Dr. Blau is pleased to announce the release of his book, Masculinity Defined: Gynecomastia and the Search for the Perfect Pecs. This book was written for the millions of men who need reliable information about a subject that is rarely discussed: male breasts (gynecomastia) and male body image in a changing era.
Many men with excessive breast tissue, or gynecomastia, suffer from low self-esteem due to their appearance. Gynecomastia correction represents a unique and growing field of plastic surgery, and this book puts a human face on stories that often go untold. This is the first and only gynecomastia book from a true expert: a plastic surgeon who performs the procedures himself.
Plastic surgeons have made tremendous strides in gynecomastia correction over the past twenty years. In fact, the number of male breast reduction procedures has increased by 20% during this time, more than any other plastic surgery procedure. This change happened because of new surgical techniques that produce better, more consistent, and permanent results with almost no recurrence and minimal, inconspicuous incisions.
While the average plastic surgeon performs only a few gynecomastia surgeries each year, in the last three years alone I have performed over 1000 gynecomastia procedures on patients from all over the world, accounting for 2% of all gynecomastia surgery performed in the United States. According to the American Society of Plastic Surgeons, the average Plastic surgeon performed just 9 gynecomastia surgeries during this same period. I continue to use my vast experience to teach other plastic surgeons to utilize my techniques. I am the lead author of articles on gynecomastia surgery published in the premier academic plastic surgery journals, PSNews and Plastic and Reconstructive Surgery.
This book is the culmination of over two decades of experience treating men with gynecomastia. It is for the man who suffers from gynecomastia and wants to understand his options, and also for general audiences interested in a society that increasingly scrutinizes men’s bodies as it does women’s.
Kindle Edition: $9.99
A must read for anyone considering gynecomastia surgery…
–Dr. Robert Bernard, MD, Past President, American Society of Aesthetic Plastic Surgery
Correction of Gynecomastia in Body Builders and Patients with Good Physique
by Mordcai Blau, MD and Ron Hazani, MD
Good results with surgery for gynecomastia in bodybuilders
In men with ‘good physique,’ steroids are common cause of breast enlargement, reports Plastic and Reconstructive Surgery
January 28, 2015 – With attention to some unique patient characteristics, breast reduction surgery achieves good aesthetic outcomes in bodybuilders with gynecomastia–enlargement of the male breast, according to a report in the February issue of Plastic and Reconstructive Surgery®, the official medical journal of the American Society of Plastic Surgeons (ASPS).
ASPS Member Surgeon Mordcai Blau, MD, a plastic surgeon in private practice in White Plains, N.Y., reviews his extensive experience with gynecomastia surgery in bodybuilders. He highlights key patient characteristics and technical issues, including the causal role of anabolic steroids and hormone supplements. Dr. Blau’s coauthor was Ron Hazani, MD, a plastic surgeon in Beverly Hills, Calif.
Click here for the article. (ASPS Journal Website) or view a PDF.
Focus on Gynecomastia Surgery in Bodybuilders
An expert in male breast reduction, Dr. Blau has performed gynecomastia surgery in nearly 1,600 bodybuilders and other patients with “good physique.” The new report focuses on 1,073 such patients, followed up for one to five years after surgery.
The men ranged in age from 18 to 51 years; 15 percent were competitive bodybuilders. All were free of hormonal or other diseases that can cause gynecomastia. In some cases, gynecomastia developing in adolescence–usually a temporary condition–became permanent after the patient started using steroids or hormone-containing supplements.
For several reasons, gynecomastia surgery in bodybuilders calls for a different approach, Dr. Blau believes. In contrast to other groups of gynecomastia patients, who tend to be overweight or obese, bodybuilders usually don’t need removal of excess fat or skin.
However, they do need special attention to prevent bleeding and scarring. Bleeding risk is higher because of increased blood flow in the highly developed chest muscles. Steroids and unregulated supplements including protein shakes, vitamins, and fish oils may also increase bleeding risk.
