To view before and after photos, please refer to the gallery page: Gynecomastia Before & After Photos

The word comes from the Greek word gyne, meaning “woman”, and mastos, meaning “breast”. In practical terms, this means a female type breast present on a man.

“Gynecomastia can be an embarrassing condition, but it is surprisingly common, especially in adolescent boys,” says Mr Allen Rezai, Consultant Plastic, Aesthetic and Reconstructive Surgeon. “Overall, almost half of all men may experience the condition at some time in their lives. The condition can also appear or re-appear later in life, in middle age and older adulthood,” says Mr Rezai. “Gynecomastia during puberty generally disappears on its own. Later in life, the problem can often be traced to medications or treatments for prostate cancer.”

Mr Rezai continues: “Underlying the condition, especially during puberty, is an imbalance of oestrogen (the female hormone) and testosterone (the male hormone). When oestrogen levels get too high, the breast glands can begin to grow. In about 90% of cases the condition disappears of its own accord with maturity, but for the remaining 10% the problem persists into adulthood.
“When Gynecomastia occurs during puberty, it usually appears at around the age of 13 or 14. If the enlarged breasts are clearly visible, an already self-conscious teenager will frequently become embarrassed. And depending upon how enlarged the breasts are, there might also be some sensitivity and tenderness.
“A paediatrician should also carry out a thorough physical examination to be sure that there are no tumours, thyroid problems, or other medical conditions that might explain the breast growth. After ruling out other conditions, they will typically recommend waiting a few months to see if the gynecomastia disappears. In the majority of cases, it will indeed disappear within about 3 to 6 months,” says Mr Rezai.
“Most teenagers do not need any treatment for Gynecomastia,” declares Mr Rezai. “But if the breasts are very tender and the patient is troubled by a large amount of growth, then a doctor might recommend a course of medication. This will typically work by interfering with the oestrogen activity within the breast cells, thereby stopping the growth. Published studies indicate that about 60 percent of patients undergoing such therapy have complete regression from Gynecomastia. However, in the cases where it does not help, male chest reduction or liposuction can be carried out.”

When Gynecomastia occurs later in life, it is usually also due to an imbalance of hormones, says Mr Rezai. “This is because in older men, testosterone levels decrease whilst oestrogen levels increase. This is often accompanied by an increase in body fat, which increases the likelihood of the condition. Certain medications, particularly those used in the treatment of prostate cancer, can also lead to excess breast growth in men. In such cases doctors can try changing the medication associated with the breast growth. But as in the case of young males, when this fails to produce the desired result, recourse can be made to surgery such as breast reduction or liposuction to remove the excess tissue.”

Mr Rezai goes on to explain that in a few cases, there are additional aspects to consider. For example, if there is significant glandular tissue present, this may require surgical removal. And if there is significant skin excess over the chest, a form of breast uplift might be needed.

However, whatever the cause of the Gynecomastia, medical treatment targeting the originating condition rarely results in a full reduction of breast size. For these patients, surgery is the only option.
Male Chest Reduction surgery, explains Mr Rezai, is performed under general anaesthetic with patients requiring an overnight hospital stay. It will take approximately 60 to 90 minutes. There are various aspects requiring consideration which will determine the precise nature of the surgery. For example, if there is significant glandular tissue present, this may require surgical removal. And if there is too much excess skin over the chest, a form of breast uplift might be needed. However, in the majority of cases, all that will be required is liposuction.
Following surgery, an adhesive dressing and support vest are worn for about one week, after which time any sutures will be removed. Most patients can return to work after one to two weeks and resume their normal activities within a month. All these aspects will be evaluated and discussed in detail with each patient at consultation.
In conclusion, Mr Rezai explains that the overall outlook for Gynecomastia sufferers is good. Today there is no longer any need to suffer in silence. And it will undoubtedly come as quite a surprise to most men just how many of their fellow males have the very same problem. A problem that can be discussed with their doctor or specialist consultant without the slightest need for embarrassment, and with the likelihood that in most cases a solution will be available, permitting them in future to be able to enjoy life to the full, perhaps participating in sporting activities, or simply being able to relax on the beach, at last freed from the constant concerns and self-consciousness brought about by their former condition.

RealSelf Patient Reviews of Allen Rezai, MD