What gynecomastia is and what surgery addresses
Gynecomastia is the development of breast tissue in men — a condition that affects an estimated 30–60% of adult males at some point. Most adolescent cases resolve spontaneously; adult cases that have persisted for more than a year rarely resolve without surgical treatment.
The enlargement may consist of:
- Fatty tissue only (pseudogynecomastia) — often diet-resistant chest fat that does not affect the glandular structure
- Glandular tissue only — firm tissue beneath the nipple that has a distinct disc-like consistency, frequently tender
- Mixed — both components, the most common pattern in adult cases
Surgical approach is determined by tissue composition, not by patient preference. The pre-operative examination — including palpation of the chest to assess the glandular component — determines whether the procedure will be liposuction alone, glandular excision alone, or combined. Performing liposuction on a predominantly glandular case leaves the firm tissue unchanged; performing excision on a fatty case is unnecessary surgery.
- Approach: Liposuction (fatty) ± glandular excision through periareolar incision (glandular)
- Anaesthesia: General anaesthesia or deep sedation
- Duration: 1.5–2.5 hours
- Hospital stay: Day case
- Compression vest: 4–6 weeks continuously
- Return to office work: 5–7 days
- Return to chest exercise: 6–8 weeks
- Final result: 3–6 months
The three approaches
Liposuction alone
For predominantly fatty enlargement with little or no glandular tissue. 3–4 mm cannula incisions, often using VASER (ultrasound-assisted) liposuction for the fibrous male breast tissue. Scars essentially invisible after healing. Recovery is fastest.
Liposuction + glandular excision
The most common approach in adult cases. Liposuction addresses the fat; a small periareolar incision allows removal of the firm glandular disc beneath the nipple. The combined procedure is sometimes called "pull-through" technique when the gland is removed through the cannula incisions.
Skin excision
Reserved for severe cases — typically post-massive-weight-loss patients with significant skin redundancy. Adds visible chest scars (peri-areolar with vertical or horizontal extensions). Uncommon in non-MWL cases.
Recovery and what most patients experience
Gynecomastia recovery is one of the more straightforward in body contouring. The chest is not a high-motion area, the incisions are small, and the procedure typically does not require drains.
- Days 1–7: Compression vest worn continuously. Bruising and swelling. Light walking encouraged. Most patients return to desk work within a week.
- Weeks 2–4: Bruising fades. Treated areas feel firm and lumpy — this is normal and not the final result. Sutures (if any) removed at day 10.
- Weeks 4–8: Light exercise except chest-specific work. Compression continues or transitions to lighter support.
- Weeks 6–8: Chest exercise (push-ups, bench press) is gradually reintroduced.
- Months 3–6: Final contour becomes visible as residual swelling and firmness resolve.
Risks
- Asymmetry — minor differences are common; significant ones may require revision.
- Contour irregularities — over-excision (sunken or "donut deformity") and under-excision (residual fullness) are the two main aesthetic complications. Conservative excision with planned touch-up beats aggressive single-session excision.
- Hematoma — collection of blood, more common in chest surgery than in some other areas. May require return to theatre if significant.
- Sensory changes in the nipple-areola complex — usually temporary, occasionally persistent.
- Seroma, infection, hyperpigmentation — less common.
- Scar issues — peri-areolar scars usually heal well; skin-excision cases may have visible scars.
Frequently asked questions
Who is a candidate for gynecomastia surgery?
How is the procedure performed?
How visible are the scars?
How long is the recovery?
Can the tissue come back?
What are the risks?
Should I have hormonal testing first?
Will my nipple sensation change?
Is gynecomastia surgery right for you?
Send three photos (front, side, side with arms raised) and Doç. Dr. Erdal will give you an honest assessment of whether your case is fatty, glandular, or mixed — and which approach fits.
Request an assessment