Gynecomastia is the abnormal enlargement of the breast tissue in men. This common condition, colloquially referred to as “man boobs”, is often-mocked but is a legitimate cause a range of psychological and social problems among the men it affects. Gynecomastia can often cause embarrassment and severe self-image issues. These, in turn, limit a person’s life — for example, the condition could affect confidence within a relationship, or deter a person from taking part in activities such as swimming. At my clinic in London, Westminster, you’ll receive compassionate, discreet assistance.

Surgical correction may be an excellent way to help you when you’re suffering from gynecomastia. It is also an attractive option for those considering enhancing the shape of their chest in general.


What Causes Gynecomastia?

Most cases of gynecomastia are idiopathic. That means there is no specific cause of the condition. In some cases, the cause may be attributed to:

  • Normal Physiological Changes:
  • After Birth: Baby Boys Commonly Have Enlarged Breast Tissue Because of the Mother’s Hormones
  • During Puberty: Hormonal Changes May Cause an Increase in Breast Size (Making it Important to Wait Until Growth Has Completed Before Seeking Surgery)
  • Later Life: The Reduction of Testosterone Levels May Cause Gynecomastia
  • Pharmacological Causes:
  • Hormones
  • Steroids
  • Marijuana
  • Many Others
  • Pathological Causes:
  • Testicular Tumours
  • Pituitary Tumours
  • Liver Problems
  • Thyroid Problems
  • Breast Cancer


Do I Need Any Tests Before Surgery?

I always recommend a series of routine tests before considering surgery for gynecomastia. These tests include:

  • Liver, Kidney, and Thyroid Function tests
  • LH, FSH, Testosterone, Estradiol, and Human Chorionic Gonadotropin (hCG)

You can ask you General Practitioner (GP) to order these tests to investigate any pathological cause of your gynaecomastia. You should see your doctor and ask them to refer you for further investigation (such as an ultrasound scan), or to hospital specialist, if you have any of the following serious symptoms:

  • Localised Swelling (Lump) in the Breast
  • Recent Onset of Pain or Tenderness in the Breast
  • One-sided Gynaecomastia
  • Testicular Mass or Lump
  • Signs of Thyroid Problems: Tremor, Palpitation, Heat Intolerance, Weight Loss
  • Signs of Hormonal Problems: Decreased Libido, Erectile Dysfunction, Reduction of the Field of Vision


What Surgical Techniques Exist?

There are various techniques, often used in combination, to correct gynecomastia. This includes:

  • Liposuction
  • Open Excision via Semi-Circular Periareolar Incision
  • Areola Reduction via Circomareolar Incision
  • Skin Reduction via Circomareolar Incision
  • Skin Excision via Inverted T-Shape Scar (Wise-pattern)
  • Excision via Transverse Incision and Free Nipple Areola Grafting
  • Extended Skin Excision into the Sides of the Chest / Axillae

The choice of technique will depend on:

  • The Amount of Excess Breast Tissue
  • The Type of Excess Breast Tissue (Fatty or Fibrous)
  • The Amount and Distribution of Excess Skin
  • The Size and Location of Nipple and Areola
  • The Patient’s Preference of Scars


Is Gynecomastia Correction Suitable for Me?

Surgical correction of gynecomastia is a safe option for improving the shape of the male chest by removing the excess breast gland and skin. You will need to accept some form of scarring. The size and location of the scar will depend on the degree of excess skin. I recommend that patients younger than 20 do not have surgery, because gynecomastia might naturally resolve itself during teenage years. You should, at a minimum, undergo routine blood tests and investigations if you have any significant symptoms listed above, in the “Do I Need Any Tests Before Surgery?” section.

What Will Happen at the Consultation?

I will take a focused and detailed history to explore your concerns, needs, and possible causes of the gynecomastia. I will examine your chest for asymmetries, lumps, and abnormalities before taking some measurements. I will then discuss the suitability of surgery with you, as well as the type of surgery, expected outcome, and any alternative options. I will explain the procedure in detail, as well as your recovery, the possible risks, and any complications.


What Will Happen on the Day of Surgery?

Most of the gynecomastia procedures I perform are conducted as day-case surgeries, meaning you will be able to go home on the same day. I will see you before surgery and add some markings onto your skin. Then, the anaesthetist will see you to begin the anaesthesia. During surgery, you will be given a dose of antibiotic to reduce the risk of infection. I will infiltrate the chest with plenty of local anaesthetic (a numbing medicine) to numb your skin and deep tissue. When you wake up after surgery, you may feel some tightness but should not feel any significant pain due to the effect of the local anaesthetic. The wounds will be covered with dressings. You will be given strong painkillers to take home, which should control all pain and discomfort.


What is the Recovery?

You will experience swelling, bruising, and discomfort for the first few days. The pain will be controlled by taking the painkillers on a regular basis. It usually takes one to two weeks to get back to day-to-day light activities. It might take up to four weeks to return to full physical activities. You should wear a well-fitted pressure vest and refrain from upper body physical exercise for 6 weeks after surgery.

What Follow-up Do I Get?

I will see you one week after surgery to check the wounds. 6-8 weeks after surgery, I’ll see you again to check the scars. Finally, 6 months later, I will check the shape of your chest.


Are There Any Alternatives?

That would depend on your aims and expectations, which are better measured and discussed during the consultation. Non-surgical options for the treatment include treating any identifiable cause such as treating tumours and hormone imbalances, or stopping medications, steroids, hormones, and drugs that might be the cause. Tamoxifen is an anti-estrogen tablet used for the treatment of gynaecomastia with variable response rates. For women looking to augment their breasts, I provide skilled breast augmentation procedures.



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Omar Tillo, 106 Crawford Street, London, Westminster W1H 2HY, UK
ember of Royal College of Surgeons Member of General Medical Council Member of UEMS Member of UKAAPS Member of British Medical Association