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Gynecomastia Surgery (Male Breast Reduction)

Gynecomastia (sometimes spelt gynaecomastia) is a relatively common but emotionally distressing condition, causing prominent male breasts or “man boobs”. Gynecomastia surgery using a variety of cosmetic surgery techniques is one of the most effective treatments for reducing this condition.

Gynecomastia (enlargement of the male breast tissue) is a condition which can run in families. It can be made up of excess glandular tissue, fatty tissue or excess chest skin (in varying ratios).

Aurora is now part of The Private Clinic, please click here to find out more about Gynecomastia – Male Chest Reduction and The Private Clinic. World renowned plastic surgeon Mr Adrian Richards is part of The Private Clinic expert team.

There are some medical causes of gynecomastia which include: the use of certain drugs (i.e. marijuana, smoking) and conditions such as liver disease. Some other causes are associated with weight gain. If you are concerned that you may have gynecomastia, it would be of benefit to reduce your weight as this may improve the situation. If you are taking any medications such as steroids, these can also make the problem worse so should be stopped if possible. In most cases, however, the gynecomastia is idiopathic (meaning ‘no cause found for the condition’).

Considering Gynecomastia Surgery?

There are many reasons why men of all ages and physical builds seek a surgical solution. Some common factors which influence their decision include:

  • Embarrassment, particularly when changing in public
  • Problems with sexual relationships
  • Unhappiness with physical appearance and outline in clothing
  • Emotional conflict over sexual identity

There are various different methods for treating gynecomastia. These depend on the area, tissue composition and degree of severity. The options range from exercise to painkillers and surgical treatment in severe cases. The surgical options include liposuction or excision or a combination of both.

How will it impact on your life?

As a man, having prominent breasts can be quite disconcerting. It can be very embarrassing when changing in public, especially as a young man potentially still at school. This can lead to bullying and teasing which can leave emotional scars later in life. You could have problems in your sexual relationships, and lack the confidence to enter into a relationship. You could also be unhappy with your physical appearance, and how your clothes sit. We find people tend to wear baggy clothing to try and cover the gynecomastia.

The aim of this surgery is to reduce this prominent breast tissue and achieve a more natural contour to your chest area to increase your self-esteem and make you feel comfortable with your physical appearance.

Male Breast Reduction FAQs

The main symptom associated with gynecomastia is enlarged male breast tissue. Typically, men suffer from prominence in both breasts but it is not uncommon to find asymmetry (one breast larger than the other). Gynecomastia can also occur on just one side (unilateral gynecomastia).

Puffy nipples are common gynecomastia symptoms, where glandular tissue is enlarged just in the area of and around the male areola causing a swollen, protruding look to the nipples.
It's important to understand what causes prominent male breasts in order to establish the most effective course of treatment. If you're suffering from gynecomastia (also known as ‘man boobs’ or ‘male breasts’), you probably want to know why you are affected by this condition. Unfortunately, in many cases of true gynecomastia, a cause is not easy to determine.

In the vast majority of cases there is no specific cause. This is known as idiopathic gynecomastia and it is normally down to the pattern of fat distribution in individuals. Such conditions often run in families, with fathers and sons having similar patterns of fat distribution in the chest area.

It is quite common for males to develop prominent breasts during puberty as increasing hormone levels cause one or both breasts to develop unevenly. As many as 90% of adolescent males experience this but the problem usually settles down with maturity. In approximately 10%, however, the condition continues into adulthood as gynecomastia.

