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.




Dr. Delgado Bio


Dr. Delgado, MD is a world-recognized plastic surgeon and specialist in the treatment of male breast enlargement, also called gynecomastia. He has developed new techniques and owns and operates, which has become the largest gynecomastia forum in the world. Dr. Delgado holds the two most coveted credentials; the certification by the American Board of Plastic Surgery and membership in the American Society of Plastic Surgery.