Gynecomastia Surgery

1. What Is Gynecomastia?

Gynecomastia is the abnormal enlargement of breast tissue in men.

• This enlargement may be due to:
• Increased fat tissue
• Enlargement of the glandular (breast) tissue
• Or a combination of both

Gynecomastia is not only an aesthetic problem; in many men it can cause psychological distress and loss of self-confidence.

2. What Causes Gynecomastia?

Gynecomastia most commonly occurs due to:

• Hormonal imbalances
• Pubertal (adolescent) hormonal changes
• Excessive weight gain
• Certain medications (steroids, hormones, antidepressants, etc.)
• Alcohol and substance use
• Genetic predisposition

In some cases, no clear underlying cause can be identified.

3. Types of Gynecomastia (Fat, Glandular, Combined)

Fat-predominant (pseudogynecomastia):

• Fat accumulation in the chest area is predominant

Gland-predominant:

• A firm, rubbery breast gland is present

Combined type:

• Both excess fat and excess glandular tissue are present together

The surgical technique is chosen according to the type of gynecomastia.

4. Goals of Gynecomastia Surgery

With gynecomastia surgery, the aims are to:

• Correct the male chest contour
• Eliminate the bulging around the nipple and areola
• Achieve a flatter, more masculine chest
• Improve comfort and confidence when wearing clothes

The goal is to obtain a natural and athletic-looking chest.

5. Who Is a Suitable Candidate for Gynecomastia Surgery?

Suitable candidates are male patients who:

• Still have breast enlargement despite exercise and weight control
• Are in a general state of health suitable for surgery
• Have had their hormonal work-up evaluated
• Have realistic expectations

In temporary pubertal gynecomastia, surgery is not recommended immediately.

6. Preoperative Evaluation and Planning

During the evaluation process:

• The type of breast tissue is determined
• Hormone tests are requested if necessary
• Skin elasticity is assessed
• Incision locations and technique are planned

The aim is maximum correction with minimal scarring.

7. How Is Gynecomastia Surgery Performed?

• The surgery is performed under general anaesthesia or local anaesthesia with sedation
• If there is excess fat, liposuction is performed
• If there is firm glandular tissue, it is removed through a small incision around the areola
• If needed, both techniques are used together
• Incisions are usually planned so that they are barely noticeable

8. Liposuction and Gland Removal

Liposuction:

• Fat tissue is removed with thin cannulas

Gland excision:

• Firm breast gland tissue is surgically removed

The combined approach provides a flatter and more natural result.

9. Anaesthesia and Day of Surgery

• No pain is felt during the procedure
• Mild to moderate pain may occur after surgery
• Most patients are discharged on the same day
• Pain is usually controlled with simple painkillers

10. The First Days After Surgery

• Swelling and oedema are normal
• Bruising usually improves within 1–2 weeks
• A compression garment (chest vest) should be worn regularly
• Arms should not be overstrained in the first days

11. Staying in Istanbul and Follow-Up

A 3–4 day stay in Istanbul is usually sufficient for:

• Follow-up examination
• Dressing changes and early healing assessment

Stitches may either be removed or dissolve on their own, depending on the technique used.

12. Returning to Social Life, Work and Sports

• Desk-based work: 4–7 days
• Everyday social life: around 1 week
• Sports and weight training: 4–6 weeks

Wearing the compression garment as instructed directly affects the quality of the final result.

13. Possible Risks and Limitations

• Asymmetry
• Irregular or wavy skin surface
• Temporary loss or change of sensation
• Rarely, bleeding or infection

With an experienced surgeon and proper technique, these risks are low.

14. Results and Expectation Management

The goals of gynecomastia surgery are:

• A flat, masculine chest shape
• A natural contour
• Long-lasting results

The aim is not an overly hollow or sunken chest, but a healthy, proportional and masculine-looking chest.