The first question at nearly every gynecomastia consultation at Southwest Plastic Surgery is about price. Dr. Frank Agullo doesn’t dodge it. The practice’s starting fee is $7,050, and it’s genuinely all-inclusive: anesthesia, the surgical facility, pre-op testing, and recovery garments are built into that number, with only prescription medications billed on top.
What Dr. Agullo won’t do is quote that number as the final one without an exam first. “Gynecomastia” covers more than one problem, and the real price follows from which one is actually in front of him.
Not Every Chest Is the Same Diagnosis
There’s true glandular tissue, firm and fibrous, sitting under the nipple. There’s pseudogynecomastia, which is simply fat with no gland enlargement. Most patients who come through the practice have some combination of both. The plan, and the price, is built around that distinction rather than around the word on the intake form.
Most Patients Wait Longer Than They Have To
“This is actually very common,” Dr. Agullo says. “Although some patients in their puberty come in for correction, most patients come in once they’re financially independent and can take care of the procedure themselves. They’re usually very self-aware of the chest fullness, and it has caused them anxiety and made them uncomfortable in social settings.”
Anabolic steroids, testosterone therapy, and certain medications can also cause development of the breast gland, and the gland itself grows. Dr. Agullo is direct about the misconception patients bring in most often: “The fullness in the chest that’s fatty in nature will decrease with weight loss, but the gland itself will not change with weight changes. It’s incorrect to assume gynecomastia can be resolved with weight loss.”
Building an Honest Quote
The $7,050 starting price covers removal of the enlarged gland, and Dr. Agullo says it’s actually pretty rare for a patient to need only that. Those cases are usually athletic patients with well-developed pectoral muscles and no real excess chest fat, just fullness behind the nipple. Most patients need more, and the practice adds only what a given chest actually needs:
| Added to the base price | What it addresses |
|---|---|
| Liposuction of the breast with Renuvion J-Plasma | The excess subcutaneous fat, often driven by the gland’s own growth, with skin tightening built in for the laxity left behind |
| Liposuction of the lateral chest wall and axilla with Renuvion | Fullness that extends past the central chest and blunts pectoral definition |
| A donut lift (circumareolar incision) | More severe cases with true breast ptosis, or an areola stretched by longstanding tissue |
A full quote reflects the gland removal plus whichever of these apply. That’s why the office can’t give a number over the phone. It comes after Dr. Agullo examines the tissue in person.
Is It Ever Really Scarless?
“We no longer have to put a scar underneath the areola to remove the gland behind the nipple and areola,” Dr. Agullo says. “I use a method where a small incision is made inferior and lateral to the breast or chest. It’s about four millimeters long, and it’s used for the liposuction of the lateral chest and the breast area. Through the same incision, I can insert an arthroscopic shaving device and shave down the gland, without a need for a large incision.”
“The reason we used to have to make an incision is because the breast gland is rubbery, and the liposuction cannula cannot suction out the breast gland, as it is more indurated than the soft fat,” he explains. “But using the arthroscopic shaver, we’re actually shaving down the gland and removing it. With this technique, we have less risk of contour irregularities. Many times, after an excisional gland surgery with a scar, there’s a large divot behind the nipple and areolar complex. This can be avoided using the arthroscopic shaving device, and also by injecting fat into the area after gland removal.” The exception is the more severe case needing the donut lift for true ptosis or a stretched areola, a real incision, just a well-hidden one.
Why So Many Patients Wait Years to Ask
“The male patients who come in for this procedure have had a lot of psychological anguish because of the fullness in their chest,” Dr. Agullo says. “They’ve been bullied. They’ve stayed away from summer pool activities, or they go swimming with their shirts on, or avoid it altogether. They are self-conscious about it. They have a hard time in the locker rooms. So when they come in, they are very motivated to resolve this.” He tells them plainly: “It’s very common, and a lot of people are in their same shoes.” A consultation carries no cost and no commitment.
Recovery and What’s Included
The all-inclusive starting price covers the compression garment patients wear during recovery, which supports the chest wall as swelling resolves and helps the skin settle against the new contour. Patients recovering from gynecomastia surgery are also welcome to pair post-op care with the practice’s Med Spa and Laser services once cleared, for scar management or general skin care during healing.
Why Southwest Plastic Surgery Publishes Its Fees at All
“I’d like to think our practice distinguishes itself by providing excellent patient service, pre- and post-operative care, and the latest current techniques and innovations,” Dr. Agullo says. “Because of this, a lot of our fees are on the higher end, and we publish them so patients know before a consultation what it may entail financially, and whether it works for them.” The goal, in his words, is fewer surprises after a consultation and better-educated patients walking in.
About Dr. Frank Agullo
Frank Agullo, MD, FACS, is double board-certified by the American Board of Plastic Surgery and the American Board of Surgery and a Fellow of the American College of Surgeons. He completed his plastic surgery fellowship at Mayo Clinic and serves as a Clinical Associate Professor of Plastic Surgery at Texas Tech University Health Sciences Center Paul L. Foster School of Medicine. He has been named a Castle Connolly Top Doctor for thirteen consecutive years.
Ready to Talk?
Bring the real question, not just the number the internet gave you. The team will walk through which gynecomastia you actually have and what an honest quote looks like.
Call (915) 590-7900, text 1-866-814-0038, or book online at agulloplasticsurgery.com/appointments. #StayBeautiful.
@RealDrWorldWide on Instagram, TikTok, and Snapchat, @Agullo on X, or @AgulloPlasticSurgery on Facebook.
Cross-links
- Editorial version on drworldwide.com: “The Gynecomastia Quote Nobody Explains: Why $7,050 Is Just the Starting Line”
- Patient-facing version on agulloplasticsurgery.com: “What Gynecomastia Surgery Actually Costs in El Paso (And Why the Number Moves)”
