Mr Ken Stewart
Consultant plastic surgeon
GMC 3499203
Gynaecomastia surgery in Edinburgh
Enlargement of the male breast — gynaecomastia — affects up to 50% of men at some point, and for many it is a longstanding source of self-consciousness. Quaba Plastic Surgery has treated gynaecomastia in Edinburgh for over 30 years. Surgery is performed by consultant plastic surgeons on the GMC Specialist Register at Waterfront Private Hospital, using liposuction, gland excision, or skin removal depending on the nature of the enlargement.
- Anaesthetic
- General anaesthesia, or local anaesthesia for smaller areas
- Length of surgery
- 1-2 hours
- Hospital stay
- Day case at Waterfront Private Hospital
- Recovery
- 1-2 weeks off work, 6 weeks before strenuous exercise
- Guide price
- from £5,800
- Consultant plastic surgeons on the GMC Specialist Register
- Surgery at Waterfront Private Hospital, regulated by Healthcare Improvement Scotland
- Your consultation and your operation with the same consultant
Contents
Results from our patients
Liposuction and gland excision for gynaecomastiaGynaecomastia surgery for long-standing chest asymmetrySkin removal from chest with free nipple grafting and abdominoplastySee all 21 gynecomastia results
Real patients, shared with their consent and not retouched. Results vary from person to person.
What patients say
★★★★★
very professional sound people felt like i was in good hands throughout the whole process (had gyno surgery and would totally recommend Dr Omar Quaba)!
★★★★★
Thank you team waterfront.
From consultation with Omar , pre op phone calls to surgery day with Omar every stage and every person made me feel at ease and important. Staff extremely professional.
I’m very happy with my results, just had my 6 check.
Thank you to Omar and team Waterfront.
★★★★★
Mr Quaba made me feel very at easy and he was very easy to talk to regarding issues concerns and made the whole experience so much easier and better. Couldn’t fault.
Quoted word for word from Trustpilot. Read all our reviews
Is it right for me?
Gynaecomastia surgery suits men over 18 whose breast enlargement has persisted after reversible causes have been ruled out, and who remain self-conscious about their chest.
- You are over 18. During puberty gynaecomastia usually improves on its own as hormone levels stabilise, so surgery is not offered earlier.
- You are at or near a healthy, stable weight. If you are overweight, losing weight may itself improve the enlargement.
- You are not using medications or substances that contribute to breast enlargement, such as anabolic steroids.
- Your expectations are realistic about scars, recovery, and the degree of correction possible.
Where a hormonal or medical cause is suspected, examination and blood tests are arranged before any decision about surgery. If your gynaecomastia is mild, or likely to resolve on its own, the honest advice can be to wait.
Unsure? Try the free AI consultation, or ask at your appointment.
What gynaecomastia surgery involves
Gynaecomastia surgery removes the excess fatty and glandular tissue that creates the appearance of male breasts. Surgery takes place at Waterfront Private Hospital under general anaesthesia — or local anaesthesia for smaller areas — and takes 1 to 2 hours as a day case.
The first step at consultation is making sure there is no reversible cause for your gynaecomastia. Once you have been examined, your options are discussed in full. The approach is to avoid large scars on the chest wherever possible: liposuction is performed thoroughly, and for some patients liposuction alone is enough. Where firm breast tissue remains, a small semi-circular cut is made around the bottom half of the nipple and the firm tissue is removed through it.
If you have a lot of loose skin — common after significant weight loss — a skin-removal procedure may be required. This leaves more obvious scars on the chest and is only recommended where the skin will not retract on its own.
Liposuction, gland excision and skin removal
There are three surgical options for treating male breast enlargement (gynaecomastia), used alone or in combination:
- Liposuction: removes excess fatty tissue through small incisions. It works well where the skin quality is good and the breast tissue is not too firm.
- Gland excision: removes firm glandular tissue through a small semi-circular incision around the lower half of the nipple, usually after liposuction.
- Skin removal: for severe enlargement with loose skin. It removes the excess skin at the cost of more noticeable scarring across the chest.
The treatment choice depends on the nature of the enlargement — the firmness of the breast tissue and whether loose skin is present. A good cosmetic outcome is very much dependent on surgical technique, and the main surgical risks include removing too much or too little tissue and unevenness.
What gynaecomastia surgery can and can't do
Gynaecomastia surgery removes the fat, gland and, where needed, skin that give your chest a breast shape. Most men end up with a flatter chest, but not always a perfectly flat one, and the result depends on what is causing the enlargement.
It can
- Remove excess fat with liposuction and firm gland tissue from behind the nipple.
- Remove loose skin where there is a lot of it, in exchange for longer scars.
- Give you a flatter chest, so fitted clothes and T-shirts sit better.
- Ease chafing and sensitivity in the area.
- Reduce a difference between the two sides.
It can’t
- Give every man a perfectly flat chest. Where the skin is loose, it may not shrink back fully, especially if the enlargement has been there for years.
