Gynaecomastia: what are we talking about?
Gynaecomastia refers to breast enlargement in men. It may be due to excess breast gland, excess fat, or most often both at once. It can affect one side or both.
It is common in adolescence and often disappears on its own. When it persists into adulthood, it can become a real nuisance in daily life: choice of clothes, sport, the beach, how others look at you. Many men do not dare to talk about it, yet it is a very common reason for a consultation.
This article follows the journey in order: looking for a cause, the decision, preparation, the procedure, then recovery. The site's "Gynaecomastia surgery" page, suggested at the bottom of this article, covers the essentials. The information remains general: only your surgeon can adapt it to your situation.
Before any surgery: looking for a cause
Before considering an operation, the doctor tries to understand why the breasts have developed. Certain medicines, the use of anabolic steroids, a hormonal imbalance or an illness may be involved.
To assess the situation, the consultation includes a clinical examination. Depending on the case, the doctor may also request a hormonal blood test and an ultrasound. If a cause is found, it is treated first: surgery only comes afterwards, if the problem persists.
If you take anabolic products, simply tell the doctor: this information matters, and stopping them is part of the preparation. Never change a medical treatment on your own: it is the doctor who decides whether it needs adjusting.
When can surgery be considered?
Before making up your mind, take the time to talk about your expectations with the surgeon. He or she explains what the procedure can correct in your case, and what it cannot change. A stable weight is preferable: it allows a more accurate assessment of what is due to fat and what is due to the gland.
Surgery is not an obligation: it is a personal decision, made after a consultation and time to think it over. It can be discussed with a plastic surgeon in several situations:
- gynaecomastia that persists after the end of puberty, as it then rarely disappears on its own;
- physical or psychological discomfort, for example avoiding the beach, sport or certain clothes;
- excess fat localised on the chest that persists even at a stable weight;
- excess skin on the chest after major weight loss.
Preparation: consultations and instructions
During the consultation, the surgeon examines the chest, assesses the share of gland, fat and skin, and explains the technique he or she proposes. It is the right time to ask your questions about scars, the length of recovery and your return to work.
Also arrange for someone to take you home: after an anaesthetic, driving yourself is not advised. Finally, organise the first days at home so that you can rest, and keep loose clothes that are easy to put on over the vest within reach.
Preparation generally includes the following steps, specified by the team according to your situation:
- a consultation with clinical examination and a search for a cause;
- an ultrasound and a hormonal assessment if the doctor considers them useful;
- stopping any anabolic products;
- a pre-operative anaesthesia consultation and blood tests;
- buying the prescribed compression vest, to bring with you on the day of the procedure.
The day of the procedure, step by step
The procedure is most often performed under general anaesthesia and generally lasts one to two hours. The technique depends on what is in excess: fat, gland, skin, or several at once. Here are the main steps:
- liposuction of the chest, through small incisions, to remove the excess fat;
- removal of the gland through a discreet incision at the lower edge of the areola;
- skin removal if needed, when the skin is very stretched, with longer scars in that case;
- closure and dressing, sometimes with a small drain;
- fitting of the compression vest.
Recovery: vest, work, sport and result
Gynaecomastia surgery is most often done as day surgery or with one night in hospital: you go home the same day or the next day. Bruising, swelling and tenderness of the chest are usual in the first days; the team explains how to relieve the pain.
The compression vest is worn for about a month. Office work generally resumes after a week, and sport after about a month, gradually. These timeframes vary from one person to another and are set by the surgeon during follow-up visits.
The result settles over a few months. Keeping a stable weight helps to maintain it. Follow-up continues until the scars have healed, with regular check-ups with the surgeon.
Possible risks, coming from abroad and warning signs
Like any surgery, gynaecomastia surgery carries risks, which are explained in consultation: haematoma or fluid collection, monitored and treated if needed, bruising, temporarily altered sensation of the areola, small contour irregularities, and more visible scars when skin is removed.
If you are coming from abroad, you can describe your situation in the quote request form: your file is reviewed by the relevant specialist, then the team helps you plan the consultation and the procedure. Communication is in French, English or Arabic. Plan to stay long enough for the first check-ups.
After the procedure, certain signs should prompt you to contact your surgeon quickly, without waiting for the next appointment:
- fever, unusual or increasing pain;
- significant or rapid swelling on one side of the chest;
- bleeding, discharge or redness of the scar;
- pain or swelling in the calf, or shortness of breath: in this case, call without delay.
Frequently asked questions
Can gynaecomastia go away without surgery?
Yes, often in adolescence, when it frequently disappears on its own. When a cause is found, such as a medicine or anabolic steroids, treating it comes first. When it persists into adulthood, it rarely disappears on its own, and surgery can then be discussed with a plastic surgeon.
Are sport or a diet enough?
They can reduce the share of fat, but not the breast gland itself. This is why enlarged breasts can persist despite a stable weight and regular activity. The surgeon assesses in consultation what is involved: fat, gland or both.
Are the scars visible?
Most often, the gland is removed through a discreet incision at the lower edge of the areola, and liposuction is done through small incisions. When the skin is very stretched, skin removal may be needed, with longer scars. The surgeon explains the technique suited to your case.
Do I need to stay in hospital?
Gynaecomastia surgery is most often done as day surgery or with one night in hospital. You go home the same day or the next day, with the compression vest and the team's instructions.
What is the difference with a breast reduction?
Breast reduction concerns women: it reduces the volume of heavy breasts, to relieve the back and restore a proportionate bust. Gynaecomastia surgery concerns men: it removes the excess gland and/or fat to give the chest a flat, masculine appearance. Both procedures have their own page on the site.
This article is for general information only. It does not replace the advice of your doctor, who alone can adapt instructions to your situation.
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