Surgery For Men

Gynaecomastia Surgery

at Cadogan Clinic, London’s Leading Cosmetic Surgery Specialists. 

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Medically Reviewed April 2023, by Mr. Bryan Mayou (GMC: 1414396) - founder of the Cadogan Clinic and one of the world's leading plastic surgeons

What is Male Breast Reduction (Gynaecomastia)?

Male breast reduction surgery is a liposuction technique designed to combat excessive breast development in the male chest area, otherwise known colloquially as 'man boobs'.

This is an extremely common cause of embarrassment to men and can be treated easily and discreetly via this effective procedure. This is one of the most common cosmetic procedures for men.

The overall effect is to deliver a more sculpted, aesthetically pleasing breast and chest area, firmer to the touch and with tightened, smooth overlying skin.

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Excessive breast development, or gynaecomastia, in males can be caused by:

  • A natural hormone imbalance, e.g. oestrogen / testosterone
  • Weight gain or obesity
  • Medical condition, e.g. testicular disease, cirrhosis
  • Steroid use 

Male Breast Reduction At a glance

Surgery Time

Up to 1 hour

Time off work

1 week

Hospital Stay

Day Case

Shower

After 1 week

Reasonable Mobility

1 day

Exercise

4 weeks

Sexual Activity

After 4 weeks

Sleeping on back

1 week

Full Recovery

6 weeks

Driving

1 week


Why do people have it?

In the majority of cases excessive breast development is caused by excessive fat deposit levels, but on occasion, it can be caused either by hormonal problems or as a side effect by those taking oestrogen to treat cancers or steroids in some cases.

This can develop among teenagers as most have some breast development at puberty, and is often uncomfortable and can cause them to become very self-conscious and lose some of their body confidence. For most young men, it regresses naturally over a few years as they grow out of puberty. However, there are many cases where it does not regress, and the enlarged breasts will remain. Other times, only the nipple may remain enlarged, this is commonly known as 'Puffy Nipple'.
 
This condition is also very common with older men. As their bodies begin to change, they produce less testosterone, while at the same time many older men tend to have more body fat which causes the body to begin producing more oestrogen. All these changes in the hormones can cause excess tissue growth in the breasts. Losing weight may help in some cases, however, the breast tissue may not improve through this alone.

Who is suitable?

Cadogan Clinic considers individuals fit for the procedure, if all of the following are true of them:

  • You are in good psychological and physical medical health
  • You are at your ideal body weight
  • You have a positive outlook and realistic expectations of what can be achieved via surgery
  • You are seeking to remove excess fat deposits in your chest
  • You are seeking to remove excess skin in your chest
  • You are seeking to tighten the skin in your chest area
  • You are seeking to improve the shape and contours of your chest
  • You are seeking to restore symmetry to your chest area
  • You are looking for long lasting results 

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The cost of a Male Breast Reduction (Gynaecomastia)

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How does a male breast reduction procedure work?

Liposuction is the main form of treatment for enlarged breast tissue in males. As leaders in the field of liposuction at the Cadogan Clinic, we have developed and trialled various liposuction techniques for over 35 years.

We now use techniques that not only reduce fat but also the fibrous breast tissue that causes the breast to become enlarged.

  • Traditional Liposuction to remove excess fat and contour the shape of the chest via the traditional technique 
  • BodyJet Liposuction – an alternative water-assisted liposuction that is gentler and minimises bruising and swelling post-surgery. This is our preferred technique (we use, and power-assisted liposuction (PAL), using both Lipomatic and Microaire) as the discreet entry points required for the laser avoid unnecessary scars, and the skin will normally retract and tighten to create a nice chest form among younger patients with elastic skin
    We avoid ultrasound techniques such as Vaser, as it is less effective and has more complications.

In patients with predominantly glandular as opposed to fatty breast tissue, there may be a need for direct removal of the breast disc, which would be done in combination with liposuction. This specific surgery is called Webster's Procedure. We make the incision around the edge of the areola, and it is very discreet.

Male breast reduction typically takes around 1 - 2 hours to complete and is usually performed under general anaesthetic. Cadogan Clinic's post-operative scar programme will be relied to produce the very best scarring results.

