Our advanced male breast reduction techniques allow for short surgery, minimal downtime, and virtually invisible scars


    Gynecomastia - n. any growth of the adipose and glandular tissue in a male breast.

    Up to 60% of men suffer from this breast-enlarging condition.

    What is Gynecomastia?

    Excess breast tissue development in men is actually a common disorder of the endocrine system, yet is largely un-discussed. The condition can be hugely embarrassing for men, who may manifest the condition anywhere on a wide range of over-development from puffy nipples to full female-like breast development. The underlying condition is most frequently caused by a hormonal imbalance and can be managed medically, but the only cure for eliminating permanent growth is breast reduction surgery.

    Although men do not typically feel tenderness with gynecomastia, it sometimes occurs in the early stages of development. A more common occurrence is unilateral or uneven proliferation of the glandular tissue growth between the left and right side, which occurs in 14%-50% of all cases. Interestingly, left-sided breast development in men is more common than right-sided development. Many men with gynecomastia initially fear they have breast cancer. Although breast cancer is possible in men, it only occurs in one in a thousand men. Further, breast cancer typically manifests as a hard lump, versus the soft tissue feel of gynecomastia.

    What causes male breast development?

    There are several reasons men may develop excess tissue in their breast. The most common reasons include:

    • higher than normal levels of estrogen
    • lower than normal levels of androgens
    • aging
    • puberty
    • extra or altered sex chromosomes, such as those seen in Klinefelter syndrome
    • alcohol abuse
    • liver cirrhosis, kidney failure, and thyroid disorders
    • marijuana usage
    • steroid usage
    • some prescription drugs, like methyldopa (for blood pressure), cimetidine (for peptic ulcers), diazepam (Valium), antidepressants, and spironolactone (a diuretic)
    • some chemotherapy drugs
    • testicular cancer (in up to 10% of patients)
    • herbals such as tea tree oil and lavender oil

    Who can get gynecomastia?

    Gynecomastia is strictly a male diagnosis, but men of any age and size can get it. While men with a BMI over 25 have an increased incidence of the disease, even the most physically fit can get it. While losing weight and lifting weights can reduce the appearance of male breasts, it cannot eliminate it entirely.

    What is involved in male breast reduction surgery with Dr. Bindewald?

    Surgical options for gynecomastia patients vary based on the severity of the condition. In many cases, liposuction alone is an effective treatment. Procedure techniques vary and are planned in detail with you directly by Dr. Bindewald. He does not outsource your surgical plan to anyone else, regardless whether you are having surgery for early-onset Type 1 puffy nipples or extensive Type 7 surgery with nipple grafts and anchor lifts.


    Dr. Bindewald's extensive experience with highly complex reconstructive surgeries, both in the military and in private practice, puts patients at ease both in the office and in the operating room. Although surgical emergencies for elective procedures are relatively rare, it is important to remember that all surgery has risk. That being said, both patients and staff alike appreciate Dr. Bindewald's experience and education as a trauma surgeon and his calm, knowledgeable demeanor regardless of the situation.

    How satisfied are patients with their gynecomastia surgery?

    As with many conditions that severely affect the psyche, men who choose to undergo surgery to re-masculate the look of their chest are highly satisfied with their results. RealPatientRatings,com, a website dedicated to getting real comments from U.S. plastic surgery patients, calculates a 92.2% overall satisfaction with the procedure. Similar results were found in an NCBI published multicentric study published in 2011, where patients reported an overall improvement in their quality of life after gynecomastia surgery with an average satisfaction score of 8.2 out of 10.


    Patient satisfaction is further evidenced by the growing volume of annual surgeries performed. According to the American Society for Aesthetic Plastic Surgery (ASAPS), there were over 24,000 male breast reduction surgeries performed in the U.S., and 27,456 just a year later. The surgical procedure has seen 35% growth since the year 2000, attributed to both clinical advancements as well as greater awareness of its prevalence. Men now account for more than 40% of breast reduction surgeries annually.

