Enlargement of the male breast area, or gynaecomastia, is a common problem, that may be the source of significant embarrassment or self-consciousness. There are many different causes, and while the great majority of cases are physiological (i.e. due to normal hormones), there are some more serious, but rare causes of the condition. These include drug side-effects (both from prescribed drugs such as some anti-ulcer or heart medications, as well as illicit drugs such as cannabis or anabolic steroids), excess alcohol use, kidney or liver disease, or liver disease. For this reason, I recommend that you see your GP in the first instance, in order that these issues can be outruled, and you can focus on the surgical options at the time of your consultation.

I assess each case on an individual basis, as there are a number of surgical options available, depending on the extent of the problem, the patient’s build, the level of scarring that will be acceptable to the patient, and the desired end result. It is important that you have a good understanding of the results that can be expected from this surgery. Good surgical technique is essential for a good outcome, but a number of other factors such as pectoral muscle development, body fat percentage, skin elasticity, and the shape of the ribcage, will influence the end result.

The swelling in the breast area in gynaecomastia is due to a combination of fatty and glandular tissue. Liposuction alone (performed via tiny incisions) is often sufficient to treat the area, however, it is less successful in managing glandular tissue, which may require surgical excision in addition to a liposuction procedure. Depending on the amount of tissue that requires excision, the scar may be limited to around the nipple, or in cases where there is a significant amount of excess skin, the scars will extend beyond this area.

You will be made fully aware of what to expect in advance of the surgery. It is important to note that a thin layer of fat has to be left on the under-surface of the skin, to prevent abnormal adherence between the skin and the underlying muscle, which would give an unnatural result. Following the operation, a surgical drain may be left in place for a couple of days, and you will usually have to wear a compression garment for up to six weeks.

Health insurance covers this proceudre in a limited set of circumstances. Patients will be advised at the time of consultation if they meet the criteria set down by the insurers for cover. In the majority of cases, this procedure is performed on a self-pay basis.