Gynecomastia can, itself, be a symptom of other underlying health issues or (rarely) more serious syndromes:

Lifestyle gynecomastia causes
  • Excessive alcohol consumption
  • Marijuana use
  • Steroid use
Disease gynecomastia causes
  • Hyperthyroidism
  • Hypogonadism
  • Kidney or liver failure
  • Liver disease
  • Medication side effects from hormone treatments, chemotherapy, radiation therapy and certain medications
  • Tumours of androgen-producing glands
  • Syndromes such as Klinefelter’s Syndrome (a condition where a male has an extra X chromosome)
These causes account for approximately 10% of cases and it is important to rule them out. It is recommended to see your GP for diagnosis and assessment of your gynecomastia symptoms before considering corrective surgery. This will allow you to rule out the slim possibility of a more serious condition and rest assured that you are rectifying a distressing but purely aesthetic problem. Do not feel alarmed by the above-mentioned possibilities if you do suffer from gynecomastia, as the vast majority of male breast cases are not caused by any of these and are mainly due to a genetic disposition to develop tissue in this area.
It is true that one of the contributory factors to gynecomastia is carrying too much weight. We would advise you to check your body mass index (BMI) which is a measurement of your weight when compared to your height. 

The normal values lie between 20 and 25 depending on your body frame. For example for a 70kg man, the average height is approximately 1.76 metres.

BMI Level Weight Measurement
Below 20 Underweight
20 - 25 Normal weight
26 - 29 Slightly overweight
30 - 39 Significantly overweight
If your body mass is over 25, your gynecomastia will be improved to some extent by getting your body mass index down to a normal figure of between 20 and 25.
'True' gynecomastia is made up of mainly glandular rather than fatty tissue. To be diagnosed with gynecomastia, you must have breast tissue greater than 0.5 cm in diameter. Male chest fat or excess skin (i.e. after weight loss or through ageing) is not technically considered to be gynecomastia.

However, if you do suffer from excess skin on your chest, you may still be a good candidate for cosmetic surgery to treat this problem. Male breast reduction surgery at Aurora Clinics uses a variety of techniques and excisional techniques are particularly good for dealing with excess skin. Fatty tissue causing gynecomastia-type symptoms may respond better to liposuction techniques (after an initial program of exercise).

‘True’ gynecomastia symptoms, of enlarged glandular tissue tend to require a combination of liposuction and excision. Your surgeon is the best person to advise you about the best course of treatment for you during your consultation.
Gynecomastia is a completely benign condition i.e. it is not associated with male breast cancer. However, any swelling in the chest area (particularly if it appears or gets larger suddenly) should be checked immediately by your doctor in order to rule out the chance of misdiagnosing these conditions.
We strongly recommend that you have a consultation if you are considering gynecomastia treatment. It is important to rule out medical causes for this condition as these (although uncommon) can be serious. There are also numerous treatment options for gynecomastia so it really is best to seek expert advice rather than attempting to self-diagnose.
Your surgeon will ask about:
  • Your gynecomastia, including any social difficulties such as swimming and wearing tight clothing
  • They will then enquire about your health and any medical issues, such as medications and lifestyle habits which can contribute to gynecomastia
  • Your surgeon will also assess your body mass index (BMI) to ensure it is within normal boundaries. If it is over 25, your surgeon will recommend a program of exercise and diet to lower your BMI, as it can have significant impacts on the fatty distribution within the breast tissue
  • If your surgeon has ruled out any underlying cause for your gynecomastia and you are of normal weight they will discuss the various available options for treatment
  • You will be encouraged to express your concerns and your reasons for considering surgery
Your surgeon will also discuss the surgical procedure in detail, including:
  • Location and size of any scars
  • The likely amount of reduction of your gynecomastia
  • Aftercare, particularly the type of support clothing and dressings that you will wear afterwards
  • Your recovery time
  • Which activities you can perform after surgery
  • Possible complications that can occur following surgery
You will not have to make an immediate decision about whether you want surgery after your consultation. Your surgeon should give you some background reading material on gynecomastia and allow you significant time to make your decision. At Aurora Clinics, we advise people to think carefully about whether surgery is right for them and encourage patients to have as much understanding as possible of the causes of gynecomastia, the options, the likely outcome from treatment and any possible complications. We find by providing people with as much information as possible, they are able to weigh up the pros and cons of the operation in order to make an informed decision about proceeding.
At your gynecomastia surgery consultation, it is important that your surgeon shows you photographic results from past cases of patients they have treated with a chest appearance which is similar to yours.

