Information about the procedure
Surgical reduction of enlarged breast glands in men, restoring a flat, masculine chest contour.
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What it involves
Gynaecomastia is enlargement of the breast gland in men. It can affect one or both sides and often causes significant psychological distress — avoiding beaches, swimming pools, changing rooms and close-fitting clothes.
It is important to distinguish true gynaecomastia, in which the glandular tissue is enlarged, from pseudogynaecomastia, in which the problem is fat. The two require different approaches and often occur together.
Before surgery, possible causes are investigated — pubertal gynaecomastia, medications, anabolic steroids, hormonal disorders, and liver or kidney disease. In some cases, treating the cause is enough.
Types and approaches
Liposuction
When the enlargement is mainly fatty and skin elasticity is good. It is performed through small incisions, leaves minimal scarring and has the easiest recovery.
Excision of the gland
Dense glandular tissue does not respond to liposuction and is removed surgically through an incision along the lower edge of the areola. The removed tissue is sent for histological examination.
Combined approach
The most commonly used approach — liposuction for the fatty component and excision for the glandular component. It gives the most even contour.
With skin removal
In marked gynaecomastia or after major weight loss, the skin does not retract sufficiently and has to be removed, which leaves longer scars.
Who it is suitable for
Suitable for
- Stable gynaecomastia that has persisted for more than 12 months
- A cause that has been identified and, where possible, eliminated
- Stable weight
- Physical discomfort or tenderness in the area
- Limitations in everyday life, sport and choice of clothing
Not suitable, or postponed, in cases of
- Pubertal gynaecomastia in its active phase — it often resolves spontaneously by the age of 18–20
- Continued use of anabolic steroids or of medications that cause it
- An unexplained finding in the breast — requires imaging before surgery
- Planned significant weight loss
- Current smoking with no willingness to stop
Preparation
- Hormone tests and breast ultrasound where indicated
- A review of the medications and supplements you take
- Pre-operative tests and a consultation with a cardiologist or an anaesthetist
- Stopping smoking
- Obtaining a compression vest for the post-operative period
How it is performed
The operation is performed under general anaesthesia or local anaesthesia with sedation, depending on the extent of surgery. It takes about one to two hours. It is usually done as a day case or with one overnight stay.
In a combined approach, liposuction is performed first, then the glandular tissue is removed through a small incision along the lower edge of the areola.
A thin layer of tissue is left under the areola to avoid a hollow — removing too much creates a depression that is harder to correct than the gynaecomastia itself.
Recovery
- The first 48 hoursModerate discomfort and swelling. The compression vest is worn day and night.
- The first weekMost patients return to light office work after 5–7 days. No heavy lifting.
- 2–4 weeksThe swelling subsides considerably. The contour is not yet final and may look uneven.
- 1–3 monthsThe tissues soften and the contour smooths out. The compression vest is usually worn for 4–6 weeks.
- 6 monthsThe final result, with faded scars.
Pain and discomfort
Discomfort is moderate and feels more like muscle soreness than acute pain. Most patients switch to ordinary painkillers after the second or third day. The areas treated with liposuction remain tender to the touch for a few weeks.
Risks and complications
Every intervention carries risks. Listing them does not mean they are expected to occur — it allows you to make an informed decision.
- Contour unevenness or residual fullness
- A depression beneath the areola following overly aggressive tissue removal
- Changes in nipple sensation
- Haematoma — the most common complication of this operation
- Asymmetry between the two sides
- Visible scars around the areola
- Recurrence with continued use of steroids or medications
Results and longevity
If the cause has been eliminated and your weight remains stable, the result is long-lasting. Glandular tissue that has been removed does not grow back.
Weight gain can bring back fullness in the area, as some fatty tissue remains.
Continued use of anabolic steroids is the most common cause of recurrence.