Emphasis on Complete Removal of Breast Gland Tissue
Bodybuilders are “perfectionists with regard to their physique and chest aesthetics; hence their level of expectations is higher,” Dr. Blau writes. He performs the procedure through a one-inch incision, made on the underside of the areola surrounding the nipple.
In outlining his surgical technique, Dr. Blau highlights the need for complete removal of all breast gland tissue. After surgery, pathology reports usually show excessive development (hypertrophy) of the gland tissue, although a few patients had precancerous cells.
Most patients are “extremely satisfied” with their surgical results, Dr. Blau reports. He also notes that the “vast majority” of patients continued to use anabolic steroids. Because the gland was completely removed, there were no problems with recurrent gynecomastia.
Complications were uncommon and generally minor. There was a six percent rate of hematomas–blood collections causing pain, swelling, and bruising. Dr. Blau notes this problem became less common after he began providing stricter instructions regarding preoperative and postoperative care: stopping all use of steroids and supplements before surgery, and resuming exercise gradually after surgery.
Plastic surgeons may see increased interest in gynecomastia surgery among bodybuilders and other men with good physique, Dr. Blau believes. He suggests that surgeons performing gynecomastia surgery start with simpler cases, before proceeding to the more-challenging demands presented by bodybuilders.
While many men are affected by gynecomastia, most don’t seek treatment, according to this month’s introductory video by Rod J. Rohrich, MD, Editor-in-Chief, on the Plastic and Reconstructive Surgery website. The February issue also reports on a new technique for men seeking breast reduction after massive weight loss. “In these two papers, we see how the surgical treatment of Gynecomastia can improve both aesthetics and patients’ quality of life,” Dr. Rohrich comments. “Plastic surgeons are constantly studying and refining these surgical techniques to create the safest, most effective procedure possible.”
Plastic and Reconstructive Surgery® is published by Lippincott Williams & Wilkins, part of Wolters Kluwer Health.
Click here to read “Correction of Gynecomastia in Body Builders and Patients with Good Physique.”
Article: “Correction of Gynecomastia in Body Builders and Patients with Good Physique” (doi: 10.1097/PRS.0000000000000887)
About Plastic and Reconstructive Surgery
For more than 60 years, Plastic and Reconstructive Surgery® has been the one consistently excellent reference for every specialist who uses plastic surgery techniques or works in conjunction with a plastic surgeon. The official journal of the American Society of Plastic Surgeons, Plastic and Reconstructive Surgery® brings subscribers up-to-the-minute reports on the latest techniques and follow-up for all areas of plastic and reconstructive surgery, including breast reconstruction, experimental studies, maxillofacial reconstruction, hand and microsurgery, burn repair, and cosmetic surgery, as well as news on medico-legal issues.
The American Society of Plastic Surgeons (ASPS) is the world’s largest organization of board-certified plastic surgeons. Representing more than 7,000 Member Surgeons, the Society is recognized as a leading authority and information source on aesthetic and reconstructive plastic surgery. ASPS comprises more than 94 percent of all board-certified plastic surgeons in the United States. Founded in 1931, the Society represents physicians certified by The American Board of Plastic Surgery or The Royal College of Physicians and Surgeons of Canada. ASPS advances quality care to plastic surgery patients by encouraging high standards of training, ethics, physician practice and research in plastic surgery. You can learn more and visit the American Society of Plastic Surgeons at http://www.plasticsurgery.org or http://www.facebook.com/PlasticSurgeryASPS and http://www.twitter.com/ASPS_news.
Gynecomastia, simply put, is an overdevelopment of male breast tissue. Typically gynecomastia affects newborns, adolescents, and older adult males, though the reasons for the development of the excess tissue are often different.
In pre-teen and teen boys, gynecomastia is usually caused by hormonal changes associated with puberty. It isn’t uncommon among males of this age. However, for most males going through puberty the gynecomastia usually disappears after one year. For some teens, the breast tissue doesn’t decrease after the first year or even the second year of puberty, as it does for most.
