Before and After Photos of Gynaecomastia surgery

​Gynaecomastia

Mo Salhab MD, MRCS, MS, PG Dip, FRCS

Oncoplastic, Reconstructive & Aesthetic Breast Surgeon 

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​​​​Gynaecomastia (sometimes referred to as 'man boobs') is a common condition that causes boys’ and men breasts to swell and become larger than normal. It is most common in teenage boys and older men. it is essential that older men with one sided breast lump seek medical advice, this is to exclude rare possibility of breast cancer in men. To learn more about male breast cancer  click here


What are the signs of gynaecomastia?


Signs vary from a small amount of extra tissue around the nipples to more prominent breasts. It can affect one or both breasts.  Sometimes, the breast tissue can be tender or painful, but this isn’t always the case. 


What causes gynaecomastia?


Gynaecomastia can have several causes. 


  • Hormone imbalance: Gynaecomastia can be caused by an imbalance between the sex hormones testosterone and oestrogen. Oestrogen causes breast tissue to grow. While all men produce some oestrogen, they usually have much higher levels of testosterone, which stops the oestrogen from causing breast tissue to grow.  If the balance of hormones in his body changes, this can cause a man’s breasts to grow. Sometimes, the cause of this imbalance is unknown. The growth in breast tissue is not due to extra body fat from being overweight, so losing weight or doing more exercise will not improve the condition.


  • Newborn baby boys: Gynaecomastia can affect newborn baby boys because oestrogen passes from the mother to the baby. This is temporary and will disappear a few weeks after the baby is born.


  • Puberty: During puberty, boys’ hormone levels vary. If the level of testosterone drops, oestrogen can cause breast tissue to grow. Many teenage boys have some degree of breast enlargement. Gynaecomastia at puberty usually clears up as boys get older and their hormone levels become more stable. 


  • Older age: As men get older, they produce less testosterone. Also, older men tend to have more body fat, and this can cause more oestrogen to be produced. These changes in hormone levels can lead to excess breast tissue growth. 


  • Other causes: Gynaecomastia can also be caused by: 


  1. Side effects of medication, such as anti-ulcer drugs or medication for hypertension, heart disease, hormonal treatment for prostate cancer, some antibiotics and anti-retroviral therapy for HIV disease
  2. Illegal drugs, such as cannabis, heroin or anabolic steroids
  3. Drinking too much alcohol
  4. A health abnormality, such as kidney failure or liver disease
  5. Overactive thyroid
  6. Klinefelter’s syndrome, a rare genetic disorder
  7. Lumps or infection in the testicles 


Does Gynaecomastia increase risk of Breast Cancer?


No, Gynaecomastia is a benign condition and it does not increase your risk of developing breast cancer. However, it’s still important to be breast aware and go back to your GP if you notice any other changes regardless of how soon these occur after your diagnosis of gynaecomastia.


What happens in Breast Clinic?


when you come to the breast clinic with a breast lump, Mr Salhab will ask you questions about your problem, duration, associated symptoms, medication and lifestyle, social history and your desires. You will have a full breast clinical examination. Other tests such as Ultrasound scan and needle biopsy  maybe requires to confirm the diagnosis of gynaecomastia. Mr Salhab may request a blood test to establish the cause of Gynaecomastia in case no clear cause was identified during the clinic visit.


Treatment for Gynaecomastia


There are different options to treat Gynaecomastia. Mr Salhab will discuss with you the pros and cons of the following treatment options:


  • Medical Treatment:


There are many medications that can be considered for the treatment of gynaecomastia. Each medication can cause potential side effects. Therefore it is very important that such side effects are discussed prior to starting the treatment

Tamoxifen  has been shown to reduce breast volume in gynecomastia, it is most often used for severe or painful gynecomastia. 

Danazol is a synthetic derivative of testosterone that decreases estrogen synthesis by the testes. It works by inhibition of pituitary gland that direct the sex organs to produce hormones.
It is less commonly used to treat gynecomastia than other medications due to side effects.

Aromatase inhibitors: has also been used to treat gynaecomstia.



  • Surgical Treatment


Surgical treatment depends on the size of gynaecomastia. The aim of surgery is to remove excess fat and glandular tissue and occasionally excess skin.

The technique chosen for you will be determined by your anatomy, size of breasts and your desired result. Options include removal of  fatty tissue by liposuction of chest wall , removal of the tissue under the breast through a small incision at the edge of the areola,  or combination of both techniques . For those men with enlarged breasts with redundant skin, removal of excess skin maybe required, this may lead to more scarring on the chest wall.

The operation is performed under general anaesthetic, which means you will be asleep during the procedure. It is usually performed as a day case, though sometimes you may need to stay in hospital for one or two nights after your operation. You will also need to plan time off work so that you can recover at home.

As with any cosmetic procedure, it is important that you review your expectations thoroughly before you decide to proceed. Mr Salhab will explain the results you can expect after gynaecomastia surgery, and will discuss the associated risks and alternatives to the procedure before going ahead.


  • How much does gynaecomastia surgery cost?


The  package price for the  majority of Gynaecomastia surgery at the Yorkshire Clinic is £3826.  ( This package price covers the surgeon, the anaesthetist and hospital costs with one follow up appointment)  Some cases may cost more depending on the size of gynaecomastia and operation involved.


  • Who is a Good Candidate for Gynaecomastia surgery?


Candidates must be in good health, non smokers, have no active diseases or serious, pre-existing medical conditions, and must have realistic expectations of the outcome of the surgery. They should have normal stable weight.  Good candidates for surgery have firm, elastic skin that will adapt to the new contours of the body.


  • What can I expect after surgery and the recovery period?


Following the procedure, you may have drains in place, drains are usually removed next day. You will be able to eat, drink and mobilize early. You will feel swollen and have chest wall discomfort that will usually require analgesia. You will have dissolvable stitches and waterproof dressing which you ll have on for one week.  You will be reviewed in clinic and the wounds checked at a week.  Excessive straining in the first couple of weeks should be avoided and you should continue to wear a support garment for 4-6 weeks after surgery. Light exercises can be started  after a week and normal exercise after 2 weeks. At week 6-8  after surgery you will be reviewed to assess your final result. you are advised to massage the scars as soon as they are healed.


  • Gynaecomastia surgery risks and complications


The Procedure is largely safe and majority of patients are delighted with the results. However, certain complication may occur, recognised complications include numbness, bruising, swelling infection, seroma and haematoma formation ( blood collection) , skin necrosis, delayed wound healing and thickened scar. Although excess breast tissue is removed in surgery, some tissue will be left in place and recurrence of gynaecomastia may occur  in some patients.