What are the benefits of Gynaecomastia surgery?

There are numerous benefits of male breast reduction surgery, both physical and psychological. Gynaecomastia surgery can have the following benefits:

Firmer, leaner upper chest area: Men with gynaecomastia can feel that the condition compromises their masculinity, particularly when they are often compared to the female form.

By removing the excess fat, the male chest is left looking leaner and firmer, as gyanecomastia surgery eliminates the ‘wobbly’ appearance associated with the condition. Male breast reduction surgery leaves the patient with a more defined and ‘masculine-looking’ chest.

Ability to wear tighter cut clothes/t-shirts: Depending on the amount of fat and/or tissue removed, male breast reduction surgery can help a patient to comfortably fit into a smaller clothing size. Men who wore baggy clothing in order to hide their chests often find themselves swapping this shapeless clothing for something tighter-fitting which proudly shows off their new firmer, leaner chest.

Makes physical activity easier: Carrying any extra weight around can have a huge impact on physical activity. Running, jogging, jumping and any other vigorous form of exercise can feel uncomfortable or even painful when you have gynaecomastia. Women can experience similar discomfort and pain if they exercise without a sports bra, or in a sports bra that does not provide adequate support. Men, of course, do not have this option, but gynaecomastia surgery can effectively remove this problem.

Reduces back pain: Carrying excess weight in the chest area can have a negative impact on posture and this often leads to back pain. This is a common complaint in men suffering with gynaecomastia. They may also walk hunched over in a bid to hide their chests, which can lead to a humped back and can be a further cause of back pain in gynaecomastia patients. If left unchecked, back pain caused by bad posture may require medication or further medical treatment, which can be costly and time-consuming.

Male breast reduction surgery will allow you to walk tall and remove this additional health issue.

Improved sense of emotional wellbeing: Men who have gynaecomastia can find that the condition has a negative impact on their self-esteem. They may find themselves embarrassed or ashamed of their chest, taking steps to draw attention away from the area. For example, a man with gynaecomastia may avoid going to the swimming pool, sunbathing on the beach or using communal changing areas. In short, anywhere where he may have to remove his top. The condition may even affect his ability to form or maintain intimate romantic relationships. All these things can greatly affect a person’s quality of life.

Male breast reduction surgery can help to restore confidence and self-esteem, which in turn will have a positive impact on all areas of a person’s life, including socially, romantically and in the workplace. 

In conclusion, gynaecomastia surgery can have a huge impact on all areas of life, from taking away the discomfort of exercise, reducing the likelihood of back pain and giving you back the confidence you need to live your best life.


Gynaecomastia Surgeons

We have invited a selection of the country's very best consultants to join us at the Cadogan Clinic so that you can be sure that whatever the nature of your treatment, you will be seeing one of the top practitioners in the country.


What to expect

Below you will find some key information to help you prepare for surgery and make necessary arrangements to ensure you have the support you need and that everything runs smoothly on the day.

The first step for all of our Male Breast Reduction patients is to meet with the surgeon we feel is best placed to perform your procedure for a consultation. At the consultation you will be able to discuss with your surgeon what your hope to achieve from the procedure, as well as discuss in detail what may or may not be possible given your existing anatomy.

Your surgeon will take you through the options available to you, and which is the most preferential for you given your stated ambitions. Having established this, several key measurements will be made and standard clinical photography will be taken.

Some questions you may want to ask your surgeon include:

  • Am I a good candidate for this procedure?
  • Can I achieve the results I am asking for?
  • What will be expected of me to get the best results?
  • Do you have before-and-after photos?
  • How long of a recovery period can I expect, and what kind of help will I need during my recovery?
  • What scars will I be left with?
  • Will I be in pain after the surgery?
  • How soon after Male Breast Reduction can I return to work?

Finally a comprehensive discussion regarding risks and complications will take place, alongside a discussion regarding what to expect in the post procedure and recovery phase. Your previous medical history will also be recorded (including previous surgery, medications, allergies etc.) and an assessment of your fitness for surgery.

If your surgeon feels you are a good candidate for surgery, you are then invited to consider whether you would like to proceed for surgery or otherwise following a two week 'cooling off' period.