The distinction should be when the gynecomastia is large. In this case it will usually remain and can cause psychological and social problems. When this occurs, it may be an indication for early age surgery. Children as young as twelve years old have undergone gynecomastia correction surgery. It should always be done in consultation with the parents and surgeon, and sometimes a psychologist, social worker and a teacher. At this early age it is important to consult a gynecomastia expert who must be a board certified plastic surgeon.
Image Courtesy of ShutterStock
Visit Your Child’s Doctor
Adolescent gynecomastia may not be a serious problem. Yet in some cases, it is caused by an estrogen-producing tumor, which may be problematic if left unchecked. Typically, this only occurs in pre-teen boys that haven’t reached puberty yet, but may happen as your child enters their teens.
It is beneficial to visit your child’s doctor to talk about the tissue, as estrogen-producing tumors do sometimes require treatment.
Certain Medications Can Cause Gynecomastia
Many of the medications that produce gynecomastia are not ones you would be giving to a pre-teen or teen male. However, there are certain drugs you should know about that increase breast tissue and actually cause gynecomastia.
- Oral steroids, such as Prednisone, are used for health problems like asthma. Short-term steroid use prescribed by a doctor does not cause gynecomastia.
- Medicines used to treat ulcers can sometimes cause gynecomastia when used for long periods of time.
- Epilepsy medications, such as Dilantin, have been linked to gynecomastia in pre-teen and teen boys.
Symptoms of Gynecomastia
Gynecomastia is usually discovered when a parent or child notices swelling in the breast area. The area has been described as having a rubbery or very firm feel, yet the child does not feel discomfort.
In many cases, adolescent boys don’t notice the onset of gynecomastia or don’t mention it to parents until they feel embarrassed or uncomfortable with their bodies.
A gynecomastia diagnosis from a doctor is usually quick. It requires a physical examination and a look at the child’s medical history. The doctor may focus on certain medications as the cause.
If the breast tissue is unusually large, is focused only on one side, or is tender or very hard, a biopsy may be necessary to determine if there could be a tumor or breast cancer.
Unless your child is taking a specific medication known to cause gynecomastia, not much can be done. Gynecomastia typically goes away on its own, so doctors do not generally advise surgical intervention – at least when a child is in their early teens.
In a small number of cases, gynecomastia that is caused by a lack of testosterone and an increase of estrogen is able to be treated with hormone therapy.
Image Courtesy of Wikipedia
Gynecomastia often feels like a serious problem to an adolescent male. After all, they may feel that they look different than their peers or that their bodies are not developing the right way.
While is it important to have gynecomastia evaluated by a doctor, it is also important to let your child know that it may be a normal part of their growth. Almost all adolescent males do grow out of it – within two years at the most.
I am probably a somewhat unusual patient for Dr. Blau as the field of expertise for which he has become renowned is gynecomastia. I am a transgender female to male patient seeking what is commonly known as ‘top surgery’ i.e. removal of breast tissue and reconstruction of chest.
As a bodybuilder I was introduced to him by friends who had received surgery at his Westchester office and had extremely positive outcomes. I went for my initial consultation about two years ago but because I was not in a position to have the surgery done at that time I returned again two months ago to have another evaluation.
As was the case on my previous visit, I found the office staff to be extremely friendly and the waiting room comfortable and the surroundings homely rather than intimidating.
On meeting Dr. Blau he examined me and evaluated me for surgery explaining what he would do and what results he hoped he would achieve. It turns out that I have a concave in my chest which he felt could be filled in by taking fat from my lower back via liposuction during the procedure and this would create a much better result. I am sure many surgeons who practice in this field would not have been so concerned with that. I found this extremely reassuring and exciting, knowing that I would finally have the physique I wanted making my transition complete.
