It´s more common for people to see a flat chest as a masculine chest. So, it can be extremely embarrassing for men to have an over development of breast tissue, causing a breast-like appearance. According to some reports, around 30% of men will be affected at some point in their lives and roughly 1 in 4 men over 50 will have some degree of enlarged breasts.

Enlarged male breasts, a condition known as gynecomastia, is the development of fat and hardened tissue under the areola portion of the breast. This is typically due to an imbalance of testosterone and estrogen levels but there can be many causes including;

  • The use of alcohol or steroids
  • Antibiotics
  • Certain antidepressants
  • Chemotherapy
  • Over active thyroid
  • The aging process

Men typically develop gynecomastia during one of three periods in their lives.

1. As an infant which normally resolves by itself after 2-3 weeks.

2. During puberty, mainly due to hormone fluctuations and can last anywhere between 6 months and a couple of years.

3. Lastly, 1 in 4 men between 50 and mid-60s will develop some degree of gynecomastia.

The condition can be a particularly embarrassing one and many men will avoid activities involving being shirtless as the condition can impact their confidence. Gynecomastia is easily treatable and typically has no side effects.

The state of gynecomastia is categorised in a grading system, divided into four different gynecomastia stages.

1. Pseudo-gynecomastia: The first stage often occurs in younger patients. Yet one can develop it at all ages.

2. Glandular gynecomastia: This form of gynecomastia tends to be more common in lean men who exercise frequently, for example bodybuilders. As the percentage of fat is so low in this case, breast formation is caused by glandular tissue. (Liposuction is not used for this procedure.)

3. Mixed gynecomastia: Men with mixed gynecomastia have both breast growth and excess skin. Liposuction is used for this procedure.

4. Massive weight loss reduction: Obesity is a common and growing problem. When losing weight in order to achieve a stable bodyweight there can be considerable skin left, which can be surgically removed.


What are the surgical techniques?

Gynecomastia treatment is typically treated with two different kinds of surgery.


Excision techniques are usually recommended when glandular breast tissue and/or excess skin must be removed. This method is also used if the nipple needs to be reduced or repositioned to create a more masculine contour. This can be completed under sedation or general aesthetic and the surgeon will discuss the options with you during the consultation.


Liposuction gives the possibility to remove (localised) fat deposits. These fat deposits are often resistant to a diet and exercise. Local anesthesia is often used for this procedure, but in some cases, it is possible to undergo the procedure under complete anesthesia. The surgeon will make small incisions and remove the fat, suturing the area/s after.


Results and recovery

After the procedure you will be provided with compression clothing to minimise the swelling and to support the breast contour as you heal. It is important that you give yourself time to heal, avoid exercise and take a few days off work. Your surgeon will prescribe you medication to prevent infection and manage any pain. In most cases you can return to work within a week if you are healing well.

The results after the operation will be immediately visible. With the days the swelling will naturally decrease and the result will become even more visible.


For more information or to find out if you are a suitable candidate for surgery, book an appointment with Dr Pietro di Mauro now