There are four grades of gynecomastia depending on the size of the breast tissue and the amount of skin (Simon Classification).
As part of the pre-operative work up, a full endocrine (hormonal) screen will be employed to ensure there are no underlying causes. A baseline ultrasound scan may also be performed to ensure it is true gyaecomastia (glandular tissue as opposed to pseudo-gynaecomastia which is adipose or fat tissue).
An ultrasound scan will clearly delineate and establish the size of the glandular tissue as well as exclude the presence of any suspicious mass within the breast tissue. Surgery in true gynecomastia entails liposuction and then removal of the glandular tissue immediately after the liposuction. This is usually reformed through an incision placed from 3 to 9 o’clock at the nipple areolar -skin interface. This produces a faint final scar, which is not usually noticeable. The fat under the nipple is also mobilised to prevent any depressions being visible beneath the nipple.
In some circumstances, it may be necessary for skin to be removed. It is necessary to wear a support garment for a period of six weeks post-operatively.