My surgery was initially scheduled for October 21st but due to the fact that I thought I may have a Urinary Tract Infection, which surfaced three days before surgery, Dr. Blau was unwilling to take a risk of operating in case the infection spread.
It turned out not to be a UTI but nevertheless his caution showed that he took my surgery and my general health and outcome very seriously which again reflects his professionalism.
My surgery is now scheduled for November 18 and I will update with details of my procedure and results as soon as I have recovered sufficiently.
The White Plains Award Program has chosen Dr. Mordcai Blau for the 2013 White Plains Awards in the Cosmetic Surgeons classification.
For most companies, this recognition is a result of dedication and efforts as well as the work of others in the organization that have helped build the business. Dr. Blau’s team is now a part of an exclusive group of small businesses that have achieved this selection.
Each year, across the greater White Plains area, the White Plains Award Program chooses only the best local businesses. They focus on companies that have demonstrated their ability to use various marketing methods to grow their business in spite of difficult economic times. The companies chosen exemplify the best of small business; often leading through customer service and community involvement.
We are excited for this achievement!
Breast cancer is one of the leading causes of death in women. But did you know that women aren’t the only ones affected by this disease? Believe it or not, men are also susceptible to breast cancer. While this occurs in men far less than in women, it is still a cause for concern. According to the American Cancer Society, approximately 2,240 cases of breast cancer in men will be diagnosed in 2013. About 410 men will die this year from breast cancer. And, though it is less likely (approximately 100 times less likely) for men to develop breast cancer than women, with statistics like this, it is still a cause for concern.
In order to help you better understand this disease in men, it is important to understand the causes and why it happens.
Image courtesy of ShutterStock
What is male breast cancer?
Cancer refers to any malignant tumor, or the development of a group of abnormal cells, in any part of the body. Cancer becomes harmful to the body when these abnormal cells divide uncontrollably and form lumps or tumors. Tumors can grow and interfere with the digestive, nervous, and circulatory systems and they can release hormones that alter body function. These cells can develop in the breast tissue of a male. The development of this disease is rare in men and is quite worrisome. The collection of abnormal cells can grow quite large and take over surrounding tissues. It can also metastasize, or spread, into other parts of the body. Many men don’t know they are susceptible and in turn aren’t getting screened by a doctor the way women have been taught to do.
What causes male breast cancer?
Just like in women, we are not exactly certain what causes the development of breast cancer in men. It could be linked to genetics or environmental conditions, and recent studies are indicating that it could also be linked to gynecomastia.
Gynecomastia refers to an increased production in the amount of tissue in a man’s breast. Men naturally have breast tissue, but since their breasts are not used in the same manner as women’s, they normally don’t produce large amounts of this tissue. However, in the case of gynecomastia or pseudogynecomastia, there are instances when there is an increase in the development of this tissue.
When there is an excessive amount of breast tissue, it is believed that there is a greater chance of the development of abnormal cells, which can lead to the development of breast cancer.
Signs of Gynecomastia
Typically, breast tissue in men is too small to be felt or seen. However, in cases of gynecomastia, there is usually the feeling of a growth under or around the nipple and areola. In more extreme cases, men can actually develop small breasts.
Link between Gynecomastia and Male Breast Cancer
The development of gynecomastia is linked to an excessive production of estrogen. Extra breast tissue and an increased amount of estrogen in the male body is thought to increase the chance of breast cancer developing in men. While the studies on this connection are still in the beginning stages, evidence does suggest a link. More needs to be learned and studies are continuously being conducted in order to determine the exact correlation of these two conditions.
While breast cancer occurs less in men than in women, it is still important for both genders to check themselves regularly.
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Tel. Number: 914-428-4700
This is a notification recognizing that Dr. Blau Gynecomastia New York has been selected for the 2012
Best of White Plains Awards in the Cosmetic Surgeon category by the White Plains Award Program committee.