  • Gynecomastia Surgery with Dr. Matt Bindewald

    "When you come to Dr. Bindewald's office for your gynecomastia surgery the process and explanations are comprehensive. You leave the initial consultation with a clear understanding of everything from the procedure itself to the recovery. Further, you understand the exact costs - including the hospital and supply fees - so there are no surprises after surgery. Because of Dr. Bindewald's favorable expense structure, the total out-of-pocket cost for patients is lower than in many other places. Finally, it's refreshing to know the surgery is being performed by such an experienced reconstructive surgeon - the aesthetic outcome of gynecomastia surgery with Dr. Matt Bindewald is exceptional."

  • When is surgical intervention for gynecomastia required?

    Men overwhelmingly elect surgery when their breasts are about the size of a tennis ball. This is considered Type 2 gynecomastia.

    Although surgical intervention for gynecomastia is rarely required due to its benign nature, many patients opt for surgery. Men typically begin considering surgery at the Type 2 level of breast development, when the size of their breasts is noticeable through their shirt.


    Regardless of the size of your breast tissue growth, patients should schedule a doctor's appointment to rule out other, more severe conditions. Further, because gynecomastia is most easily treated in it's earliest stages, when breast ducts become inflamed and/or the size of the areola begins to increase, some patients can avoid future surgery with early intervention.


    Given the high occurrence of gynecomastia among adolescents, parents should be sensitive to the condition and bring their children in for clinical guidance. Many cases of gynecomastia spontaneously regress in both adolescent and adults, so in most patients only follow-up is necessary.


    If gynecomastia persists for more than 1 year, even if the underlying condition or hormone imbalance is effectively treated, surgical intervention will likely be required in order to remove the excess tissue. Why? Over time, collagen fibers form around your tissue and ducts, becoming fibrous. Once this occurs, the excess tissue is permanent.

  • Symptoms of Gynecomastia

    • enlargement of one or both male breasts
    • glandular or adipose tissue growth (vs fatty tissue growth)
    • enhanced breast size caused by tissue located directly under areola
    • increase in size of areola
    • breast swelling and possible tenderness
    • rubbery, compressible feel (not hard)

  • Gynecomastia by the numbers

    Physiologically, gynecomastia peaks occur in infancy, puberty, and over the age of 50 - during periods of hormonal transition in the body. Infant & pubertal gynecomastia typically resolve on their own.


    of men between the ages of 50 & 80 have gynecomastia

    up to 70%

    exhibit signs of gynecomastia during puberty; 75% of cases resolve on their own within 2 years, with only 5% of cases requiring surgical intervention for cure


    of male babies have gynecomastia


    of cases are caused by drugs


    of men have gynecomastia at time of autopsy


    of men with BMI > 25 kg/m have gynecomastia

  • Other Gynecomastia Facts

    Between 200,000 and 3 million cases of gynecomastia are reported each year

    Between 200,000 and 3 million cases of gynecomastia are being reported in the U.S. each year. As the condition gains more exposure, men are realizing that 1 in 3 adult men and 1 in 2 older men face the same concern and are now doing something about it. Regardless of a man's age when he develops the condition, it is hard to process psychologically.

    Grades & Types of Gynecomastia

    Similar to other medical diagnoses, gynecomastia is graded and classified by level of severity. Getting an accurate diagnosis of your condition is essential to determining proper treatment. Gynecomastia is categorized into 4 grades and 7 types. Men overwhelmingly elect surgical intervention at Type 2 gynecomastia.

