Stephen McCulley, Reconstructive and Aesthetic Surgeon. MBChb, FCS(SA)Plast, FRCS(plast)

How old does a patient have to be to get treatment for gynaecomastia?

As it is not unusual for teenage boys to experience changes in their breasts during puberty, therefore it is advisable to wait until development has stopped and a definite diagnosis of gynaecomastia can be made. This will generally be around the age of 18 or over.

What causes gynaecomastia?

Gynaecomastia is caused by an imbalance of hormones, where an excess of oestrogens (female hormones) outnumber the androgens (male hormones) present in the body. It is common during puberty, and will generally settle down once puberty has passed. However, true gynaecomastia is a more permanent condition as is likely to require surgery.

There are a number of things that can trigger true gynaecomastia. In some cases, it can be a side effect of illegal drug consumption (anabolic steroids and marijuana in particular), alcohol abuse or a reaction to some forms of medication (especially, anti-ulcer drugs or medication for heart disease).

It is also associated with problems with the male sex organs, especially when the condition involves decreased testosterone production. Gynaecomastia is also linked to hyperthyroisism, chronic kidney failure, and cirrhosis of the liver.

Is there an increased risk of breast cancer if I have gynaecomastia?

No, gynaecomastia does not increase the chances of a man developing breast cancer. It is important to obtain a proper diagnosis from a medical professional however, to ensure that the breasts are enlarged as a result of gynaecomastia and not breast cancer.

How much scarring can I expect from a gynaecomastia procedure?

In the majority of cases, gynaecomastia will be treated using a combination of liposuction and open surgery. The incision will be made through the border of the areola, which will help obscure the visible scarring. In time, the scar is likely to fade which will further reduce its visibility.

How do I know if I need surgery for my gynaecomastia or if I can reduce it with weight loss?

A pure case of gynaecomastia cannot be reduced by losing weight, or exercising, as the breasts are enlarged by excess glandular breast tissue rather than simply by fat. Aside from undergoing a thorough examination, the most obvious way to determine whether you have gynaecomastia is when you loose weight elsewhere on your body but the breasts remain enlarged.

What is pseudogynecomastia?

Pseudogynecomastia is when a man develops breasts as a result of being severely overweight or obese. In this case, the breasts are enlarged by excess fatty deposits, rather than by breast tissue.

Will the results from the surgery be permanent?

Yes, providing that weight stays stable, once all of the excess tissue is removed from the breast, the surgery will be permanent.