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An abnormally large, feminine male chest can be a source of embarrassment and lowered self esteem. Male breast reduction surgery with Florida’s top gynecomastia specialist Dr. Silvia Rotemberg has provided men with masculine contoured chest and the confidence to show it off.

About Gynecomastia

Gynecomastia is a condition where males produce extra breast tissue, resulting in a feminized chest. It is actually fairly common, with more than 50% of men enduring some level of the condition. Even though it does not cause any physical harm or pose any risk to the body, emotionally and psychologically it can take a toll.

Sometimes gynecomastia will go away on its own, as most cases are associated with puberty. However, if present through adult years, it cannot be reduced by working out since it is not fatty tissue but glandular tissue. Surgical intervention is the only solution to reducing the glandular tissue. Dr. Silvia Rotemberg has extensive knowledge and experience when it comes to treating gynecomastia, making sure to remove the majority of tissue while leaving enough to create a masculine contour with defined pecs.


There is no single source that causes gynecomastia onset, but the most commonly seen correlation is a spike in estrogen levels. Men produce both male and female sex hormones, but testosterone is generally produced in much higher levels than estrogen. Nonetheless, estrogen levels can increase in men due to puberty, aging, medications, Klinefelter Syndrome, hyperthyroidism, or simply an unidentified cause of imbalances in hormone levels.

In cases of puberty driven gynecomastia, there is no set answer whether the condition will remedy itself, but a lot of the times it will. Alternatively, when levels shift with age, it is less likely the condition will go away on its own.

Certain medications can be a cause of hormone imbalances. When you come in for a gynecomastia consultation with Dr. Silvia Rotemberg at her Florida location, please mention any medications you take and she will be able to determine if they are the origin of your gynecomastia. Additionally, some studies have linked marijuana to estrogen level increases in men and women.

Conditions such as hyperthyroidism and klinefelter syndrome create a large spike in estrogen levels in men. Hyperthyroidism is a condition where the thyroid gland is off balance; this is generally caused by genetics. The thyroid gland is responsible for hormone production, so when it is not working properly, hormone levels aren’t either. Klinefelter syndrome on the other hand actually produces an extra female X chromosome, creating XXY as opposed to the standard XY. Symptoms of the aforementioned conditions can include hair loss, mood swings, and breast tissue increase.


Gynecomastia doesn’t always appear the same physically for everyone. Some men and children may have more mild cases that are hardly detectable, while other have extremely feminine breasts. There are four different levels of gynecomastia: mild, moderate, visible, and feminine. These levels range from slight protrusion to visible feminine skin redundancy. Dr. Silvia Rotemberg performs customized male breast reduction surgeries for all of her patient to address each individual concern and provide desired result.

Before and After Photos

Gynecomastia versus Pseudogynecomastia

It is important to understand the great difference between the conditions of gynecomastia and pseudogynecomastia. Gynecomastia results in an enlarged male chest due to glandular tissue; pseudogynecomastia results in an enlarged male chest due to fatty tissue. This is a big differentiation that must be concluded during the consultation examination because their treatment methods differ. Gynecomastia has to be reduced with the excision of breast tissue with a special scalpel, while pseudogynecomastia is reduced with liposuction. If the two are both present in a large male chest, both treatments can be performed simultaneously. Dr. Silvia Rotemberg is highly skilled at concluding the difference between the two conditions and treating appropriately.

Who is a Candidate?

Good candidates for male breast reduction surgery are men who have an enlarged male chest or are not satisfied with its contour despite exercise. Not being able to contour the chest via working out most likely indicates that the condition is gynecomastia. It is not necessary though to come into the consultation knowing the underlying cause of chest enlargement; Dr. Silvia Rotemberg will be able to identify the source after an examination.

gynecomastia-miamiIdeal patients will have good skin elasticity, are physically healthy and emotionally stable. The procedure does not have specific age limits; however, it is best for young adults to have reached complete growth before undergoing male breast reduction. This is for two reasons. One, the condition may resolve on its own once the hormone levels balance out after teenage years. And two, if a patient undergoes the procedure before the chest has fully developed, a second reduction surgery may be necessary to re-contour the chest.

More and more men are beginning to realize gynecomastia can be treated easily, safely, and effectively. According to a recent study, male breast reduction surgery has risen more than 117% since 1997, making it part of the top 5 cosmetic surgeries for men.

What to Expect During Your Consultation?

At your initial consultation with male breast reduction expert Dr. Silvia Rotemberg, she will perform an examination to determine the underlying cause of your enlarged chest. The examination will also determine if you are healthy enough to undergo the surgical procedure, and any necessary preparation instructions you may need to fulfill such as further tests or take/stop certain medication. It is helpful to bring a list of questions you have to the consultation so Dr. Silvia Rotemberg can ease any concerns. We want to make sure you are comfortable and confident with your decision to get male breast reduction surgery. Financial information and cost will also be discussed at this time.

Before Surgery

All surgical procedures require some basic preparation, while the more individualized instructions will be provided after the consultation examination at Dr. Silvia Rotemberg’s Florida office. The general instructions typically include not smoking, drinking, or consuming anti inflammatory medication three to four weeks before the procedure. If the doctor prescribes medications, they must be picked up in a timely manner; most of these will be necessary immediately after surgery. Lastly, please make sure to have someone to pick you up after the surgery and take you home.

Male Breast Reduction Surgery

The fatty tissue / glandular tissue ratio is different for each patient so each male breast reduction surgery is custom tailored.

Male breast reduction surgery performed for gynecomastia can take between two to four hours under the patient’s choice of general or local anesthesia. Incisions are made on the natural chest crease or around the areolas depending on the amount of breast tissue. Dr. Silvia Rotemberg removes a certain amount of breast tissue that will reduce chest size, but still leaves enough to be able to manipulate into a masculine contour.

Male breast reduction surgery performed for pseudogynecomastia can take one to two hours under either general or local anesthesia. Liposuction is used to remove the fat deposits responsible for the enlarged chest. The incisions for the insertion of the thin cannula are made either on the bottom of the areolas or in the armpits. The same keen eye for natural proportions is used for this method too.

For those who have experienced massive weight loss, excess chest skin can be removed to create a defined contour. The areolas can also be relocated to a more proportionate place on the chest if desired.

In cases of combined gynecomastia and pseudogynecomastia, tissue excision and liposuction are performed together in the same surgical session. Both procedures are performed as an outpatient, meaning men are able to return home after they are released from the recovery room.

After Your Male Breast Reduction


After the procedure Dr. Silvia Rotemberg will place tiny drains in the incision locations and wrap a compression garment around the chest. The drains will be removed in a few days, but the compression garment must be kept on for a couple weeks. Swelling and tenderness of the chest are normal and will quickly subside. Any discomfort can be controlled with tylenol or prescribed medications. Patients are able to resume light activities in about four days, and more strenuous activities and heavy lifting can be continued after two to three weeks.


Defined, contoured results can be enjoyed once the swelling goes away. Scars from the incisions are small and tend to fade into the already blunt borders of the areolas or hidden in the armpits. Male breast reduction surgery patients have said they are more confident to be shirtless at the beach and in intimate situations. Many have also said they’ve become more motivated to work out and play sports to maintain chiseled results.

The procedure cannot counter the natural process of aging and cosmetic changes to the body that may come with it like sagging skin. Eating healthy and regularly working out can help the body keep the newly sculpted pecs.


The cost of male breast reduction surgery depends on the technique used to address the enlarged chest and the specifics of the individual case such as anesthesia, additional body contouring procedures, etc. The helpful staff of Dr. Silvia Rotemberg will provide each patient with a quote after a consultation examination.