    Gynecomastia Grades

    Grade ||| Description ||| Severity

    1 ||| localized mass of tissue concentrated around areola ||| mild

    2 ||| moderate breast enlargement exceeding perimeter of areola, breast area appears puffy ||| mild to high

    3 ||| moderate breast enlargement exceeding areola boundaries with breast protrusion beginning to develop ||| high and extremely visible

    4 ||| marked, distinct breast enlargement with skin redundancy and feminization of the breast ||| severe and visibly feminine

    Gynecomastia Types

    Type ||| Description ||| Feel ||| Sag ||| Size ||| Surgery

    1 ||| Puffiness of the male nipple; may appear shiny ||| tissue feels hard ||| skin is tight ||| approximately the size of a large egg with a cone shape appearance of the areola and nipple ||| rarely treated with surgery

    2 ||| Excess tissue begins to spread beyond the areola area ||| tissue feels fatty; skin is still tight ||| protrusion of chest < 45 degrees ||| between the size of a tennis ball and a softball ||| most common type for surgery, liposuction or traditional breast reduction techniques

    3 ||| Excess tissue spreads across male breast ||| tissue and skin begin to loosen ||| breast begins to sag at an angle between 45 and 60 degrees; nipple begins shifting into a downward pointing position ||| approximately the same size as Type 2 ||| tissue removal via liposuction or breast reduction techniques

    4 ||| Tissue sag is significant and becomes extremely noticeable ||| extremely loose feel ||| chest angle between 60 and 90 degrees ||| approximately the same size as Types 2, 3 and 4 ||| surgery would require both tissue and excess skin removal to prevent future sagging

    5 ||| Breast tissue visibly sags below the fold of the chest; areola above chest fold ||| loose, soft feel ||| bottom of areola below the chest fold; chest angle > 90 degrees ||| approximately the same size as Types 2, 3 and 4 ||| surgical options same as Type 4

    6 ||| severe sag of breast; bottom of areola falls below chest fold ||| breast size and sag may feel very uncomfortable to patient ||| areola may extend into arm pit ||| large size ||| invasive surgery; would include anchor lifts and free nipple grafts

    7 ||| extreme breast sag; entire areola below chest fold ||| breast size and sag highly uncomfortable; chafing probable ||| areola points directly downward ||| breast roll contains noticeable volume ||| invasive surgical requirement

    Is male breast reduction surgery covered by insurance?

    Although the condition is psychologically devastating to many men, it is a technically a benign condition and thus surgery is rarely covered by insurance. Medical treatment for the underlying hormone imbalance causing the condition is, however, generally covered by insurance.

    How much does gynecomastia surgery cost in San Antonio?

    The latest data from the American Society of Plastic Surgeons reports the average cost of gynecomastia surgery is $3,333, excluding anesthesia, hospital fees, and other related expenses. Most of our patients find that surgery in our San Antonio office for gynecomastia is less than the national average. Our San Antonio based team provides patients with a comprehensive quote for their gynecomastia surgery, eliminating any ambiguity and allowing patients to fully focus on making the decision that is best for them.


    Many patients from throughout Texas and even neighboring states Oklahoma, New Mexico, and Louisiana, find that travel for surgery in San Antonio provides them the best option for a superior cosmetic outcome with low downtime and advantageous pricing.

  • Contact Us Today

    Are you considering male breast reduction surgery? Dr. Matt Bindewald has extensive experience with complex reconstructive surgery procedures, and is known for his attention to detail when planning the techniques and tools he will use during surgery to achieve the perfect aesthetic outcome for each patient given their unique situation.


    Dr. Bindewald's exacting techniques and artistry, combined with our transparency in pricing, has resulted in patients who are overwhelmingly pleased with their final outcome as well as their pocketbook. Although we typically only perform procedures on males over 18 years of age, we are more than happy to meet with teenagers who are struggling with gynecomastia to help them through this challenge and discuss their options.


    We accept and welcome patient questions both online and in person; Dr. Bindewald responds to all patient inquiries directly. Our HIPAA-compliant website and email ensures your utmost discretion and privacy when sending communication to our surgical team.


    Contact us online or schedule an appointment in our San Antonio office today. Many out-of-town patients consult with us online first before scheduling their in-person consultation. You can reach us at the phone number or email address listed below.


    Contact us online or schedule an appointment in our San Antonio office today. You can reach us at the phone number or email address listed below, through this web form, or schedule your own appointment via our online request form, which can be accessed here.

    7950 Floyd Curl Drive, Ste. 1009
    San Antonio, TX 78229
    Mon-Thurs, 8am-5pm
    Fri, 8am-12pm