Gynaecomastia commonly known as ‘man boobs’ or ‘moobs’ is an extremely common cause of embarrassment to men which can be treated easily and discreetly.

Breast development in men is commonly considered to be a sign of femininity but this only the case in a minority of patients who suffer from hormonal problems or those that are taking oestrogen to treat cancers, or steroids in some cases.

Most teenagers have some breast development at puberty, which 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 reman 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 hormonescan cause excess tissue growth in the breasts.



Many obese men also have an excess of oestrogen in their bodies due to being overweight, so a combination of excess fat and excess oestrogen can cause the breast tissue to enlarge. Losing weight may help in some cases, however the breast tissue may not improve through this alone.

Liposuction is the main form of treatment for enlarged breasts in males and for treatment of the condition ‘Puffy Nipple’. At the Cadogan Clinic we have developed and trialled various liposuction techniques for over 35 years. We use techniques which are particularly effective at removing not only fat but also the fibrous breast tissue that causes the breast to become enlarged.

Our preferred techniques are water assisted liposuction (we use BodyJet), and power assisted liposuction (PAL), using both Lipomatic and Microaire. We avoid ultrasound techniques such as Vaser, as it is less effective and has more complications.

Discreet entry points for the laser helps to avoid unnecessary scars, and the skin will normally retract and tighten to create a nice chest form. However, in older patients if the breasts are particularly large and the nipples are low on the chest wall, the skin will not retract, and the chest will still sag. In those cases, a small minority of patients may require a skin lift at a later stage to achieve their desired over-all look.

In patients with predominantly glandular as opposed to fatty breast tissue, there may be a need of a 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. Cadogan’s post-operative scar treatments will be used to produce the very best results. 

During your initial consultation with our highly skilled surgeons you will be able to express your concerns and we will go over the different options available to you for treatment. Some of our surgeons offer Crisalix Imaging, which is an advanced virtual imaging software that enables you to see a before and after of your results in real time at the consultation.

No matter your personal reasons for treatment, Cadogan Clinic offers the access to leading UK surgeons, techniques and state-of-the-art facilities for your treatment.

Frequently Asked Questions

Gynaecomastia is a condition in which there is increased tissue in the male breast to create a less masculine shape. It is a bodily reaction to an imbalance of circulating hormones and can become a source of great aesthetic concern amongst suffers. Gynaecomastia first appears at puberty and can affect one or both breasts, often unevenly. It tends to become more prominent with weight gain and age. Gynaecomastia has colloquially become known as male breasts, or ‘moobs’.

 

Gynaecomastia may occur unilaterally or bilaterally presenting the sufferer with swollen breast tissue and often tenderness. There may be an increase in the diameter of the areola or asymmetry of breast tissue. If a swelling appears suddenly in adult life, one should suspect breast cancer or malfunction of the testicles.

 Anti-oestrogen medication also be effective in some patients, but there are no other surgical alternatives.

Patients who meet their surgeon have usually failed to have regression of their problems spontaneously or with drugs. The surgeon will ascertain whether there are particular causes such as loss of testicles or ingestion of steroids. Bodybuilders beware! The majority of patients are likely to be offered surgery presuming there are no other medical problems.

The preferred treatment for Gynaecomastia is to use Liposuction to remove this stubborn fatty, glandular tissue. We most commonly use Water Assisted Liposuction (BodyJet) or Power Assisted Liposuction using MicroAire or Lipomatic. We have found other techniques such as Ultrasound (VASER) or Laser Assisted less effective. In younger people, or where the tissue is fibrous, it may be necessary to carry out Webster’s procedure, either on its own or in combination with liposuction. This is a direct excision of breast disc through a discrete peri-areolar incision. The skin itself is allowed to retract so that the operation is essentially scarless.

Infrequently, there are however, patients with very large breasts where there is too much surplus skin and at a second stage, a reduction of skin with repositioning of the nipple is required.

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.

Breast Reduction (Gynaecomastia) Results

Click here to view our gallery of before and after and Breast Reduction (Gynaecomastia)

What to expect

Free Consultation with a Patient Advisor

We offer a free, no-obligation 30-60 minute consultation with one of our Patient Advisors. They will work with you to understand your objectives and the results you want to achieve, talk you through the procedure and answer any questions you may have. If you decide that you would like to proceed to the next step and see a surgeon, your Patient Advisor will be happy to arrange this for you. At this point, you will be required to pay a consultation fee. 

Surgical Consultation

The next step is for you to meet your chosen surgeon at the Cadogan Clinic. Your surgeon will use this time to make a comprehensive medical assessment of you, your condition, and your expectations before making a recommendation and personalised treatment plan for you. You will then discuss the outcomes you can expect to see and ask any questions.

The Procedure

On the day of your procedure you will be welcomed at the Cadogan Clinic by your Patient Advisor and dedicated nursing staff. Following a brief medical check, you will meet with both your surgeon and anaesthetist to run through the details of your procedure one final time and answer any last questions you may have.

Recovery

After the procedure, you will recover in the capable hands of our aftercare team. As we are a day-case facility you can expect your recovery to be complete within 2 to 3 hours. If your surgeon is happy with your results, you will be able to be discharged from the Clinic the very same day. In some cases patients may wish to stay locally in our exclusive partner hotel the day before or after your procedure in order to be close to their surgeon. Talk to us about these options if this is for you. 

After Care & Support

Our care and support continues in the days and weeks following your procedure with our complimentary aftercare programme. This comprised of a series of appointments made with your surgeon and nursing team to monitor your progress and recovery. They will also introduce you to several scar minimization techniques and bespoke products to aid your progress. Our team are also on call to answer any questions you have around your surgery at any time you are concerned.

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