Gynaecomastia is the hypertrophy of the chest resulting in an enlarged breast or breasts in men. Hormonal irregularities can cause a disproportionate growth of the breast gland and fat content. Due to this imbalance of tissue, a distinction must be made between a genuine gynaecomastia (increase in glandular tissue) and a pseudo-gynaecomastia (pure increase in fat content). In many cases, there is a combination of these variants. A detailed patient history must be obtained during consultation prior to surgery to exclude any possible medical causes. This includes an in-depth blood and hormone analysis in addition to a physical examination. MRI and mammography imaging is indicated in symptoms of one-sided breast hardening without sharply defined edges. A testicular tumour must also be excluded. With drug-induced gynaecomastia (anabolic drugs) there will be a corresponding patient history.

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Gynaecomastia is a harmless feature in perfectly healthy individuals. Surgery is indicated with symptoms of occasional pain and in particular psychosocial aspects impacting on the patient himself.

The goal of the operation is the aesthetic and functional re-establishment of the male chest.


Generally this is an out-patient procedure with a choice of either sedation or general anaesthesia. Once a solution of lidocaine and adrenalin (tumescence) has been injected and the bulk of the enlargement consists of fat, the fat is removed via a liposuction cannula. If however, there is enlarged breast tissue, the lower edge of the areola is cut in a semi-circular shape and the tissue is removed. Additional skin tightening is only required in a few cases, since usually the tissue undergoes shrinkage as a result of and during the course of scarring.


In addition to the non-specific risks such as infection and postoperative bleeding, wound-healing impairments and scars, there are specific risks such as recurrence, asymmetry and irregularities of the skin surface. There may also be decreased sensation in the nipple.

After the operation a compression vest should be worn in order to avoid further swelling. The sutures are removed after two weeks. Thereafter, the care of the scars are treated with appropriate ointments.