This will give you the best possible idea of the result of your surgery, likely scarring and also the amount of reduction of the chest area that can be achieved. It is important to remember, however, that scarring varies between individuals and your surgeon will make sure you have a full understanding of how the scars could appear. We would also advise that you see the results of the surgery from different angles, including:
  • a full frontal photograph
  • a ¾ photograph and
  • a photograph from the side
In particular, look for the location and quality of the scars and whether you think they would be noticeable and you would be comfortable bare-chested. Different gynecomastia surgery techniques produce different patterns of scarring, for example:
  • Liposuction alone should produce minimal scars in the chest area
  • Liposuction with excision of breast tissue usually involves a semicircular scar below the brown area of the nipple where it meets your normal coloured skin
  • Liposuction, excision of breast tissue and removal liposuction normally creates a scar all the way around the edge of where the areola meets your normal coloured skin
A small lump of tissue may be felt under the nipple or surrounding area, which can cause tenderness. It is unusual to experience severe pain due to gynecomastia.
Unfortunately, non-surgical techniques have not proved to be very successful in treating true gynecomastia. Changing medication (under your GP’s guidance) could have a positive impact if this is found to be the cause, as could treating any underlying health conditions.

If your male breasts are identified as being composed mainly of fatty tissue and you are overweight, certain gynecomastia exercises may be of benefit. Gynecomastia surgery is not suitable for men who are above their recommended BMI, so if you are overweight it may be worth trying these exercises to see whether you notice any improvement before considering further action.

Compression garments can hide chest deformity and stabilize bouncing tissue, bringing some emotional relief and physical comfort. If your male breasts are tender as a result of gynecomastia, cold compresses may be applied. Pain relievers may also be taken. If experiencing pain, it is recommended that you contact your GP for a clinical evaluation.

Other than reaching your optimum physical health, trying to hide the problem and pain relief, for those with true gynecomastia, surgery is often the only option.
Many men think that gynecomastia exercises will improve their male breasts (or ‘man boobs’) and to a certain extent this is correct. Gynecomastia is made up of fatty tissue, glandular tissue and, to a lesser degree, excess skin. ‘True’ gynecomastia condition is composed mainly of glandular tissue.

Essential cardiovascular exercises combined with a good diet that reduces body weight can improve the appearance of gynecomastia by reducing the fatty content of the breast tissue. However, for cases of gynecomastia where the tissue composition is mainly glandular, exercise is unlikely to have a great deal of effect. Nonetheless, it is always worth trying exercise first as it can only be of benefit to reach your optimum weight before attempting to resolve other health or physical issues.
Specific chest exercises for the pecs, such as push ups, press ups and bench presses will not have a significant impact on the overlying breast tissue. This is because the exercises cause the pectoralis muscle, which is the main muscle of the chest, to increase in size and become more bulky.

Unfortunately no amount of specific chest exercises will affect the overlying breast tissue which causes gynecomastia. In fact, gynecomastia can often be made worse by rigorous and extensive chest exercises which cause the breast tissue to push forward.
Most cases of gynecomastia are caused by a combination of fatty cell accumulation and breast tissue. These amounts vary significantly in individuals and treatment varies accordingly.

Treatment for mainly fatty gynecomastia with little breast tissue and no skin excess. If your gynecomastia is mostly composed of fatty tissue without a significant central area of breast tissue and you are of a normal weight, it is likely that it is caused predominantly by an accumulation of fatty cells. The best treatment for this is liposuction to remove the fatty tissue. The advantage of liposuction is it involves minimum scarring and there is a relatively quick recovery.

Treatment for gynecomastia with both fatty and breast tissue elements. Gynecomastia without skin excess but with a significant central area of breast tissue is best treated with liposuction to reduce the fatty element to the breast, combined with an incision underneath the nipple to access and remove the central area of breast tissue.

