Before planning surgery, it is important to identify — and where possible address — any underlying cause of gynaecomastia.

Potential contributing factors may include:

• hormonal imbalance
• medications
• anabolic steroid use
• weight gain
• liver, thyroid or kidney disease
• rare hormone-producing tumours.

Where appropriate, further medical investigation may be recommended prior to surgery.

Gynaecomastia surgery may be appropriate for patients who:

• have persistent enlargement of the male chest
• are bothered by chest contour or nipple prominence
• experience discomfort or tenderness
• have stable weight
• have not improved with non-surgical management
• wish to achieve a flatter, more masculine chest shape.

Good candidates are generally medically well, weight stable and able to safely recover from surgery.

Factors that can affect suitability include smoking, obesity, unstable weight, anabolic steroid use, poorly controlled medical conditions and unrealistic expectations.

If these factors are relevant to you, Dr Alex Cameron and the Morphē Clinic team will work with you before surgery to help optimise your preparation and recovery.

Preparation for gynaecomastia surgery begins with careful assessment of the chest contour and the type of tissue contributing to enlargement.

During your consultation, Dr Cameron will assess:

• whether the tissue is primarily fatty, glandular or mixed
• skin quality and elasticity
• nipple position
• chest wall shape
• any asymmetry
• potential underlying causes.

Where appropriate, blood tests, imaging or further medical review may be recommended prior to surgery.

Preparation may also include smoking cessation, weight stabilisation and optimisation of any underlying medical conditions before surgery.

The goal is not simply tissue removal, but creating a natural chest contour that suits your body shape and proportions.

The most appropriate surgical approach depends on whether the enlargement is primarily due to fatty tissue, glandular tissue beneath the nipple, or a combination of both. Gynaecomastia surgery is usually performed under general anaesthetic as day surgery

For patients whose enlargement is largely fatty, liposuction alone may provide excellent contour improvement. Small incisions are used to insert fine cannulas, allowing excess fatty tissue to be removed and the chest carefully contoured. This approach generally involves minimal scarring and relatively rapid recovery.

When firm glandular tissue is present beneath the nipple, direct surgical excision is usually required. A discreet incision is typically placed around the lower border of the areola to allow dense glandular tissue to be carefully removed while preserving a natural chest contour.

Liposuction is commonly combined with glandular excision to blend the surrounding chest contour and improve overall definition.

In long-standing or more severe gynaecomastia, excess skin may remain after tissue removal. In these situations, additional skin excision or repositioning of the nipple may occasionally be required to improve chest shape and contour.

Dressings and a compression garment are applied following surgery. Compression garments are typically worn for approximately 4-6 weeks to help reduce swelling and support skin retraction during healing.

Dr Cameron performs gynaecomastia procedures at Burnside Hospital, St Andrew’s Hospital or Glenelg Community Hospital.

Gynaecomastia surgery can significantly improve chest contour, nipple prominence and overall chest definition.

Most patients notice:

• a flatter chest contour
• reduced nipple prominence
• improved shirt fit
• greater comfort during exercise and physical activity
• improved confidence in fitted clothing and social situations.

The goal is to create a chest contour that looks natural and masculine rather than over-operated or excessively hollow.

The final result depends on factors such as:

• skin quality
• chest wall shape
• tissue composition
• degree of enlargement
• healing characteristics.

In patients with significant skin excess or reduced skin elasticity, some residual looseness may persist and additional skin tightening procedures may occasionally be required.

For many men, surgery also leads to meaningful improvements in confidence, posture and participation in physical and social activities.

Recovery following gynaecomastia surgery is usually straightforward, although swelling, bruising and tightness are expected during the early healing period.

Most patients experience mild to moderate discomfort during the first one to two weeks after surgery. Pain is generally manageable with simple pain relief such as paracetamol and anti-inflammatory medication, with stronger prescription pain relief used when required.

Swelling and temporary firmness beneath the skin are common and gradually improve over several weeks to months.

Swelling and temporary firmness beneath the skin are common and gradually improve over several weeks to months.

Compression garments are worn continuously for approximately four to six weeks to help reduce swelling, support contour healing and improve skin retraction.

Temporary numbness or altered nipple sensation is common and usually improves gradually over time.

Small scars typically heal very well and are usually difficult to notice once fully healed.

Follow-up appointments are scheduled throughout your recovery, and Dr Cameron is happy to review you at any stage if you have concerns.

As a general guide, most patients are able to return to regular activity as follows:

• Walking and light activity: within several days
• Desk-based work: usually 1 week
• Light exercise: around 2 weeks
• Gym and upper body exercise: around 4–6 weeks
• Swimming: around 4 weeks
• Heavy lifting: around 4–6 weeks
• Driving: usually several days to 1 week, provided you are comfortable and not taking sedating pain medication.

All surgery carries some degree of risk. These risks are reduced through careful preparation, surgical planning, post-operative care, and the experience and judgement of Dr Cameron and the Morphē team.

General risks associated with surgery will be discussed with you before your procedure.

Risks specific to gynaecomastia surgery may include:

• Swelling and bruising. Swelling and bruising are expected and usually improve over several weeks.
• Contour irregularity. Minor irregularities or asymmetry can occur, particularly in patients with significant glandular tissue or reduced skin elasticity.
• Residual fullness. Some residual tissue fullness may persist depending on tissue type and chest anatomy.
• Altered sensation. Temporary numbness or altered nipple sensation is common and usually improves over time. Permanent sensory change is uncommon but possible.
• Scarring. Scars are generally small and well concealed, although scar quality varies between individuals.

Risks specific to gynaecomastia surgery may include: (cont.)

• Skin laxity. In patients with poor skin elasticity or severe gynaecomastia, residual loose skin may persist after surgery and further skin tightening procedures may occasionally be required.
• Haematoma. Bleeding beneath the skin can occur and occasionally requires return to theatre for drainage.
• Recurrence. Recurrence of gynaecomastia is uncommon, but can occur if underlying hormonal causes persist or anabolic steroid use continues.
• Need for revision surgery. Further surgery is occasionally required to improve contour, asymmetry or residual tissue fullness.