The Masculine Look You Want

The concept for an attractive body is different for men than it is for women. While strength is important for everyone, men place extra emphasis on having an upper body that looks strong and flat, with squared-off pectoral muscles. Sometimes, no amount of weight lifting can deliver the lean, sculpted pectoral muscles men want, or reduce excess fat and breast tissue in the chest area (a condition known as gynecomastia). So that these men can have the strong, masculine look they’ve worked so hard for, Dr. Evdokimow also performs breast sculpting and breast reduction for men.

About gynecomastia

Gynecomastia is the development of feminine-looking breasts in males. It occurs much more frequent than initially thought; in fact, recent studies show overall incidence of 32% to 36%, and even as high as 40% to 64.6% in adolescent boys and older men. There are several possible causes: 

Teenagers and young adults

  • Idiopathic (unknown cause), accounts for 25% of all cases
  • Developmental – from birth, during puberty or through aging
  • Tumors, although this is rare
  • A common congenital disorder known as Klinefelter syndrome (the presence of an extra X chromosome in a male) can be responsible for gynecomastia and should be considered carefully before surgical male breast reduction as it increases the risk of breast cancer
  • HIV, ETOH abuse, steroids, body building supplements, marijuana use

Some young adult male chests have large breast mounds in the pectoral area with portruding nipples. The gyneccomastia procedure can sculpt the pectoral area flat and eliminate nipple protrusion.


  • Hypogonadism – Research has shown that an excess of female hormones (estrogens) and a decrease of the male hormones (androgens) could be responsible.
  • Systemic issues such as thyroid disorders, kidney failure, liver disease or adrenal problems.
  • Other conditions such as HIV, ETOH abuse, spinal cord problems, chest trauma and stress.

Older men often have enlarged breasts with loose skin and sagging nipples. Dr. Evdokimow's gyneccomastia procedure can reduce the loose skin and correct the condition.

Massive weight loss

Massive weight loss can lead to male breasts appearing similar to female breasts with the nipple located in the lower part of the skin envelope. The gynecomastia procedure can significantly reduce the skin envelope and reposition the nipple as a free nipple graft. 

Problems with nipple and areola

  • Large areola in men is usually sign of femininity 
  • Protruding nipple due to this condition – the nipple is not large but resembles nipple in erect position. Very bothersome for men because is visible through shirts

Areola reduction corrects the large areola and nipple reduction can correct the protruding nipple. 

Male chest enhancement

  • Fat grafting is the preferred method in Dr. Evdokimow's practice combined with VASER® LipoSelection of the peripectoral area.

During the consultation, Dr. Evdokimow will want to know your medical history, including your use of medications and over-the-counter drugs. He’ll also perform a thorough physical exam. He’ll look for possible breast cancer (although it is very rare) as well as endocrine disease. In most cases, there's no identifiable cause. Dr. Evdokimow will develop a unique treatment plan specifically for you.

What to expect

Male breast reduction is usually performed as an outpatient procedure under general anesthesia. Depending on the cause of gynecomastia, the type of gynecomastia, the degree of enlargement and the condition of the overlaying skin, we'll use one of the following techniques:

  • Liposuction alone, although this may be too difficult if you need to treat fibrous tissue.
  • Ultrasound-assisted liposuction. This is the most popular procedure of choice for teenage and adult males. There are three stages. First, the treatment area will be infused with tumescent fluid (a sterile solution containing epinephrine and local anesthetic). Then fat will be liquefied. Finally, the liquefied fat and fragmented breast tissue will be aspirated through a small tube.
  • Excision and/or liposuction combined with skin reduction.
  • Reduction procedures similar to breast reduction for women will be applied in extreme cases.
  • A combination of liposuction, ultrasound-assisted liposuction and excision.

A postoperative compression garment, combined with soft foam pads, should be worn for two to three days followed by use of a compression garment for several weeks. Normal activity can be resumed in about a week; however, strenuous physical activity should be avoided for four to six weeks.

David Evdokimow, MD, has many years’ experience helping gynecomastia patients achieve a more masculine chest appearance. 


To learn more about the latest procedures for the male breast reduction or to schedule an appointment, please call our practice at 908.221.1136. For your convenience, you can arrange your one-on-one consultation with Dr. Evdokimow by filling out our online Request an Appointment form. Our gynecomastia patients come to us from Chestertown, Far Hills, Madison, Summit and Milburn.


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