Gynecomastia Surgery in Seattle
Surgical Treatment Options
Most patients treated by Dr. Pratt for male breast enlargement are treated with minimally invasive procedures using a combination of the following 3 procedures:
- Liposuction of the subareolar fullness and diffuse breast tissue of the chest
- “Stealth” Excision of fibrous or rubbery subareolar glandular tissue
- Inframammary Crease Release – (As needed with large breasts/excess skin)
Combination Treatment of Gynecomastia
Details of The Procedures:
Liposuction: Dr. Pratt utilizes a tumescent technique in which a small incision is made in the armpit crease, and then saline solution containing adrenaline (epinephrine) is injected into the tissues to be suctioned. Once all of the blood vessels have constricted down, the suctioning is carried out using a Power Assisted Liposuction technique, which facilitates the removal of the fatty breast tissue. Once the entire breast has been reduced with liposuction, the incisions in the armpit crease are carefully closed.
‘Stealth’ Gland Excision: Following aggressive liposuction of the anterior and lateral chest, Dr. Pratt will evaluate the breast for residual fullness. In the vast majority of patients, there will be a soft, movable lump of soft tissue centered beneath the areola. Sometimes this tissue is firm, rubbery and less mobile. In either case, Dr. Pratt will make a 2-3mm incision within the areola through which the fibrous and glandular tissue is carefully removed. The incisions are then carefully closed in order to minimize the visibility of the scar. Although this procedure has been previously described, Dr. Pratt has coined it ‘Stealth’ because typically these scars are imperceptible at conversation distance.
Inframammary Crease Release: A distinct inframammary crease is a hallmark sign of a female breast. Presence of a crease in a male chest is quite feminizing and acts as a tell-tale sign that an individual suffers from gynecomastia.
After Crease Release
Thus, if there is a significant crease separating the breast and lower chest regions following liposuction and ‘Stealth’ gland excision, a special instrument will be utilized to release the ligamentous attachments of the crease skin from the underlying chest wall.
As a result of this crease release, the visible division between the breast and lower chest is eliminated and the chest appears more masculine.
Additional Procedures for Gynecomastia
‘Scarless’ Areolar Size Reduction: Dr. Pratt rarely makes incisions to remove the excess areolar skin around the areola (Peri-areolar excision) in order to reduce the areolar size. Following radical removal of the subareolar gland, shrinkage of the skin and soft tissue often occurs to a greater extent than initially seems possible, therefore, in majority of cases of enlarged areola, Dr. Pratt takes will advise the patient to take a more conservative wait-and-see approach following liposuction and ‘Stealth’ gland excision. Weight loss patients with stretch damaged skin are sometimes an exception to this strategy, thus Dr. Pratt approaches each patient on a case-by-case basis.
‘Scarless’ Nipple-Areolar Reduction and Repositioning
‘Scar-less’ Nipple-Areolar Repositioning: In patients with saggy nipples and areolas following liposuction, ‘Stealth’ Gland Excision, and Inframammary Crease Release, Dr. Pratt has developed a technique which can reposition the nipples and areolas higher on the chest without additional incisions or scars.
Formal Male Breast Reduction (with or without nipple areolar free grafts): In patients with gynecomastia associated with extremely severe skin excess and poor elasticity such as that seen with massive weight loss patients or with transgender patients, surgical removal of skin may be required along with removal of the underlying breast tissue. This procedure may entail a wedge excision of skin and breast tissue along with free nipple grafting in order to properly position the nipple and areola.
An ‘Anchor-Type’ Breast Reduction with skin removal is sometimes required, with the scars of this procedure resembling a female breast reduction.
‘Anchor-Type’ Breast Reduction
Again however, it must be emphasized that very few patients that Dr. Pratt treats for gynecomastia will require breast skin excision, excisional areolar reduction or free nipple grafts, thus he rarely commits to the more extensive scarring of these procedures unless he is absolutely sure that it is actually needed.
Why should I make an appointment to see Dr. David Pratt in consultation regarding my enlarged male breasts/puffy nipples?
Dr. Pratt is unquestionably a premier gynecomastia surgeon with over 21 years of experience in performing male breast reduction surgery, including direct excision, liposuction and crease release in male patients suffering from enlarged breasts. Additionally, Seattle Gynecomastia Center is what Dr. Pratt likes to refer to as somewhat of a “Gynecomastia Treatment Center of Excellence”, seeing over 100 gynecomastia patients per year. As a result, our staff has vast experience in dealing with the unique needs male patients, particularly gynecomastia patients. We understand the ‘embarrassment factor’ and do everything we can to make your visit as private and confidential as possible.
Dr. Pratt and his staff are passionate about gynecomastia surgery and are dedicated to patient education regarding male breast enlargement. Dr. Pratt’s utmost concern is the comfort, safety and privacy of each and every patient; however, his concerns don’t end there. Dr. Pratt is committed to performing the best possible gynecomastia operation and having the most outstanding results possible, for all of his gynecomastia patients. At our modern offices in both Kirkland and Everett, patients will experience a private, comfortable and secure atmosphere where patients with male breast enlargement can be seen in consultation by Dr. Pratt, without the possible embarrassment of having to be seen by other staff members. Also, Dr. Pratt takes all of the before and after photos himself!
Sounds great! How do I proceed?
The first step in obtaining the ‘guy’s chest’ that you have always dreamed of is to set up a consultation to be seen by Dr. Pratt. He will give you honest and frank answers to all of your questions and let you know if you are a good candidate for male breast reduction surgery.
Our office is open during routine business hours (9-5) Monday through Friday. Dr. Pratt sees patients coming from north of Seattle and Canada at our Everett office. Patients coming from Seattle and south including those coming from Tacoma and Portland are usually cared for at our Kirkland office. You can reach us at
425-285-2112 or at email@example.com.