Excess skin and gynecomastia composed of fatty tissue and breast tissue. If you have loose skin in the chest area combined with fatty and excess gland tissue the best treatment is to remove the fat with liposuction, the gland with excision and to tighten up the skin by removing a segment through excision.

There are a number of gynecomastia treatment options available in the UK if you are embarrassed by enlarged male breasts. However, due to the complex nature of diagnosing gynecomastia, identifying your unique breast tissue composition and selecting the best course of treatment for you, it is always recommended that gynecomastia treatment is undertaken following a consultation with an expert.
Liposuction is very commonly used - either alone or with other treatments - to improve enlargement of male breast tissue. There are a number of different types of liposuction including:
  • Tumescent liposuction
  • Vaser liposuction
  • Smart liposuction
  • Power-assisted liposuction
All of these techniques are similar in that suction via a tube is used to remove the fatty breast tissue. They differ in that each of the above techniques uses a different energy source to help dissolve the fat before it has been removed by suction.

In tumescent liposuction, fluid is injected to help dissolve the fatty tissue, whereas in vaser therapy, sound energy is used to disrupt the wall of the fat cell making it easier to remove via suction. Smart liposuction is a less invasive form, using a laser on small localized areas. And power-assisted liposuction uses a vibrating cannula to loosen fat cells from the body for easier suction.

Advantages of the liposuction technique:
  • It is a relatively simple procedure to perform
  • It involves minimal scarring
  • The recovery period is relatively quick
Disadvantages of the liposuction technique:
  • Liposuction techniques only remove the fatty element of breast tissue and do not remove the breast gland. If the breast gland is the principle cause of gynecomastia this will not be removed with liposuction and some gynecomastia can remain.
  • Over time, enlargement of the male breast tissue generally stretches the skin. Liposuction techniques remove the fatty elements within the breast and rely on natural skin contraction to tighten the skin. Skin tightening only occurs to a limited extent and tends to occur more in younger people.  Therefore, liposuction techniques only deal with relatively modest amounts of skin excess.
If the skin excess is significant and the nipple has descended due to skin stretching, an excisional technique may be used to lift the nipple and tighten the skin of the enlarged and stretched chest skin.
  • In excisional gynecomastia surgery, your surgeon will make a cut in your breast to access the breast tissue. This cut is usually located around the outside of your areola (the round area around the nipple).
  • This allows the surgeon to directly access the breast tissue and remove any excess tissue from the breast area.
Excisional techniques have the following pros and cons:

Pros Cons
More ability to remove the breast tissue as well as the fatty tissue from the breast. Involves more scarring than liposuction, which is normally located around the nipple.
It also has the ability to tighten up the stretched skin of the breast area.
Your recovery depends on whether you have had liposuction or excisional surgery. If you had liposuction, you will normally be back to everyday activities within one week. You will be encouraged to wear a light support garment for 4-6 weeks following the procedure to gently compress your chest area. This reduces swelling and bruising and speeds recovery.

Recovery from the excisional technique is slightly longer because of the incision around your nipple area. Your stitches may need to be trimmed around one week after your operation. You may also need to wear a support garment in the same fashion as if you had liposuction.

This procedure is considered permanent however it is possible for your gynecomastia to recur if you put on weight following surgery.
  • It is important to achieve a normal weight before any surgery for gynecomastia: gynecomastia surgery is NOT a solution if you are carrying excess weight
  • You need to discuss with your surgeon which type of surgery is most appropriate for you
  • Following excisional surgery and liposuction you will have scars on your chest which (although they will fade) will be permanent. The scarring from surgery varies from different techniques and may involve a semicircular scar at the bottom of the brown area of the nipple (areola) at the junction with the skin
  • If more of the skin needs to be removed, the scar may stretch all around the nipple, allowing your surgeon to remove a doughnut area of skin and pull it inwards. For more severe gynecomastia, scars may be required on the normal chest skin itself, although this is normally avoided if at all possible.

The next step

We always encourage people to do as much research as they can when considering cosmetic surgery, so for more information on gynecomastia surgery: