Gynaecomastia Surgery Explained by a Harley Street Surgeon: Real Case, Real Results
I’m a cosmetic surgeon based on Harley Street, London, and I’m board-certified in cosmetic surgery. Over the past 10 years, I’ve performed more than 5658 gynaecomastia surgeries.
Gynaecomastia refers to the development of enlarged male breast tissue. The term comes from “gyno” (meaning female) and “mastia” (meaning breast). This condition can range from mild puffiness around the nipple to fully enlarged breast tissue with excess skin.
How Gynaecomastia Affects Men
Gynaecomastia affects patients in more ways than people often realise. Simple, everyday activities, like wearing a t-shirt, going to the gym, taking your top off before swimming, or even socialising, can become major sources of anxiety.
Why I Specialise in This Surgery
I chose to specialise in gynaecomastia surgery because of the positive impact it has on people’s lives. The feedback from patients has been incredibly moving, many share how, after surgery, their confidence improves, they feel freer in their daily lives, and they can finally wear clothing they’ve always avoided.
Some write back telling us they’ve gone swimming for the first time in years or worn outfits they used to be self-conscious about. The emotional and mental transformation is just as powerful as the physical one.
My Personal Approach to Gynaecomastia Surgery
Each gynaecomastia case is different. That’s why my approach is always tailored to the individual.
Some patients need gland removal only. Others require liposuction, or a combination of both. In some cases, patients may need skin tightening, contouring of the chest, or skin excision. More severe cases may even require nipple repositioning, which involves larger incisions.
There is no one-size-fits-all solution. Every patient receives a plan based on their unique anatomy and goals.
A Real Patient Case: John’s Surgery Day
Today we’re operating on John, a professional athlete in his 20s who has struggled with gynaecomastia for several years. He also has a history of anabolic steroid use, which may have contributed to the condition.
Because he’s in excellent shape and has low body fat, liposuction isn’t needed. We’ll focus solely on removing the glandular tissue.
Surgical Plan and Procedure
Here’s what we’re doing:
Local Anaesthetic Injection – We begin by injecting local anaesthetic around the gland.
Small Incision – A tiny cut is made along the lower border of the areola, where the darker skin meets the lighter skin.
Gland Removal – We carefully cut around the gland, avoiding the muscle beneath. The tissue is removed smoothly and cleanly.
Stitching – Once we’re satisfied with the contour and have checked for bleeding, we close the incision using resorbable stitches.
I often refer to the gland tissue as “goat cheese” because of the texture, it used to remind me of scallops.
The Second Side
We repeat the same process on the opposite side:
Local anaesthetic is injected.
A small incision is made.
The gland is carefully dissected and removed.
We check for bleeding, then close with internal stitches.
The outcome is a flat, contoured chest with minimal scarring thanks to the precision of the incision placement.
Recovery and the Importance of Compression
Immediately after surgery, the chest will appear slightly swollen, that’s due to the local anaesthetic. But as the swelling subsides, the contour will improve dramatically.
A crucial part of recovery is the compression vest. We start with an elastic bandage for the first two days, followed by a surgical-grade compression vest for two weeks.
The vest supports healing by:
Reducing swelling
Preventing fluid build-up
Helping maintain the new chest shape
Some patients, especially those who have had liposuction or skin excision, may need to wear it for longer, sometimes up to two months.
Can You See the Vest Under Clothing?
Many patients ask if the compression vest is noticeable under clothing. In most cases, it’s completely discreet. You can easily wear it under a shirt or t-shirt and go to work or social settings without anyone noticing.
Final Thoughts
Gynaecomastia surgery can be life-changing. Whether the cause is hormonal, genetic, or due to steroid use, this condition can severely impact confidence and quality of life.
If you’re struggling with gynaecomastia, I encourage you to reach out and explore your options. We’re here to help, and no question is too small.
Contact us here to book a free video consultation directly with Dr Hassan Nurein.