“Our selection of your company is a reflection of the hard work of not only yourself, but many people that have supported your business and contributed to the subsequent success of your organization”.
The White Plains Award Program hereby grants Dr. Blau Gynecomastia New York exclusive display this press release and the digital award image in any media formats and through any media channel.
As 2012 comes to a close, we’d like to evaluate the journey our practice has gone through in the past year and highlight some of our accomplishments.
The practice recently submitted statistics to the American Society of Plastic Surgeons on the number of surgeries done over the past year. In 2012, Dr. Blau performed 317 gynecomastia, or male breast reduction surgeries, which was over 95% of the total procedures performed at his practice. Considering that on average, each plastic surgeon only performs 2-3 surgeries of this nature a year, it is quite impressive. Only a handful of other surgeons worldwide perform more than 100 male breast reduction surgeries each year. Of these surgeries about 100 were performed from patients residing outside of the country. Dr. Mordcai Blau and his staff make concerted effort to cater to international patients by providing extensive information on staying in the White Plains area and by providing individualized instructional packets designed for each patient based on his individual needs far in advance of the surgery to ensure each patient is prepared. His staff was more than happy to do this for all 317 gynecomastia patients, regardless of whether they came from out of state, out of the country, or right in town.
Since Dr. Mordcai Blau is an expert who specializes in gynecomastia surgery, he often gets many patients who require revisions from previous gynecomastia surgeries. In 2012, 100 of Dr. Blau’s surgeries were revisions. Throughout the year, Dr. Blau has found that patients have generally been satisfied and that none of his gynecomastia patients experienced a recurrence. He has found that his signature technique, the Natural Blend technique, which requires careful consideration of the contours of each individual patient’s body prior to surgery, contributes to the success of his surgeries. As an artist who has had his work showcased in several exhibitions throughout the U.S. and Europe, the Natural Blend technique combines Dr. Blau’s skills as an artist and a surgeon and helps him to map out his surgical plan to create a natural-looking contour in which the skin drapes naturally over the chest. Dr. Blau finds that this technique works especially well for bodybuilders, who represent a large portion of his gynecomastia patients. The fact that such a large percentage of his practice is comprised of bodybuilders serves as a testament to Dr. Blau and his surgical techniques as this group holds a much higher standard for physical appearance than the average patient. In an effort to further improve upon aesthetics, Dr. Mordcai Blau followed cues from his patients’ wishes and has also developed nipple reduction surgery in order create an appearance of the chest which is more typical. To see the results of his work, browse through his collection of 2,500 before and after photos.
Among his other accomplishments in 2012, Dr. Blau was featured on The Learning Channel (TLC). In the segment, the film crew followed the journey of one of his patient’s Cristian, from his early struggles with gynecomastia to his results from his gynecomastia surgery. This segment helps shed light on the problems commonly faced by those with gynecomastia.
Also in 2012, Dr. Mordcai Blau has started working on compiling his surgical knowledge of gynecomastia into a book. He hopes that this compilation of experience working on patients with gynecomastia will help inform the public and other plastic surgeons about best techniques and practices for male breast reduction surgery. He hopes to incorporate successes from 2013 into his book.
Below you will find a guest blog post by Dylan Stein, MS, LAc . Dylan is an acupuncturist in New York City specializing in men’s health, dermatology and pain management. He has written a short post here for my readers and also my patients about managing pain after surgery. I think you will like his suggestions.
Also, please visit his website to see if acupuncture might be of use to you.
Cosmetic surgery is an incredible advancement in the field of healthcare. So many people suffer from issues of low self-esteem and poor body image. Cosmetic surgery provides an opportunity to change this. There are a few ways you can prepare yourself and then manage unwanted symptoms naturally after surgery. The best things you can do to prepare for surgery are get adequate rest, eat a diet rich in vegetables and low in refined carbohydrates (high sugar snacks, baked goods made with white flour, and tropical fruits), and drink at least 8 glasses of water per day in the two weeks leading up to your surgery date. Sleep is a time for your body to heal and recoup lost resources. By getting at least 8 hours of sleep per night leading up to your surgery, you will have prepared yourself to start healing sooner.
