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.

You may be suitable for a Male Breast Reduction if you have:

• Excess fat deposits in your chest
• Excess glandular breast tissue in your chest
• Asymmetrical chest
• 'Puffy' nipple
• Disproportionate chest size relative to rest of figure

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 here 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