What is gynecomastia?

Gynecomastia is a condition characterized by the enlargement of male breast tissue due to hormonal imbalance, genetic factors, medication use, or weight gain. It can occur on one or both sides and may cause aesthetic concerns, discomfort, or reduced self-confidence. Gynecomastia is one of the most common cosmetic issues among men and can be effectively treated with modern surgical techniques.

What causes gynecomastia?

The most common cause is hormonal imbalance, particularly between testosterone and estrogen levels. Gynecomastia can also be triggered by:

• Certain medications (hormone therapy, antidepressants, steroids)
• Liver or kidney diseases
• Thyroid dysfunction
• Alcohol and substance use
• Obesity and increased fat tissue

Identifying the underlying cause is important for planning proper treatment.

Who is a suitable candidate for gynecomastia surgery?

Gynecomastia surgery is ideal for men who experience permanent breast enlargement, discomfort, difficulty choosing clothing, or psychological distress. Candidates should be in good general health, have stable weight, and possess realistic expectations. Teenagers may also undergo surgery if the condition persists for more than 1–2 years after puberty.

How is gynecomastia surgery performed?

The goal of surgery is to remove excess fat and/or glandular breast tissue to achieve a flatter, more masculine chest contour. The technique depends on the type of gynecomastia:

• Liposuction: Used when excess fat is the primary cause. Fat is removed through small incisions.
• Excision technique: Used when firm glandular tissue must be removed. An incision is made around the areola.
• Combined technique: Both liposuction and excision are performed for optimal results.

The most suitable method is determined after physical examination and imaging.

What type of anesthesia is used?

Gynecomastia surgery is usually performed under general anesthesia. In small, fat-dominant cases, the procedure may be done under local anesthesia with sedation.

How long does surgery take and is hospitalization required?

The operation typically takes 1–2 hours depending on the severity of gynecomastia. Most patients can return home the same day, while some may stay overnight for observation.

What is the recovery process like?

Mild pain, swelling, and bruising are normal in the first few days and gradually decrease. A compression garment is worn for several weeks to support healing and help the skin adapt to the new contour. Most patients return to daily activities within 3–7 days. Full recovery and final results may take 1–3 months.

Will there be scars after surgery?

Incisions are placed along natural lines such as the edge of the areola or hidden areas near the armpit. Liposuction-only cases require very small incisions, usually just a few millimeters. Scars fade significantly over time and become barely noticeable with proper care.

What are the risks of gynecomastia surgery?

Although low-risk, potential complications include infection, bleeding, seroma formation, asymmetry, contour irregularities, temporary or permanent changes in nipple sensation, and wound healing problems. Choosing an experienced surgeon significantly minimizes these risks.

When can I start exercising after surgery?

Light walking can begin within a few days. Heavy lifting and intense chest exercises should be avoided for 4–6 weeks. Full strength training can resume after your surgeon approves.

Are the results permanent?

Since fat and glandular tissues are removed permanently, results are long-lasting. Significant weight gain, hormonal imbalance, or medication use may cause recurrence.

What should I consider before surgery?

Patients should inform their surgeon about current medications, chronic illnesses, smoking/alcohol habits, and previous surgeries. Quitting smoking before the procedure improves healing and overall outcomes. Preoperative labs and imaging are performed to determine the most appropriate surgical approach.