Gynaecomastia: what are the treatment options?

Gynaecomastia or male breast enlargement is a condition in which men develop breasts, usually due to an imbalance of hormones. This condition can be the source of embarrassment and low self-esteem. What can be done about this condition? Respected plastic surgeon Mr Navid Jallali MD FRCS (Plast) explains.

Why do some men have gynaecomastia?

The Incidence of gynaecomastia is increasing, although it is not clear why. The increase in incidence may be due to the fact that the condition is now more widely recognised and men are more likely to seek help.

There can be underlying medical conditions such as hypothyroidism that lead to gynaecomastia. Environmental factors such as heavy alcohol intake and recreational drugs can also contribute. However, in most cases there is no underlying cause identified and we use the term ‘idiopathic’ in such cases. Gynaecomastia usually starts around puberty when the male breast is sensitive to hormonal changes and unfortunately, once developed it rarely regresses.

Can gynaecomastia go away naturally?

There is a condition termed pseudo-gynaecomastia, which is due to excess body fat. This condition does improve with weight loss and exercise. Unfortunately, true gynaecomastia will never regress once it has developed.

What are the different treatment options for gynaecomastia?

The treatments for gynaecomastia can be broadly divided into medical and surgical. Medical treatment involves a drug called tamoxifen which usually needs to be taken lifelong and can have serious side effects. The surgical options for gynaecomastia depend largely on the grade or severity. Minor grades of gynaecomastia can be treated with liposuction or open excision alone. More severe grades require a combination of liposuction and open excision of the gland. The most severe form of gynaecomastia requires a formal breast reduction procedure.

What is the lower age limit for performing gynaecomastia surgery?

In general, I do not recommend surgery for anyone below the age of 18. Occasionally, younger patients may have surgery carried out if there is an underlying medical condition. You will be seen and assessed fully by myself prior to having the procedure carried out.

How much is gynaecomastia surgery?

This largely depends on the severity of the gynaecomastia. For grade 1, the procedure can cost as little as £2500. More severe grades cost between £4500-6000 to treat under a general anaesthetic. You may require an overnight stay.

What is the recovery like?

I find that fear of pain is the single most important factor in preventing patients seeking treatment. This is why I work with experienced anaesthetists who are experts at managing pain post-operatively. All patients are given local anaesthetic intra-operatively also which means that there is often very little pain after the surgery.

You will usually require around two weeks off work and need to wear a pressure garment for six weeks post-operatively. The scars usually heal extremely well (visit my website to see some recent examples).