- Avoid visible scars if skin is removed. Skin removal leaves scars across the lower chest. They fade but are permanent.
- Stop it coming back if the cause continues. Weight gain, anabolic steroids and some medicines can bring the enlargement back.
- Replace weight loss. Surgery treats a chest that has been stable for a year or more, and works best when you are close to your ideal weight.
- Make both sides identical. A small difference usually remains.
Your consultant will tell you at your consultation which of these apply to you.
Body image and how you’re feeling
Surgery for gynaecomastia is a decision about how you feel as much as how you look. If worries about your appearance have been affecting your daily life or mood, it can help to reflect on that before your consultation. The BDD Foundation, a UK charity, hosts a short, confidential self-assessment you can take in a few minutes.
What is the cost of gynaecomastia surgery?
The full price for your individual case can only be confirmed after a face-to-face consultation with the consultant who will perform your surgery. Our consultation fee with a consultant plastic surgeon is £200. Where a further consultation would help you reach a decision, this is offered without additional charge.
Quick answers
Will the same surgeon plan, perform and review my gynaecomastia surgery?
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?
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?
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?
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?
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?
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?
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?
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?
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?
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?
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?
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?
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.
Risks, and how often they happen
Every operation carries risk. Here they are in three groups. The figures come from UK national guidance and published studies, averaged across many patients, so your own risk may be higher or lower. Your consultant will go through what applies to you, and every risk is in your written consent.
- Expected
- Uncommon
- Rare
- For the long term
Expected Almost everyone, and they settle
- Swelling and bruising, most noticeable in the first ten days and settling over the following month.
- A tight, sore feeling across the chest, improving within the first week.
- Numbness or changes in sensation around the nipple and chest, usually temporary.
- A chest that feels lumpy and firm for several months, with the final contour judged at around six months.
- Small scars at the lower edge of the areola and where the liposuction cannula goes in, and longer scars if skin is removed.
Uncommon Some patients, and some need further treatment
- Bleeding under the skin (haematoma), which may need draining or a return to theatre.
About 1 in 20
- Fluid collecting under the skin (seroma), which may need draining.
About 1 in 30
- An uneven chest, or too little or too much tissue removed, leaving some fullness, lumps or a hollow behind the nipple, which may need a further procedure.
About 1 in 30
- Infection, which is rare after this operation and usually settles with antibiotics.
- Scars that thicken or redden (hypertrophic or keloid scars), more likely on the chest.
Uncommon
Rare but serious
- Loss of skin around the nipple if its blood supply is affected.
Under 1 in 100
- A blood clot in the leg or lung (DVT or PE), mainly if you have a general anaesthetic. We assess your risk and take steps to prevent it.
Under 1 in 1,000
- A serious reaction to the anaesthetic, if you have a general anaesthetic.
Very rare
For the long term
- Keep your weight stable. New fat can build up if you gain weight, and anabolic steroids or some medicines can cause new gland tissue.
- Your final shape takes three to six months as swelling settles and the skin tightens; where there was a lot of loose skin it may not tighten fully, and you will be shown examples at consultation.
- A further procedure is sometimes needed for the best result, for example to remove a little more tissue or tidy a scar.
More from BAAPS on male chest reduction.
Where these figures come from
- Innocenti et al., Aesthetic Plast Surg 2022For: Haematoma; Seroma; Contour irregularity, under- or over-resection; Nipple-areola skin loss; Sensation change and revision
- Winocour et al., Aesthet Surg J 2017;37(3):337-349 (CosmetAssure database)For: DVT or PE
- Worcestershire Acute Hospitals NHS Trust, Mastopexy or breast reduction patient leafletFor: Serious anaesthetic reaction
Aftercare and recovery after gynaecomastia surgery
Discomfort
Discomfort
Some discomfort is typical in the first few days after surgery. You may experience some numbness around your nipples and incision areas. You may experience temporary soreness, tightness and swelling, and discomfort in the incision areas. Your breasts may be sensitive to stimulation for a few weeks.
Bruising and swelling
Bruising and swelling
Your chest may feel tight and swollen for several days, and bruising is expected. The bruising gets worse before it improves and may track downwards – this is normal.
If you have had extensive liposuction, your chest may swell significantly after a few days and feel firm. The swelling is due to a mixture of blood and tissue fluid and can take several weeks to settle down.
Residual lumps and firmness
Residual lumps and firmness
It is common to feel areas of hardness, which can take up to six months to settle down.
Appearance
Appearance
Most of the discolouration and swelling will subside in 4-6 weeks.
Any scars you have may be red and angry looking for six months. In time, these usually soften and fade.
Most men return to desk-based work within 1 to 2 weeks and resume strenuous exercise at six weeks. The common early effects — discomfort, bruising, swelling, and areas of firmness — are set out above.
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.
If you have had male breast reduction surgery with us or are considering it, detailed instructions and advice are available on the gynaecomastia aftercare page.
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