Gynecomastia (Male Breast Reduction) Correction of glandular or fatty excess in the male chest

Dr. Davide Costantino
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Gynecomastia (Male Breast Reduction)

Gynecomastia is a fairly common condition characterized by an increase in the volume of the male breast region, which may affect one or both sides of the chest. Beyond being an aesthetic concern, it can affect psychological well-being and self-confidence, influencing daily life, social relationships, and freedom in dressing or engaging in physical activity.

There are two main forms:

– True gynecomastia, caused by an increase in breast glandular tissue, often linked to hormonal changes or the use of certain medications;

– Pseudogynecomastia, characterized by an accumulation of fatty tissue in the pectoral area, more common in cases of overweight or obesity.

In some cases, both components coexist, creating a mixed condition that requires a combined approach.

Before planning the procedure, the surgeon performs a thorough clinical and instrumental evaluation, often with the support of hormonal tests and ultrasound scans, to rule out endocrine or pathological causes that might require medical rather than surgical treatment.

Goals of the procedure

Gynecomastia surgery aims to restore a harmonious, toned, and proportionate male chest profile, eliminating the glandular and/or fatty excess. The expected result is a flatter, defined, and natural chest, in line with the body’s proportions and without visible signs of surgery.

The goal is not only to improve the aesthetic appearance but also to reduce psychological discomfort and enhance quality of life, restoring confidence and freedom in movement and self-image.

Surgical technique

The technique varies depending on the nature of the excess tissue and the patient’s anatomical structure.

When gynecomastia is predominantly fatty, liposuction with microcannulas is performed, allowing for targeted removal of excess fat and redefinition of the chest contours. The incisions are microscopic and placed in hardly visible areas, such as the lower edge of the pectoral muscle or the axillary fold.

If the component is glandular, surgical excision is performed through a small periareolar incision, along the lower edge of the areola, which allows the removal of excess glandular tissue while maintaining an almost imperceptible scar.

In more complex cases — with excess skin or a combination of fat and gland — the two techniques are combined, starting with liposuction and then directly reshaping the tissue.

The procedure typically lasts between 60 and 90 minutes, performed under local anesthesia with sedation or, if necessary, under general anesthesia, and, in most cases, does not require overnight hospitalization.

Recovery time and results

After the procedure, a compression band is applied to the chest, which should be worn for 3–4 weeks to promote proper tissue adjustment and prevent seroma formation. Return to work and normal activities is rapid, usually after a few days, while it is recommended to wait 3–4 weeks before resuming sports activities.

Post-operative swelling gradually reduces over the weeks, and the result becomes fully visible after about 2–3 months, when the chest appears flatter, toned, and naturally masculine.

Possible risks, although rare, include seroma, small residual asymmetries, or temporary sensory changes in the skin, which tend to resolve spontaneously over time.

The result is stable and lasting, especially if accompanied by a healthy lifestyle and a stable body weight.