A procedure in which excess breast gland and fat tissue is surgically removed in cases of male breast enlargement (gynecomastia) when hormonal causes have been excluded and conservative treatment has not been effective.
Indication
- Gynecomastia in which no underlying treatable disease is identified after hormonal evaluation
- Persistent breast enlargement lasting at least 12 months without regression
- True breast gland enlargement causing physical discomfort, pain or tenderness
- Persistent excess breast tissue that does not regress after weight loss
- Cases at older age, or causing functional discomfort once hormonal causes have been excluded
Preparation
- Endocrine evaluation: testosterone, estrogen, LH, FSH, prolactin and thyroid hormones
- Liver and kidney function tests
- Breast ultrasound (and mammography when needed) to evaluate the structure of the breast tissue
- Review of current medications (medications that cause gynecomastia are stopped)
- Smoking should be discontinued 2-4 weeks before the procedure
How it's performed
- Performed under general or regional anesthesia
- In fat-predominant cases, subcutaneous fat is removed with liposuction
- In gland-predominant cases, the gland is removed through a small incision around the areola
- In mixed type, both liposuction and gland excision are performed together
- In advanced cases, excess skin is removed and the tissue is reshaped
- Drains are placed and a compression garment is applied
Post-procedure
- Same-day discharge or 1 night hospital stay
- A compression garment is worn for 4-6 weeks
- Heavy lifting and sports activities are avoided for the first 1-2 weeks
- Light exercise can be started after 4 weeks
- Follow-up at 1-2 weeks for dressing and suture check
Risks
- Infection, bleeding, hematoma, seroma
- Sensory changes around the nipple
- Asymmetry, subcutaneous irregularity or contour deformity
- Scar formation (especially in keloid-prone individuals)
- Recurrence and possible need for revision due to insufficient tissue removal
FAQ
Does every case of male breast enlargement require surgery?
No. Hormonal causes and medication use are investigated first. If a treatable cause is found, that treatment is applied before considering surgery.
Can it recur after the procedure?
Recurrence is uncommon once hormonal balance is established. Significant weight gain or certain medications can lead to recurrence.
Are scars noticeable?
Small scars hidden along the areolar border that fade over time generally remain. Liposuction scars are very small.
When can I return to work?
Return to office work is generally appropriate after 5-7 days, while return to physically demanding work is appropriate after 4-6 weeks.
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