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GYNECOMASTIA · LITTLE ROCK, AR
Male Breast Reduction
Gynecomastia, or overdeveloped breast tissue in men, is common, and it is not something diet and exercise reliably fix. It is also not something most men want to talk about, which is part of why it goes untreated for years. Male breast reduction removes the excess tissue and restores a flatter, more masculine chest. Dr. Homayoun Pournik, a fellowship-trained cosmetic surgeon, performs the procedure in Little Rock.
1-4 hrs
Outpatient procedure, home same day
~1 wk
Back to work for most patients
~ 3–6 mos
Final results take shape
Two different problems, two different operations
Not all enlarged male chests are the same, and the difference matters more than it sounds. What your chest is actually made of determines which procedure you need, and the two are not interchangeable.
GLANDULAR
True gynecomastia
Actual breast tissue: typically felt as a firm, disc-like mass beneath the nipple. Liposuction cannot remove glandular tissue; it has to be excised. Common causes include hormonal shifts during puberty or with age, anabolic steroids, certain prescription medications, and some health conditions.
FATTY
Pseudogynecomastia
Excess fat rather than glandular tissue. This is what liposuction is for, and it is the less invasive of the two; smaller incisions, faster recovery.
BOTH
A combination
Many men have some of each, which is why the procedure is often liposuction plus excision rather than one or the other. Which combination you need is established by examination, not by looking.
Gland or Fat? Why the Difference Matters
The cause determines the treatment. True gynecomastia is growth of the breast gland itself, driven by hormonal changes, certain medications, or steroid use. It feels firm and rubbery beneath the nipple and cannot be removed with liposuction, because glandular tissue is too dense to suction away. It has to be excised. Pseudogynecomastia is simply fat, which is softer, spread across the chest, and responds well to liposuction alone. Dr. Pournik examines the chest to identify which tissue is responsible before recommending a technique. Many men have both, which is why the two approaches are often combined.
Glandular excision
True gynecomastia is enlargement of the breast gland itself, and glandular tissue is dense and fibrous, so liposuction cannot remove it. Dr. Pournik excises the gland directly through a small incision along the lower border of the areola, where the scar blends into the natural color transition of the skin. This is the technique that produces a flat chest when a firm, rubbery disc of tissue sits beneath the nipple.
- Best for: firm glandular tissue under the nipple
- Scar: hidden at the lower areolar border
- Time: 1 to 2 hours
Combined excision and liposuction
Most cases of gynecomastia involve both gland and surrounding fat, so the two techniques are performed together. Dr. Pournik removes the gland through the areolar incision and uses liposuction to feather the edges into the chest wall, which prevents the crater deformity that can follow excision alone. This is the most common approach for moderate gynecomastia.
- Best for: mixed gland and fat
- Scar: hidden at the lower areolar border
- Time: 2 to 3 hours
Tumescent liposuction
Pseudogynecomastia is fatty enlargement without true glandular growth, and fat responds well to liposuction. Dr. Pournik infiltrates the area with tumescent fluid to limit bleeding and bruising, then removes the fat through two or three incisions the width of a pencil tip placed at the edge of the chest. Scarring is negligible, risk is lower than with open surgery, and recovery is faster.
- Best for: fatty chest with good skin quality
- Scar: minimal, from access points under 5 mm
- Time: under 2 hours
Liposuction with skin excision
When the skin has lost elasticity, which is common after significant weight loss, removing the fat alone leaves the chest loose rather than flat. Dr. Pournik combines liposuction with excision of the excess skin, tightening the envelope and repositioning the nipple higher on the chest wall if it has descended. This trades a longer scar for a genuinely flat, masculine contour.
- Best for: fatty chest with loose or deflated skin
- Scar: longer, placed along the chest crease
- Recovery: longer
Are you a candidate?
Men who cannot eliminate excess breast tissue through diet and exercise may be eligible. Beyond that:
- In good overall health, and able to safely undergo surgery.
- At a stable weight before surgery, as fluctuations afterward can reverse your results.
- Look tired or older than you feel
- Realistic about the outcome.
What it will not do
This procedure is not intended to give you the contoured pectoral muscles of a bodybuilder. What you can anticipate is a flatter, more masculine chest, which for most men is the entire point, and is a different thing from what the before-and-after photos of other practices sometimes imply.
What to expect on procedure day
Male breast reduction typically takes one to four hours, depending on what is needed.
