Will the same surgeon plan, perform and review my gynaecomastia surgery?

Yes. The consultant who assesses you at your first appointment is the consultant who plans your surgery, performs it at Waterfront Private Hospital, and reviews you afterwards. There are no handovers between consultants.

What happens if I have concerns after my surgery?

A nurse reviews you at one week, and more often if needed in the early healing period. Your consultant sees you again at around six months once the result has settled. Between then, your consultant is always available — if anything concerns you, they will respond directly and arrange to see you as soon as needed.

How much does gynaecomastia surgery cost?

Gynaecomastia surgery at Quaba starts from £5,800 under local anaesthesia, from £6,800 for liposuction with or without gland excision under general anaesthesia, and from £9,400 where skin removal is needed. Each price covers the surgeon's fee, the anaesthetist's fee where applicable, the hospital and theatre fee at Waterfront Private Hospital, and all post-operative reviews until you are fully discharged.

What is male breast enlargement?

Enlargement of male breasts is a condition medically known as gynaecomastia. It occurs as a result of enlargement of the glandular tissue and excess fatty tissue in the male breast.

What are the features of gynaecomastia?

Signs vary from a small amount of extra tissue around the nipples to more prominent breasts. It can affect one or both breasts but usually affects both. The breast tissue may be tender or painful, but this isn't always true.

What are the causes of gynaecomastia?

Gynaecomastia can have several causes. Most cases are physiological (hormonal). Hormone imbalance An imbalance between the sex hormones testosterone and oestrogen can cause gynaecomastia. Oestrogen is the hormone that causes breast tissue to grow. All men have some oestrogen production, but they usually have much higher levels of testosterone, which counteracts the effects of oestrogen. When the balance of oestrogen and testosterone changes, it can cause a man's breasts to grow. Usually, the cause of this imbalance is unknown. Losing weight or doing more exercise will often not improve things as the condition is not caused by excess fat but excess breast tissue. Puberty During puberty, boys' hormone levels vary. Many teenage boys have some breast enlargement. Gynaecomastia at puberty usually clears up as boys age, and their hormone levels stabilise. Older age As men get older, they produce less testosterone. Also, older men have more body fat, and this can cause more oestrogen to be produced. These changes in hormone levels can lead to excess breast tissue growth. Rarer causes There are rare causes of male breast enlargement (such as testicular tumours, liver failure or certain medications) and sometimes a medical examination and blood tests may be needed.

Why do some men consider cosmetic surgery?

Some men may feel they wish to have gyno surgery as they feel embarrassed about their breasts. Name-calling and teasing are common among teenagers, and many men feel embarrassed or self-conscious. Men with gynaecomastia may avoid wearing tight tops or going topless while on holiday.

What are my treatment options?

If you are going through puberty, you can be reassured that your gynaecomastia will usually improve with time. This can feel like a long time to wait, but plastic surgery is not an option until you are at least 18 years old. If you are overweight, then it is essential to lose weight. Weight loss may help resolve your gynaecomastia. Men at a healthy weight should ensure they are not using any medications or substances contributing to their breast enlargement (such as anabolic steroids). Gynaecomastia surgery may be an option if reversible causes have been ruled out and you remain self-conscious about your chest.

Is male breast reduction available on the NHS in Scotland?

Cosmetic surgery is not routinely available under the NHS in Scotland. A referral is governed by the Adult Exceptional Aesthetic Referral Protocol (AEARP). You might be a candidate for male breast reduction surgery if you have severe gynaecomastia or breast asymmetry impacting your life. See your GP to make sure that there are no reversible causes for your gynaecomastia. Your GP will carry out a physical examination and may request blood tests to check things such as your levels of testosterone. If your GP feels that your gynaecomastia is severe and will not respond to diet or exercise, they may refer you to a plastic surgeon or breast surgeon for treatment. Exclusions to referral include being overweight (Body Mass Index higher than 27) and mild enlargement. Before consideration, photos will usually be requested. If you are judged to have severe enlargment, then you may be asked to attend to see a psychologist for assessment.

How do I know if liposuction alone will correct my breast enlargement?

Liposuction works well when the quality of your skin is good (as it is in most younger men) and your skin has not been stretched significantly from earlier weight gain and loss. The main factor influencing whether liposuction will work alone without excision surgery is how firm the breast tissue is underneath the nipple. In some men, the breast tissue is so firm that liposuction may not work, and a small cut is required in the lower half of the nipple to remove the breast tissue surgically (excision surgery).

What if my breasts are firm?

If you have firm tissue just under your nipples, it is unlikely that liposuction alone will work. Liposuction can still deal with fatty tissue and help tighten the skin. Once the liposuction has been completed, a small semi-circular incision is made around the areolar. The incision lets your surgeon remove any remaining firm glandular tissue. The wounds are closed with either dissolvable or non-dissolvable stitches.

When would I need a skin excision?

You might need skin removal if you have severe breast enlargement with a lot of loose skin. If the skin is not removed in these instances, it will not stretch back and potentially leave you with loose folds of skin that look unsightly. The main disadvantage of skin removal is that it leaves noticeable scars across your chest.

Is gyno surgery the same as gynaecomastia surgery?

Yes. 'Gyno surgery' is an informal name for gynaecomastia surgery, also called male breast reduction. The operation removes excess fatty and glandular tissue — and sometimes loose skin — to flatten the chest.

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