Gynaecomastia

What is gynaecomastia?

Gynaecomastia is a condition in which male breast tissue becomes enlarged. It is common and can affect one or both sides of the chest. Although it is not commonly talked about, it can cause emotional distress or self-consciousness, especially during activities like swimming or exercising. Surgery can help men who feel self-conscious about their gynaecomastia by removing excess breast tissue or, in some cases, extra skin as well.

What causes gynaecomastia?

During puberty, many teenage boys get temporary breast swelling. It usually goes away, but about 1 in 10 young men still have it into adulthood. As men get older, gynaecomastia becomes more common again – affecting around 1 in 3 older men.

Most of the time, there’s no clear cause and it’s not harmful. But sometimes gynaecomastia can be linked to:

Medicines: such as drugs for high blood pressure, heart disease, prostate cancer, steroids, and some anti-depressants.
Substance use: such as marijuana, alcohol, and some recreational drugs.
Obesity: which can increase oestrogen levels and fat deposits in the chest.
Health conditions: such as liver disease and some tumours.
Rare genetic conditions.

During your first consultation, Dr Law will take a detailed history and assess you for possible causes of gynaecomastia.

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Surgery

You may be a good candidate for surgery if you:
- Are in good health.
- Have maintained a stable weight.
- Have realistic expectations about the surgery.
- Do not smoke, or can temporarily stop smoking for the surgery.
Before your surgery, you’ll have a detailed consultation with Dr Law to discuss your goals, the procedure, and any risks. Clinical photos will be taken, and a second consultation will be arranged to answer further questions. It’s important to stop smoking at least six weeks before surgery to reduce risks. You may need blood tests and other health checks, and will receive personalised instructions to prepare you for surgery.
Surgery is usually done under general anaesthetic (you’ll be asleep) in an accredited hospital.
There are different types of surgery depending on the type of tissue you have in your chest area.
- If you have fatty tissue in the chest: Sometimes this can be treated with liposuction, which removes fat through a small tube using very small cuts.
- If you have glandular (firm) tissue: This may need to be surgically removed. This may leave a small scar around the areola (the darker skin around the nipple).
- Some men need both liposuction and gland removal.
- If there’s a lot of tissue or skin, a bigger operation with longer scars may be needed.
- Scars vary by person (genetic factors) and area of the body. Most fade over time but won’t disappear completely.
- Liposuction scars are small and usually not obvious after 6–12 months. If you are undergoing liposuction only, the scars are usually not noticeable in the long term.
- Scars from excision surgery are more visible around the nipple area.
- Large operations can leave longer, permanent scars.
- Rarely, scars can become thick, raised, or itchy (especially in younger or darker-skinned patients).
- Dr Law will take care to hide and minimise scars where possible whilst still helping you achieve your desired outcome.
After gynaecomastia surgery, your chest will be taped and you’ll wear a compression garment for about four weeks. Stitches usually dissolve on their own. Bruising and swelling are normal, and final results take time. Avoid heavy activity for at least four weeks, with most people returning to normal routines by six weeks.

Risks & complications

All surgery carries risks and may include:
- Drug reactions.
- Allergic reactions.
- Infection.
- Bleeding and haematoma (blood clot).
- Seroma (fluid collection).
Risks specific to gynaecomastia surgery will be discussed with you during your consultation and will also be provided in your consent paperwork. These include:
- Nipple numbness.
- Nipple compromise and healing problems.
- Chest asymmetry.
Choosing a specialist surgeon with proper anaesthetic support helps minimise these risks.