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Gynecomastia Surgery

Gynaecomastia (gynecomastia) is a swelling of the breast tissue in males. This condition, sometimes referred to as enlarged male breast tissue, is a common medical condition that can affect one or both sides of the chest.
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Gynecomastia Surgery Sydney

Gynaecomastia (gynecomastia) is a swelling of the breast tissue in males. This condition, sometimes referred to as enlarged male breast tissue, is a common medical condition that can affect one or both sides of the chest. Gynaecomastia surgery is a surgical procedure designed to address excess breast tissue in males through various surgical techniques.

Understanding Gynaecomastia

Gynaecomastia is very common. More than half of all young males develop the condition during puberty. As many as 2 out of 3 males aged over 50 years may have the condition. The condition involves the development of glandular breast tissue, which is different from chest enlargement due to excess fatty tissue alone.

Gynaecomastia is different from enlarged breasts caused by extra fat tissue from being overweight. True gynaecomastia involves actual breast gland tissue growth, creating a firm or rubbery mass typically centered under the nipple area.

Types of Gynaecomastia Surgery

Direct surgical removal of excess glandular breast tissue through incisions, typically around the areola. This technique is most effective when dealing with firm, glandular tissue that cannot be addressed through liposuction alone.

If you have only a small amount of excess fatty tissue and good skin elasticity, the operation may involve only liposuction. This involves using a cannula (thin, hollow tube) attached to a suction device to remove excess fatty tissue through small incisions.

Many cases require a combination of both surgical excision and liposuction to achieve optimal chest contouring. The surgeon removes glandular tissue through direct excision while using liposuction to address surrounding fatty tissue and create smooth transitions.

For severe gynaecomastia, where there is a lot of excess skin, there are several different options. These may involve additional incisions to remove excess skin and reposition the nipple-areola complex when significant skin laxity is present.

What to Expect

Consultation

The gynaecomastia surgery process begins with a detailed consultation with our experienced surgeon. During this session, your medical history, current chest structure, and treatment goals will be thoroughly evaluated. The surgeon will assess the type and amount of breast tissue present, skin quality, and whether the enlargement is due to glandular tissue, fatty tissue, or both. A physical examination will help determine the grade of gynaecomastia and the most appropriate surgical approach. This consultation is an ideal opportunity for you to voice any concerns or ask any questions you may have about the procedure.

Number and type of consultation
It is a requirement under the law, that a patient seeking cosmetic surgery must have at least two pre-operative consultations. The patient’s first consultation must be with the medical practitioner who will perform the surgery or another registered health practitioner who works with the medical practitioner who will perform the surgery (not a patient advisor or an agent). At least one of the two consultations must be in person with the medical practitioner who will perform the surgery. Other consultations can be in person or by video.

When consent can be given
A patient must not be requested to sign consent forms at their first consultation and cannot consent to cosmetic surgery until they have had an in-person consultation with the medical practitioner who will perform the surgery. The decision to have the surgery (provision of informed consent) must be made at a consultation with the medical practitioner who will perform the procedure (in person or by video).

Cooling-off Period
There must be a cooling-off period of at least seven days after the patient has had two consultations and given informed consent (signed consent forms), before the surgery can be booked or a deposit paid.

Preparation

Once you and the surgeon have agreed on the surgical plan, you will receive specific instructions on how to prepare for your gynaecomastia surgery. These may include dietary guidelines, advice on smoking and alcohol consumption, specific instructions about medications or supplements that may need to be stopped, and requirements for medical clearance or blood tests. You'll also be advised to arrange for someone to drive you home after the procedure and assist you during the initial recovery period.

Surgery

Gynaecomastia surgery typically takes 30 minutes to one hour per side and is usually performed under general anaesthesia, though various anaesthetic techniques are possible. The specific surgical approach depends on your individual case. For primarily fatty tissue, small incisions allow for liposuction using a thin cannula to remove excess fat. When glandular tissue is present, the surgeon makes an incision around the areola to directly excise the firm breast tissue. Many cases require a combined approach, using both excision and liposuction to achieve optimal chest contouring. The incisions are then closed with dissolvable sutures, and dressings are applied.
  • Surgery Time
    1 hour to 2.5 hours
  • Hospital Time
    Home same day depending on procedure

Recovery

After the surgery, you'll be monitored in a recovery room for a short period. Most patients who undergo liposuction alone can go home the same day, while those requiring tissue excision may stay overnight, particularly when drains have been placed. A compression garment will be fitted to support healing and minimise swelling. Swelling, bruising, and mild discomfort are normal but will begin to subside after a few days.

Most patients feel ready to return to work and light daily activities within one week, depending on the nature of their occupation. More vigorous activities and exercise should be avoided for about four to six weeks. Regular follow-up appointments will be scheduled to monitor your progress and ensure optimal healing.