Dr. Pournik makes a series of small incisions on your chest, positioned according to your anatomy and your goals. He injects a large volume of lidocaine and epinephrine beneath the skin to minimize blood loss and the other risks associated with liposuction, then inserts a small cannula through the incisions and removes the excess fat. In some cases excess skin is trimmed away as well, and the nipple can be repositioned where that is what a natural result requires. The incisions are closed with surgical sutures.
Recovery and results
Recovery from male breast reduction is straightforward for most men. Results are visible right away and keep improving as the swelling settles.
- FIRST DAYS
Slight discomfort, bruising, and swelling. Over-the-counter pain relievers handle it for most men, and prescription medication is available if needed. You will be placed in a compression vest before you leave the surgical facility. The vest controls swelling, supports the chest as it heals, and helps the skin settle smoothly against the new contour. - WEEK 1
Most men return to work comfortably. If your job is physically demanding you will need more time. The compression vest is worn continuously through this period, including while you sleep, and is removed only to shower once Dr. Pournik clears you to do so. - WEEKS 2–4
Light walking is encouraged from the start to support circulation, but keep your heart rate low and avoid lifting anything heavy. Most men continue in the compression vest for roughly four to six weeks total, with the schedule easing to daytime-only wear as swelling comes down. - RETURNING TO EXERCISE
Lower-body and cardio activity typically resume around three to four weeks. Chest and upper-body work (such as pressing, pulling, and heavy lifting) comes last, usually at six weeks, once the tissue has healed enough to handle load. - AS SWELLING SETTLES
The result continues to improve. Most of the swelling resolves in the first six to eight weeks, and the final chest contour is generally visible around three to six months as the last of the swelling fades and the skin retracts.
Why choose a board-certified surgeon
Male breast reduction is a contouring problem more than a removal problem. Glandular tissue and fat behave differently and often need different techniques in the same operation, and taking out too much leaves a hollow that’s harder to correct than the original fullness. Judging that balance is what the procedure comes down to.
Risks include asymmetry, changes in nipple sensation, contour irregularity, and scarring that varies by how much skin has to be removed. Dr. Pournik reviews your specific risks at consultation so you can decide with full information.
WHAT SETS DR. POURNIK APART
- Board certified by the American Board of Surgery
- High-definition liposuction training focused on natural contour, not just volume removal
- Experience with post-weight-loss cases, where skin laxity changes the approach
- Approximately 1,800 cosmetic procedures during fellowship at a high-volume body contouring center
Combining with other procedures
Chest fullness rarely stops at the chest. Liposuction of the flanks and the fold under the arm is the most common addition, because leaving those untreated tends to make a flattened chest look narrower than the torso around it rather than proportional to it. Patients arriving after major weight loss are often addressing several areas at once, and planning the chest, abdomen, and arms as one staged program usually costs less and takes one recovery instead of three.
WHY CHOOSE DR. POURNIK
Homayoun Pournik, MD
- Fellowship-Trained Cosmetic Surgeon
This procedure is chest liposuction, and liposuction rewards judgment about tissue more than force. How much to take, where to leave it, and how the skin above will behave once the volume underneath is gone.
Dr. Pournik’s cosmetic fellowship covered roughly 1,800 procedures in a single year at one of the country’s highest-volume body contouring centers, with breast reduction and high-definition liposuction both among his named specialties. Before that, twelve years in transplant surgery; around 300 organ transplants, and the first robotic kidney transplant performed in either California or North Carolina.
He asks every patient the same question at every follow-up: day one, one week, six months. Are you happy? “Nobody knows their body better than the patient,” he says. “I see them for five minutes. They’re seeing themselves for the rest of their life.”
BOARD CERTIFICATIONS & AFFILIATIONS
CONTACT US
Schedule your consultation
A consultation establishes what your chest is actually made of, which determines what will work. Dr. Pournik will examine you, explain which procedure fits, and tell you honestly what it will and will not achieve.
Frequently asked questions
Typically one to four hours, depending on what is needed.
Most men return comfortably within a week. If your job is physically demanding, you will need more downtime.
No, and it is worth being clear about that. This procedure is not intended to produce contoured pectoral muscles. What you can expect is a flatter, more masculine chest.
Right away. They continue to improve as the initial swelling subsides. Maintaining a healthy lifestyle afterward is what keeps them.
Common causes include hormonal shifts during puberty or with age, anabolic steroids, certain prescription medications, and some health conditions.
True gynecomastia is glandular tissue; pseudogynecomastia is fat.
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