Gynecomastia: A Complete Patient Guide

What is gynecomastia?

Gynecomastia is the enlargement of glandular breast tissue in men. It is a common, benign condition that can affect one or both sides of the chest, and it occurs across all ages - in newborns, during puberty, and in later adulthood. It is driven by a relative shift in the balance between oestrogen and testosterone activity, which stimulates the small amount of breast tissue that every male body contains.

Because the chest is such a visible area, gynecomastia can affect confidence, clothing choices, and comfort during exercise or swimming. Understanding what is actually causing the change is the first step in deciding whether anything needs to be done about it - and what the realistic options are.

True gynecomastia versus pseudogynecomastia

Not all chest fullness is the same, and the distinction matters because it changes the approach.

A surgeon distinguishes between these during a physical examination, sometimes supported by imaging. The reason it matters: fat can respond to weight loss and liposuction, whereas dense glandular tissue typically does not shrink with diet or exercise and is removed surgically when treatment is chosen.

What causes gynecomastia?

The underlying mechanism is hormonal, but the triggers vary. Frequently discussed factors include:

• Natural hormonal shifts during puberty, many of which resolve on their own within months to a couple of years
• Age-related changes in hormone balance in older men
• Certain medications and substances that affect hormone activity
• Some medical conditions affecting the liver, thyroid, or hormone-producing glands
• Significant weight change, which influences the fatty component

Because a small number of cases relate to an underlying medical cause, a responsible assessment includes a history and examination before any procedure is considered. Persistent gynecomastia that has been present for more than a year tends to involve established glandular tissue that is less likely to resolve without surgery.

How is gynecomastia treated?

Treatment is individualised and depends on the cause, how long the condition has been present, and the balance of gland to fat. Broadly, the options discussed at a consultation include:

• Watchful waiting - particularly for adolescent gynecomastia, which often settles without intervention.
• Addressing an underlying cause - reviewing contributing medications or medical factors where relevant.
• Liposuction - to remove the fatty component, often through very small incisions. You can read more about the technique in our aesthetic surgery information.
• Gland excision - direct removal of the firm glandular disc, usually through a small incision at the edge of the areola.
• A combined approach - liposuction plus gland excision, which is common because most cases are mixed.

What does gynecomastia surgery involve?

Surgical correction aims to flatten and recontour the chest while keeping scars as discreet as possible. The procedure is typically performed under general or local anaesthesia depending on the extent, and many cases are completed as day surgery. The surgeon removes the glandular tissue and addresses the fatty component, paying attention to a smooth transition with the surrounding chest so the result looks natural.

Recovery generally involves wearing a compression garment for several weeks to support the tissues and reduce swelling, with a gradual return to normal activity. Bruising and swelling are expected early on, and the final contour becomes clearer over the following months as the tissues settle.

Who is a candidate?

Suitable candidates are generally in good general health, have persistent gynecomastia that bothers them, and hold realistic expectations. A stable weight helps, because large weight fluctuations afterwards can change the result. The only way to know whether surgery is appropriate for an individual is a face-to-face assessment, where the gland-to-fat balance, skin quality, and goals are evaluated together.

Frequently asked questions

Will gynecomastia go away on its own?

Pubertal gynecomastia often resolves within months to two years. Gynecomastia that has been present beyond that, or that develops in adulthood, is less likely to disappear without treatment because it usually involves established glandular tissue.

Can exercise or weight loss remove it?

Weight loss and exercise reduce the fatty component and overall chest size, which helps pseudogynecomastia. They do not remove true glandular tissue, which is why a firm disc beneath the nipple often persists despite training.

Where are the scars?

Scars are placed to be as inconspicuous as possible, commonly at the lower edge of the areola where the colour change helps camouflage them, and at tiny liposuction access points. Individual healing varies.

Is the result permanent?

Removed glandular tissue does not grow back. However, significant weight gain, certain medications, or hormonal changes can still affect the chest afterwards, so maintaining a stable weight supports a lasting result.

Can both fat and gland be treated together?

Yes. Because most cases are mixed, a combined approach using liposuction for the fat and excision for the gland is frequently the most effective plan. Your surgeon will advise what suits your anatomy.