Within this period you are welcome to come in and discuss your potential surgery with your surgeon as many times as you like.

If you choose to proceed with surgery, the next time you come into the Clinic after your final consultation will be the day of your procedure. Before admission the following behavioural changes are recommended / required:

  • In the 6 weeks before your procedure we recommend smoking is discontinued as patients who smoke have a higher risk of healing more slowly and complications (see FAQs)
  • In the week before your procedure you must cease taking Aspirin or any medication that contains Aspirin
  • In the 6 hours prior to surgery you must not consume food or any drink, other than small sips of clear fluid (e.g. still water, black coffee, black tea) which are allowed up to 2 hours before admission

On the day of your procedure we ask that you arrive for your admission an hour before the agreed start time of surgery. At this point a nurse will come and record blood pressure and other relevant vitals, you will meet with your anaesthetist and your surgeon who will make the final mark-ups.

In cases where gynecomastia is primarily the result of excess fatty tissue, liposuction techniques alone will be used. A cannula, a thin hollow tube, is inserted through several small incisions and moved back and forth in a controlled motion to loosen the excess fat, which is then removed from the body by vacuum suction. An excision technique may also be used if gynaecomastia is primarily the result of excess glandular breast tissue.

The surgery should take between one and two hours.

You should not feel much pain during the procedure, but you may have some for a few days or weeks afterwards. You'll be given painkillers if you need them.

Following the procedure, you will recover in our ambulatory recovery rooms for between two to three hours, dependent on the scale of the procedure. Once our specialist nursing team are happy that your initial recovery is complete and you are safe to return home, you will be allowed to leave the Clinic accompanied by a friend or member of your family.

Once home you will have access to our dedicated on-call nursing team 24 hours a day, 7 days a week. This team of specialists are dedicated to your comfort and pain control, and are there to field any questions you may have in the immediate post operative phase.

We ask that you come in and see our nursing team 1 week after surgery to ensure your incision sites have been properly reviewed. At this juncture we also recommend you meet with one of our on site aestheticians to discuss ongoing treatment to support the healing and scarring process.

We ask that you come in to see your surgeon after 6 - 8 weeks for a final check up.

The Patient Journey. A breakdown of what you can expect on your journey with us

We are deeply invested in ensuring that every step of your surgical journey with us is as informative and reassuring to you as it can be. This article outlines what you can expect at each stage of the journey

The Patient Journey

Frequently Asked Questions

Gynaecomastia is swelling of the breast tissue in boys and men, caused by an imbalance of the hormones oestrogen and testosterone. Gynaecomastia can affect one or both breasts, sometimes unevenly.

Baby boys are often born with gynaecomastia, caused by high levels of their mother's circulating oestrogen, but it settles in weeks.

The next peak is in teenagers (1in 4) when it is tender and firm and very embarrassing. Fortunately, it usually settles within a couple of years. A minority come to surgery where the tissue is excised via a semi circular incision around the areola (the pink skin around the nipple)

In adult life, there are a variety of causes from medical conditions such as testicular disease and cirrhosis, various medications and street drugs. Bodybuilders taking anabolic steroids are at great risk of developing gynaecomastia.

Middle-aged men (1 in 3), as they put on weight, develop a soft fatty version. This can be of feminine proportions.

These fatty breasts respond well to liposuction. The breast disc below the nipple tends to contain a higher proportion of glandular tissue and may need to be directly excised.

Male Breast Reduction surgery is a surgical procedure designed to remove a surplus of fat deposits in the male breast region, and restore a proportionate contour and firmer, more masculine chest.

The choice of procedure depends on the exact condition but will primarily involve liposuction and tissue excision techniques.

The procedure is carried out as a day case procedure under General Anaesthesia, and takes between 1 - 2 hours.

There is typically bruising for up to 3 weeks with end results visible at about 3 months. Scars are usually insignificant and managed by our Scar Management programme.

The primary symptom of gynaecomastia is simply enlargement of the male breasts. Gynaecomastia is the enlargement of glandular tissue rather than fatty tissue.

It is typically symmetrical in location with regard to the nipple, however, the enlargement may be greater on one side even if both sides are involved.

