About the procedure
Gynecomastia is the enlargement of breast tissue in men due to hormonal or structural causes. In fat-dominant cases, liposuction alone is used; if glandular tissue is prominent, gland removal through a small incision at the edge of the areola is added.
Wearing a compression vest for 3–4 weeks after surgery produces a flat, firm chest contour.
In the preliminary assessment, whether the breast enlargement is mainly fat or glandular tissue is determined by examination and, if needed, ultrasound; this distinction determines the technique. Enlargement that has been present for a limited time, dates from puberty, and is not caused by medication or hormones is a suitable candidate for surgery. When glandular tissue is removed, a thin layer of tissue is left beneath the nipple to prevent a sunken look; in patients with widespread excess fat, the chest contour is blended into the surrounding areas with liposuction.
- ✓Hidden incision at the edge of the areola
- ✓Permanent result
- ✓Quick return to work
Suitability
Who is it suitable for?
May be suitable
- ✓Men with breast enlargement that has not regressed for at least one to two years after puberty is complete.
- ✓Those who feel fullness in the chest area and a firm gland beneath the nipple despite a stable weight.
- ✓People near their ideal weight who are bothered by the appearance of their chest in T-shirts and during exercise.
- ✓Patients left with sagging and excess skin in the chest after significant weight loss.
- ✓Those whose hormone tests are normal or whose underlying cause has been treated.
Should be postponed or is not suitable
- —Because enlargement during puberty usually regresses on its own, surgery is not recommended before development is complete.
- —If a triggering substance such as anabolic steroids or certain stomach and heart medications is still being used, that cause is eliminated first.
- —In one-sided, rapidly growing, painful enlargement or enlargement accompanied by nipple discharge, hormone and imaging tests are completed first.
- —If there is significant excess weight, the result of surgery done before approaching the target weight cannot be fully assessed.
The final decision on suitability is made after a physician examination and tests.
Process
How does it proceed, step by step?
- 01
Initial consultation
A first idea about the fat-versus-gland distinction is given from photographs, duration, medication, and weight history.
- 02
Tests and planning
In Istanbul, an examination and, if needed, ultrasound and hormone tests are done. Liposuction areas and the gland-removal incision are marked while standing.
- 03
Procedure day
Under general anesthesia or sedation, fat is removed with liposuction, and if needed, glandular tissue is removed through an incision at the edge of the areola. Most patients are discharged the same day.
- 04
First check-up
The next day the dressing is checked, the compression garment is fitted correctly, and any drain is removed.
- 05
Pre-departure check-up
The incision and chest contour are assessed; a schedule for garment use, exercise, and scar care is given.
- 06
Remote follow-up
The resolution of swelling and the contour are monitored with photographs; the pathology result for the glandular tissue is shared.
Recovery
Recovery timeline
Day 1
Burning and a feeling of tightness in the chest are normal; the compression garment is worn continuously, and short walks begin.
Days 3–5
Bruising and swelling are at their most noticeable; fluid leakage from the liposuction areas is normal in the first days.
Week 1
You can return to desk work. The garment is worn day and night, and movements that strain the chest muscles are avoided.
Month 1
Garment use is completed or reduced to daytime only. Walking and light cardio are allowed.
Month 3
Swelling has largely subsided and the contour becomes defined. Chest and weight training begin gradually.
Month 6
Skin retraction is complete and the scar around the areola fades. The lasting result is judged at this stage.
Timeframes are averages; they vary by person and by the scope of the procedure.
Results
Before / After
Before and after examples of Gynecomastia are shared during the consultation.
We show our patients' photos only within the scope of their written consent and in one-on-one consultations; we respect the wishes of patients who prefer not to be published on the open internet. Let us send you results from cases similar to yours together with the physician's assessment.
Let us be open
Risks and points to consider
Every medical procedure carries risks. The points below are the main known issues for this procedure; a risk assessment specific to you is made during the consultation.
- If too much tissue is removed beneath the nipple, a sunken look (crater deformity) can form; it is difficult to correct.
- Blood accumulation (hematoma) and seroma; these are the most common early problems in outpatient surgery and may require drainage.
- Reduced sensation in and around the nipple; it usually resolves within months.
- Contour irregularity, a difference between the two sides, or loose skin in the liposuction area; with significant excess skin, additional skin removal may be needed.
- Some return of the enlargement if the glandular tissue was not fully removed or the triggering cause continues.