Gynecomastia Surgery and the  “Pull Through Procedure”


Male breast reduction surgery for gynecomastia is performed in a variety of ways. The specific surgical technique depends on the “grade of gynecomastia” of the patient.  The pull-through procedure was developed by Paolo Giovanni Morselli from Italy who publish the original article in the European Journal of Plastic Surgery in 2012. The pull-through procedure has become very popular in the United States due to the small incision.

Pull Through technique Operation

The pull through procedure is performed by making a quarter-inch incision at the bottom of the areola.  Liposuction is performed to remove fat from around the breast gland.  The tissue is grasped by a special instrument and then pulled through the incision while freeing up the breast tissue from below the areola and above the muscle.  This is a blind procedure and not great access so the experience is required, especially to avoid a crater deformity.


Who is an ideal candidate?

The best candidates are grade 1 or 2 gynecomastia. These patients’ male breast enlargement is not too large and the gland can be removed and the fat blended without creating a crater deformity.

What is recovery?

If drains are used, they are removed in 2-3 days. You can drive a car and perform white-collar work in 5 days. Blue-collar work about 7-10 days. Modified exercise can begin in 2 weeks and full work-outs in 4-6 weeks.  A compression vest is worn for 4-6 weeks.

What is the cost of the “pull-through” procedure?

The expense of the surgery is explained in this cost link, but the cost is usually less due to less surgical time. So, looking at $6,000-$7,000 is a normal fee. Sometimes, local anesthesia is used and this would lower the cost.