Tenderness and sensitivity may be present, although there is typically no severe pain. The areola may have a rubbery or firm feel.

One of our highly trained, elite plastic surgeons will perform your Male Breast Reduction.

All our Male Breast Reduction surgeons are liposuction specialists have been hand picked by Mr Bryan Mayou, our founder, and the pioneer of liposuction in the UK.

Your consultation is designed to be perfect opportunity to ask all the pressing questions that you have to your consultant, ahead of making a decision on surgery. It is vital that you are fully informed before making your final decision, and the consultation is therefore a key part of the education and decision making process.

Some good examples of questions to ask, include:

  • Am I a good candidate for this procedure?
  • Do you think my goals are realistic given my existing anatomy?
  • Will I require a single surgery or multiple surgeries?
  • Can I see some before & after pictures of Male Breast Reductionprocedures you have done previously?
  • How long will my recovery take?
  • Is it true that Cadogan offers 24/7 on call nursing service?
  • What can I expect in terms of bruising, swelling and scarring?
  • What are my options if I am unhappy with my results?

No special preparation is required although it is generally advisable to do the following before any surgery

  • Stop smoking. Smoking decreases blood flow in the skin and can slow the healing process. If you smoke, your doctor will recommend that you stop smoking before surgery and during recovery.
  • Avoid certain medications and blood thinners. You'll likely need to avoid taking aspirin, anti-inflammatory drugs and herbal supplements, which can increase bleeding.
  • Arrange for help during recovery. Make plans for someone to drive you home after you leave the hospital and stay with you for at least the first night of your recovery at home.

Male Breast Reduction surgery should take between one and two hours.

You should start to see results in the days following surgery. These will fully start to appear from around the six week mark and improvements will be ongoing for the first 12 or so months.

Your results will be long lasting so long as you maintain your body weight following surgery.

Recurrence can happen, but occurs only when a hormonal imbalance persists beyond surgery. The recurrence levels are also typically materially less than the pre-surgery levels.

Your results will be long lasting so long as you maintain your body weight following surgery.

Recurrence can happen, but occurs only when a hormonal imbalance persists beyond surgery. The recurrence levels are also typically materially less than the pre-surgery levels.

You will not feel any pain during the procedure as you will be under the influence of anaesthetic.

Immediately following surgery, you may experience discomfort but any pain should be tolerable. Your surgeon can provide painkillers for this and the majority of patients no longer need them a few days after breast surgery.

Male Breast Reduction surgery is straightforward, safe surgery although you should be aware of all the risks and complications before going ahead with surgery. Your surgeon at your will go through these at length and in full at your consultation, but the main risks include

  • Scars - It is perfectly possible for the expert surgeon to hide his scars. There should be no liposuction scars acting as a giveaway on the front of the chest and even when in the Webster's operation it is necessary to carry out a direct excision of tissue. This scar is well disguised around the edge of the areolar. There should be no scars on the chest itself. Some patients make poor scars and Cadogan post-operative scar treatment is important.
  • Bleeding – bleeding is a risk of a peri-areolar subcutaneous mastectomy (Webster's operation) but is reduced by including liposuction with the procedure. Occasionally patients will bleed postoperatively and will require an early return to the operating theatre. Your surgeon will discuss any medicines which increase your risk of bleeding and it is important to control high blood pressure
  • Recurrence – any hormone imbalance may persist following surgery, so that any remaining breast tissue can also increase in size. The problem would never be as great if a reduction had not been done, but some recurrence is possible.
  • Swelling, bruising and pain - The bruising after liposuction of the breasts is often greater than in other areas and will persist for longer. Patience is necessary.
  • Seroma – This is a problem only associated with Ultrasound (Vaser) Liposuction, which we avoid.
    Increased and reduced sensation after surgery – most patients will get some alteration in the sensation of their breasts, most commonly numbness around the nipple, but in most cases this is temporary.
  • Asymmetry – it is sometimes easier to remove tissue from one breast more than the other, in which case there may be some asymmetry, when all has settled down. Lumpiness of the breast is with irregularity of removal of tissue is a complication of surgical excision (Webster's or other subcutaneous mastectomy) or Vaser liposuction. This is common when there is an inexperienced surgeon, but minor degrees can occur with a good technique.
  • Unsatisfactory results – Sometimes patients are not satisfied with the result of their gynaecomastia because there expectations and requirements are not in line with technical possibilities. It is important to have a careful discussion with your surgeon to avoid disappointment.