The initial results of your gynaecomastia surgery will be visible immediately, though swelling may obscure the final outcome. Your new chest contour will continue to refine over several months as swelling completely resolves and tissues settle into their new position. Scars will fade gradually over 12-18 months. Our team remains committed to providing ongoing care and support throughout your entire gynaecomastia surgery journey.
  • Time off work
    7 to 12 days depending on occupation and surgery technique required.
  • Cast Removal
    Garment for 6 months
  • Exercise
    6 to 12 weeks - ease in
  • Showering
    Once sutures have been removed or sponge bath in between keeping incision dry.
  • Driving
    6 weeks and not while taking prescribed pain relief. We also recommend checking with your CTA insurer as to the post surgery exclusion period.
  • Travel
    After 12 days for national and 4 weeks for international
  • Full Recovery
    3 to 6 months

Frequently Asked Gynaecomastia Questions

Gynaecomastia involves actual breast gland tissue growth, which feels firm or rubbery and is typically centered under the nipple area. This is different from pseudogynecomastia, which is simply excess fatty tissue from being overweight. True gynaecomastia will not resolve with diet and exercise alone, as the glandular tissue cannot be reduced through weight loss. A physical examination by a qualified surgeon can determine which type of tissue is present.

In teenage boys, gynaecomastia often resolves naturally as hormone levels stabilise after puberty, typically within 6 months to 2 years. However, in adult men, established gynaecomastia rarely resolves without treatment. If the condition has been present for more than one year, the breast tissue becomes fibrous and is unlikely to disappear without surgical intervention.

For adolescents, it's generally recommended to wait until full physical maturity is reached and hormones have stabilised, usually around age 18. Surgery performed too early may result in recurrence if hormonal changes are still occurring. For adult men, there is no upper age limit as long as they are healthy enough for surgery. Each case should be evaluated individually by a qualified surgeon.

Most patients can return to work within one week for desk jobs, though jobs requiring physical activity may need 2-3 weeks off. Light exercise can typically resume after 2-3 weeks, while heavy lifting and strenuous activities should be avoided for 4-6 weeks. The compression garment is usually worn for 3-6 weeks. While initial results are visible immediately, final results develop over 3-6 months as swelling resolves.

The results are generally permanent because the removed glandular tissue does not grow back. However, significant weight gain, use of certain medications, steroid use, or hormonal imbalances could potentially cause new tissue growth. Maintaining a stable weight and healthy lifestyle helps preserve the surgical results long-term.

Scarring depends on the surgical technique used. Liposuction alone leaves tiny scars (3-4mm) that are barely visible. Direct excision typically involves a semicircular incision along the lower edge of the areola, which tends to heal well and blend with the natural color change. More extensive procedures requiring skin removal will have additional scars, which your surgeon will discuss during consultation. All scars fade significantly over 12-18 months.

True recurrence is rare when the surgery is performed correctly and the underlying cause has been addressed. However, new gynaecomastia can develop if:

  • Hormonal imbalances occur
  • Certain medications are taken
  • Anabolic steroids are used
  • Significant weight is gained
  • An underlying medical condition develops

Your surgeon will discuss risk factors during your consultation.

Medicare rebates may be available if specific criteria are met. According to Medicare guidelines, the procedure may be eligible if breast enlargement is not due to obesity and is not proportionate to body habitus, with sufficient photographic evidence documenting the clinical need. Both unilateral (Item 31525) and bilateral (Item 31530) procedures have specific Medicare item numbers. Your surgeon can assess whether your case meets Medicare criteria during consultation.

Unilateral gynaecomastia affects only one breast, while bilateral affects both. About 50% of cases are bilateral, though one side may be more pronounced. Unilateral cases require careful evaluation to rule out other conditions. The surgical approach is similar for both, though bilateral procedures take longer and may have different Medicare item numbers and fees.

Exercise can reduce fatty tissue but cannot eliminate true glandular breast tissue. While some medications have been tried for gynaecomastia in certain cases, they are generally only effective in the early stages (within the first 12 months) and results are variable. For established gynaecomastia with fibrous tissue, surgery remains the most effective treatment. Your doctor can discuss whether non-surgical options might be appropriate for your specific situation.

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Dr Kenneth Brito

MD, MSurg, FACCSM, FRACGP
Dr. Kenneth Brito is a cosmetic doctor with more than 13 years of postgraduate experience. Since earning his Bachelor of Medicine and Surgery in 2007 and his Masters of Surgery from the University of Sydney in 2012, he has continued to build his expertise through advanced training. Dr. Brito values clear communication and works closely with patients to plan treatments that prioritise safety and individual needs.
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Cosmetic Doctor
MED0001680302

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Get in touch today to organise a consultation or to find out more information.

