What is gynaecomastia?

Gynaecomastia is a condition where too much breast tissue has developed. The condition can be severe and can affect one or both sides of your chest.

Is gynaecomastia surgery suitable for me?

For most teenagers, gynaecomastia goes away as your hormone levels naturally get into balance. However, in some men the condition is permanent.

Gynaecomastia is not life-threatening but you may want to have treatment if you feel embarrassed by the condition.

What are the benefits of surgery?

Your chest should have a more male appearance and both sides should look similar to each other.

Are there any alternatives to surgery?

If the condition is in its early stages, you may be able to take medication to prevent further growth.

If you are overweight and your gynaecomastia is caused mainly by fatty tissue, losing weight may lead to a reduction in the gynaecomastia.

What will happen if I decide not to have the operation?

Gynaecomastia surgery will not improve your physical health. However, treating any underlying cause will improve your health.

The problem usually gets worse with age and if you put on weight.

What does the operation involve?

The operation is usually performed under a general anaesthetic but various anaesthetic techniques are possible.

The operation usually takes 30 minutes to an hour for each side that needs to be treated.

If you have only a small amount of excess fatty tissue and good skin elasticity, the operation may involve only liposuction. Your surgeon will use a cannula (thin, hollow tube) attached to a suction device to remove the fat through a small cut.

They will make 1 or 2 small cuts on a crease line on the inside or outside of your chest.

Your surgeon will move the cannula through the tissue. Your surgeon will move the cannula at different angles so the tissue is removed as evenly as possible.

For severe gynaecomastia, where there is a lot of excess skin, there are several different options. Your surgeon will discuss what they think may be the best option for you.

How can I prepare myself for the operation?

If you smoke or use nicotine products, stopping smoking at least 6 weeks before and for 6 weeks after surgery may reduce your risk of developing complications and will improve your long-term health.

Try to maintain a healthy weight. You have a higher risk of developing complications if you are overweight.

Regular exercise should help to prepare you for the operation, help you to recover and improve your long-term health. Before you start exercising, ask the healthcare team or your GP for advice.

Speak to the healthcare team about any vaccinations you might need to reduce your risk of serious illness while you recover. When you come into hospital, practise hand washing and wear a face covering when asked.

What complications can happen?

The healthcare team will try to reduce the risk of complications.

Any numbers which relate to risk are from studies of people who have had this operation. Your doctor may be able to tell you if the risk of a complication is higher or lower for you. Some risks are higher if you are older, obese, you are a smoker or have other health problems. These health problems include diabetes, heart disease or lung disease.

Some complications can be serious and may even cause death.

General complications of any operation

• Bleeding during or soon after the operation.
• Infection of the surgical site (wound).
• Allergic reaction to the equipment, materials or medication.
• Venous thromboembolism (VTE). This is a blood clot in your leg (deep-vein thrombosis – DVT) or one that has moved to your lung (pulmonary embolus).
• Chest infection. Your risk will be lower if you have stopped smoking and you are free of COVID-19. (coronavirus) symptoms for at least 7 weeks before the operation.

Specific complications of this operation

• Small skin burns. The burns are usually mild and settle with time however they may leave small scars.
• Changes to skin colour caused by bleeding.
• Irregular body shape where fat has been removed.
• Fat embolus. Liposuction can sometimes cause fat to enter your bloodstream and move to your lungs, making it difficult for you to breathe. This is rare but can be serious.
• Injury to small nerves that supply your skin when the cannula is passed through the fat. This can cause numbness, a feeling of ‘pins and needles' or hypersensitivity.
• Developing a collection of fluid (seroma) under your skin.
• Developing a collection of blood (haematoma) under your skin.
• Loss of skin, including the areola and nipple if you have severe gynaecomastia, causing areas of skin to die.
• Developing an abscess (a collection of pus), if your body tries to control an infection by forming a wall around the infected area.
• Change of nipple sensation. This usually settles within a year but the change may be permanent.
• Stiff shoulder.
• Cosmetic problems. It is difficult to predict exactly how your chest will look after the operation.

Consequences of this procedure

• Pain. The areas that are treated can be uncomfortable for a few weeks.
• Unsightly scarring of your skin. The scars usually settle within 4 to 6 months.

How soon will I recover?

You should be able to go home the same day if you had only liposuction, or the next day when any drains have been removed.

You should be able to return to work after a week, depending on your type of work.

Most men return to normal activities after 4 to 6 weeks.

The healthcare team will advise you on exercising to help keep you to a healthy weight and to improve the cosmetic result.

Your new chest shape will take several months to settle as the swelling reduces and your skin tightens.

Summary

Surgery for gynaecomastia is an operation to remove excess tissue from your chest. You should consider the options carefully and have realistic expectations about the results.

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