A vegetable-rich diet will give your body the vitamins, minerals and anti-oxidants it needs to heal from surgery. As I tell my patients, try to eat the rainbow. This means make sure you’re getting all different colored vegetables, with an emphasis on the dark leafy greens. Add these extra vegetables to your existing meal plans. Also, try to eat refined sugars and simple carbohydrates (they digest quickly into sugar) infrequently. Sugars like this promote inflammation, which will slow or inhibit proper healing after surgery. If you’re craving fruit, try to eat organic berries, pears and even roasted sweet potatoes for a healthier version of a sugary snack. Drinking enough water each day is incredibly important. We’re lucky in New York to have excellent tap water. Consider getting a filter to remove the chlorine before drinking. Do not drink distilled water. Tap water, even unfiltered tap water, is preferable to water bottled in plastic, which can be full of chemicals, which disrupt your hormones. Adequate water intake will help your body flush out toxins and keep your body fluids at the right levels.
I teach all of my patients undergoing surgery three different acupressure techniques. Acupressure works similarly to acupuncture, but doesn’t involve needles since it’s a massage technique. Acupressure is very safe. The only contraindication is to avoid the first technique I mention below if you are pregnant. Because this kind of acupressure is so safe, you can do this a few times a day or even hourly to help manage your discomfort. The first technique is called Massaging the Four Gates. It uses a point on each hand and each foot. The hand points, known as Large Intestine 4, are between the thumb and index finger in the fleshy muscle of the web. This point has a resonance with the face, so it is particularly good for anyone who has had cosmetic surgery in that area. Coincidentally, it is also a great point for sinus headaches and toothaches for the same reason. The second point in this pair is called Liver 3, which lies in between the foot bones that connect to the first and second toes. If you touch this area, you will feel a depression in which the point lies. This coupled point pair strongly stops pain by regulating the Qi (the body’s energy) and blood of the entire body. Since the foot points are not very easy to reach on your own, you can focus on the hand points during self-massage. Massaging these points can be done gently or strongly, whatever feels most comfortable to you. You can even push and hold the points strongly if the pain is intense.
The second technique will help with pain, but it also helps with agitation or nervousness. This can be useful right before surgery if you’re feeling anxious or after surgery to help calm your nerves. This is acupressure ear massage. Gently pinch your ear between your thumb and forefinger and massage with small circles. Pay attention to the entire ear. Use just your forefinger to work into all the nooks and crannies. Be gentle, but firm. If you have very cold hands, this will be less useful, so either ask a friend with warm hands to do it or run your hands under warm water to take off the chill. The third technique is for post-surgical nausea, and is called Massaging the Inner Gate. It utilizes a point called Pericardium 6, which lies two inches or so above the inside wrist crease on the forearm, right in the middle of all the tendons that move the hand and fingers. Motion sickness bracelets stimulate the same point. Apply gentle, but firm, pressure to this point if you’re feeling nauseated. Coincidentally, this point may also be useful for morning sickness. If your doctor says it’s OK, you can also apply some lavender essential oil to this point to help control the nausea.
My final tip for patients is not from the Chinese medicine repertoire, but from homeopathy. Before taking any medications or supplements, be sure to get your doctor’s OK. The use of a homeopathic remedy called Arnica Montana may be helpful to reduce swelling and bruising after surgery. The 30C concentration is usually adequate. Follow the directions on the label. Arnica is readily available in health food stores and some pharmacies.
Continuing the pre-surgery routines I mentioned above after surgery will also be useful to encourage healing.
I hope you found this information helpful. I wish you a speedy recovery.
Yours in health,
Dylan Stein, MS, LAc.
Dylan Stein Acupuncture
Follow Dylan on Twitter @citypuncture