healthy weight and have realistic expectations for the surgery. Don’t let a condition that can be fixed in one day stop you from living your best life. Contact Dr. Ashruf today to discuss how a gynecomastia procedure will transform your body!


At the Cosmetic Plastic Surgery and Laser Center of Maryland, we strive to build relationships with our patients. In your personal consultation, you will meet with Dr. Ashruf to discuss your aesthetic goals and what you expect to achieve with a gynecomastia procedure. Dr. Ashruf will inquire about your general health, medications, health conditions that run in the family, past surgeries and any drug allergies you have. He will also perform a physical examination that will help him determine the cause of your gynecomastia. During the consultation, pictures and measurements will be taken to help Dr. Ashruf better prepare for the upcoming procedure.

Together, Dr. Ashruf and you will create a personalized treatment plan that will best achieve your goals.

Dr. Ashruf will discuss the procedure process, potential risks and expected outcomes involved with this surgery. Patients are encouraged to ask questions and discuss any concerns they have at this time. Towards the end of the consultation, you and Dr. Ashruf will plan a date and time for the procedure. He will go over how to care for the treated areas before and after the procedure. He may also give you medication prescriptions, to be filled before the surgery date. If you have any other questions before the surgery, please feel welcome to call. We will be happy to help you!


Follow all the preoperative instruction you and Dr. Ashruf discussed in your personal consultation.

Prior to your surgery, you may need to alter medication regimens. You will need to discontinue using anti-inflammatory medications and smoking a few weeks before the surgery. These products can negatively affect the blood oxygen and circulation in your body. For a healthy recovery, it is best to avoid these products.

We recommend patients to fill and pick up any antibiotics and pain medications before their surgery. Patients should also create a recovery area for when they return from their surgery. An area that is comfortable, has entertainment, food, medications and water within reach is ideal. Rest and sleep are important during your initial recovery period.

You will need to enlist the help of a family member or friend to drive you home from the surgery and stay with you that first night. You may need extra help getting to locations as you will not be able to drive if you are using pain medications.

The morning of your appointment, wear comfortable clothing that does not apply unnecessary pressure to the chest.

Gynecomastia Procedure

Depending on the details of a patient’s gynecomastia, the procedure may take about three hours.

When you arrive for your surgery, you will be greeted by the surgical team. They will then prep, mark and clean your predetermined incision sites. General anesthesia will be applied intravenously to ensure you are resting comfortably during the procedure. Dr. Ashruf will then delicately apply incisions around the breasts and areolas if necessary.

Gynecomastia is often reduced with a combination of liposuction and excision of unwanted skin and tissue. In some cases, only liposuction may be used. When performing liposuction, Dr. Ashruf will insert a cannula (a thin, hollow tube) connected with an aspirator (a suction device) into the incisions. With a gentle, controlled back-and-forth movement, Dr. Ashruf dislodges fat cells and removes them with the aspirator.

Excision techniques are used to remove excessive breast tissue and skin that has become droopy. Excision techniques are also used if the areolas have become disproportionate; therefore incisions may be made along the areola. When performing these techniques, Dr. Ashruf will use fine medical tools to remove excess skin and tissues in predetermined areas.

Once Dr. Ashruf has completed removing excess fat, tissue and skin, he will close the incisions using sutures and medical tape. Sutures may be inserted deep within the breast to help it shape to its new contour and positioning. Bandages and a compression garment will be applied to the treated areas as well. Dr. Ashruf performs this procedure from a man’s perspective to achieve a masculine contour for his patients.


Swelling and bruising are common around the treated areas. These will subside in a few weeks. A compression bandage will be applied to your chest to minimize swelling and to help your chest adjust to its new shape.

A small, thin tube called a drain may be temporarily placed in an incision to drain any excess blood or fluid. Dr. Ashruf and his expert staff will inform you of how to care for the drain and empty the receptacle it is attached to. Pain medication will help prevent any discomfort that develops. Patients who do not have physically strenuous jobs will be able to return to work within three days. If your job is physically demanding, you will need to take one to two weeks off before you will be able to resume working.

While rest is an important part of recovery, patients are advised to take short, frequent walks during their recovery period. Follow-up appointments will allow Dr. Ashruf to monitor your recovery. In these appointments, he will remove stitches, bandages, drains and surgical tape. He may also clean incision sites.

As you recover, it is important that you follow the detailed care instructions discussed and given to you in your consultation with Dr. Ashruf. Following these instructions will provide you with a healthy recovery process and your best results.


If you have developed breasts and are feeling uncomfortable with your chest, a gynecomastia procedure can prove beneficial to you! The main benefit of this procedure is a flattened, more masculine chest. However, there are many emotional and mental benefits as well. This procedure has allowed many patients to become more confident in their bodies. This causes them to engage more in physical activities and social events. A reduction in breast tissue can improve the self-image of any young or mature man. If you are interested in how a gynecomastia procedure can transform your body and improve your life, contact Dr. Ashruf today to schedule your consultation!


The results of this procedure are immediately noticeable and will improve over the following weeks as swelling diminishes. Incision lines are permanent but will be made within the body’s natural contours, and will fade in time. A gynecomastia procedure is long-lasting. To ensure the longevity of your results, maintain a healthy diet and exercise.


Every patient has a unique body and will receive their own, individualized treatment plan. Therefore, every patient’s cost will be different based on their anatomy and procedure or combination of procedures, performed. Dr. Ashruf is a board-certified plastic surgeon who strives to give his patients their best results. If you are interested in how he will help you, schedule a consultation today at (410) 590-4313!