Recovery time for this procedure will depend on the individual patient but is fairly minimal.

We usually advise that you take around a week off work following surgery as there will be bruising and swelling which may take a few days to subside. We also recommend you do not resume strenuous exercise for 4 weeks.

You will feel a little bruised and stiff for a few days but there is no restriction on movement. Any dressings can be removed in a couple of days or when they come loose, and stitches removed in a week. In the weeks after surgery, smoother skin will emerge on the chest and scars will start to heal.

Our expertise in scarring techniques along with our highly-experienced surgeons ensure a great result.

Yоu may соntіnuе tо experience ѕоmе mіld, реrіоdіс dіѕсоmfоrt and ѕwеllіng durіng your recovery, but ѕuсh fееlіngѕ аrе nоrmаl. Effective pain relief can be provided by your aftercare team should you required it. Sеvеrе pain, bleeding or swelling should bе reported tо your surgeon.

You will receive more detailed advice from your surgeon ahead of surgery.

You should expect minimal gynaecomastia surgery scars after male chest reduction surgery.

This is because male chest reduction surgery requires a very small incision that results in a very small gynaecomastia surgery scar. You should expect the gynaecomastia surgery scar to be red and slightly raised in the weeks and months after your procedure, before fading completely.

Skilled surgeons are also able to minimize gynaecomastia surgery scars and place them expertly in locations where they are not visible to the eye. Gynaecomastia surgery scar visibility can be further reduced by proper aftercare management and by regular moisturisation and massage techniques, all of which our dedicated team will advise our patients in the days following your procedure.

Please review our Scar Management programme for an idea of the options available to you at Cadogan Clinic.

Surgery is undoubtedly the most effective treatment but does need to be done by an experienced surgeon. We have in the past seen very poor results.

There will be some who wish to avoid surgery at all costs and they might consider the following.

Exercise and diet

  • The first place to start by changing your exercise and diet. It's completely free and might help reverse the body's metabolism. Since gynaecomastia is a least partially due to the build up of fatty tissue in the breast area, it only makes sense that you would want to minimize the amount of fat in your diet
  • When the body is unable to convert fat into energy, it must store it. That leads to fatty deposits and more fatty tissue. Thus, you may want to start thinking about methods to scale back your daily caloric intake or, at the very least, changing what and even how you eat on a daily basis.
  • Remember however you are only reducing the fatty element and not the more important glandular tissue
    In terms of exercise, there are several ways to target the chest area that can help to tighten up the muscle in the area. As the muscle mass becomes more defined, it helps to reduce some of the "flabby" look of the chest area.
  • This extra muscle does accentuate the breasts by pushing them outwards. This is a problem for weightlifters even if they are not taking anabolic steroids.

Medications

  • If you suspect that your gynaecomastia is due to medical reasons rather than a hormonal imbalance, you can ask your doctor to experiment with different medications. Some men, for example, have experimented with getting testosterone replacement.
  • Other popular medications to try include anti-oestrogens, Danazol, Tamoxifen and Clomiphene.
  • These are all prescription medications and are not approved by the FDA.

Herbal creams

  • We do not know of any reputable studies to show that topical herbal creams help with this condition
  • There are several herbal creams on the market such as Gynexin

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What are the risks?

Male Breast Reduction surgery is a safe procedure, but it is common to experience:

  • bruising and swelling
  • temporary numbness
  • a small amount of scarring 

As with all surgical procedures, Male Breast Reduction surgery carries some risk and it is possible that you might experience:

  • Nausea
  • Bleeding or Infection
  • Poor healing of incisions and scarring
  • Seroma
  • a collection of blood underneath the skin (haematoma)
  • death of fat tissue (fat necrosis) or embolism

Your surgeon will discuss these risks comprehensively at your consultation and explain how likely these risks and complications are, and how they would be treated.




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