Our team will give you a call to discuss your enquiry and we will then send you any relevant information via email.
You will need a GP referral for surgical procedures. AHPRA require all patients having a surgical cosmetic or medical procedure to have a GP referral. You can fax your referral to 02 8072 6824 or email office@drzacharia.com.au
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You will need a GP referral for surgical procedures. AHPRA require all patients having a surgical cosmetic or medical procedure to have a GP referral. You can fax your referral to 02 8072 6824 or email office@drzacharia.com.au

Considerations Before Cosmetic Surgery

While we aim to provide accurate information about the different surgical procedures available, it’s important to understand that the content provided here serves as a general guide only. The specifics of each surgery, including the procedure detailed above, can and will vary significantly from person to person, depending on their unique circumstances and physical characteristics.

Undergoing cosmetic surgery is a serious decision that requires ample thought, careful consideration, and meticulous planning. It should never be taken lightly or treated trivially, as it can have profound impacts on one’s lifestyle and wellbeing.

Recovery from cosmetic surgery, too, requires time, support, and proper aftercare. We strive to present realistic and transparent information about the recovery process, but individual experiences may vary. It is typical for recovery to involve certain services or requirements, such as the use of compression garments or receiving therapeutic massages. It also often necessitates significant lifestyle changes, which may include a period of absence from employment and temporary restrictions on certain activities.

In light of these considerations, we strongly encourage potential patients to engage in comprehensive discussions with their GP and our surgeons. The goal is to fully understand the implications, requirements, and likely outcomes of any chosen procedure, and to make informed decisions about their health and aesthetics.

For more information on preparing for cosmetic surgery visit health.gov.au/cosmeticsurgery

General risks and complications

  • Substantial Hemorrhage: This involves severe blood loss from the area that underwent surgery, which may necessitate additional medical interventions.
  • Susceptibility to Infection: Post-surgery, the risk of infection can rise, potentially requiring either antibiotic treatment or subsequent surgical interventions.
  • Allergic Responses: Patients may exhibit allergic reactions to medical materials such as sutures, dressings, or antiseptic solutions used during and after the procedure.
  • Hematoma Formation: This involves the development of a sizable clot of blood beneath the incision site, which may necessitate medical drainage.
  • Post-Surgical Discomfort: Patients may experience pain, bruising, and swelling in the area surrounding the surgical site.
  • Scar Development: There's a risk of developing keloids or hypertrophic scars, which are elevated, red, and thickened scars over the healed incisions. Though they can be bothersome and aesthetically displeasing, they don't pose a direct health threat.
  • Delayed Healing Process: Healing can be sluggish, especially in patients with pre-existing conditions like diabetes or those who smoke.
  • Anaesthesia Risks: Patients may experience short-term nausea following general anaesthesia, along with other potential risks associated with anaesthesia.

Gynaecomastia Surgery Risks

  • Unsatisfactory Cosmetic Outcome: Despite careful surgical planning, there's a risk that the patient might be dissatisfied with the chest contour, symmetry, or overall appearance following the surgery. This may include residual fullness, over-resection creating a concave appearance, or uneven results between sides.
  • Changes in Nipple and Skin Sensation: The surgery might lead to temporary or permanent changes in sensation of the nipple-areola complex and surrounding chest skin, including numbness, tingling, or hypersensitivity. Nipple sensation typically returns within several months but may be permanently altered in some cases.
  • Fluid Accumulation (Seroma): Following surgery, there is a risk of developing a seroma, a pocket of clear fluid that accumulates in the surgical site. This is more common in cases requiring extensive tissue removal and may require drainage.
  • Haematoma Formation: Blood may accumulate under the skin forming a haematoma, which appears as a firm, painful swelling. This typically occurs within the first 24-48 hours post-surgery and may require surgical drainage if significant.
  • Nipple or Skin Necrosis: Rarely, the nipple-areola complex or surrounding skin may suffer from insufficient blood supply leading to tissue death (necrosis). This risk is higher in smokers and those with poor circulation.
  • Contour Irregularities: The chest may develop irregular contours, including indentations, ridges, or asymmetry. This can result from uneven fat removal, irregular scar tissue formation, or skin adherence to underlying tissues.
  • Visible Scarring: While incisions are strategically placed, some patients may develop hypertrophic or keloid scars that are raised, thickened, or more noticeable than expected. Scars around the areola may also cause distortion of its shape.
  • Poor Wound Healing: The incisions may heal slowly or incompletely, particularly in individuals with diabetes, poor nutrition, or those who smoke. This can lead to wound breakdown, delayed healing, or the need for additional treatment.

Contact Facelift Plastic Surgery

Dr Zacharia
Level 1 /424 New South Head Road
Double Bay, NSW 2028

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  • Dr Michael Zacharia MED0001178357 - Otolaryngology
  • Dr Kenneth Brito MED0001680302 - General Practice
  • Dr Ahmed Alsultan MED0001647273 - General Practice
Disclaimer: Surgical and invasive procedures are not an exact science and they carry risks. Results vary with each patient depending on their age, health, weight, hormones and lifestyle. Please note that results are not permanent solutions and will change as your body changes over the years. After you consult with Team MZ, you should seek a second opinion from an appropriately qualified health practitioner
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