What is gynecomastia?
Gynecomastia is the benign enlargement of breast tissue in males. It affects men of all ages — from adolescents going through puberty to older adults — and is far more common than many realise: studies suggest that up to 60–70% of adolescent boys experience some degree of physiological gynecomastia, and prevalence remains high in adult men. Despite being physically harmless, gynecomastia frequently causes significant psychological distress, affecting self-confidence, social behaviour (avoiding swimming pools, beaches, fitting clothes, or the gym) and emotional wellbeing.
When gynecomastia persists beyond two years after puberty, does not resolve with treatment of any underlying cause, and causes genuine distress, surgical correction is the most reliable and definitive solution. Dr. Galati performs gynecomastia surgery using a combination of glandular tissue excision and liposuction, tailored to each patient's specific anatomy — achieving a flat, natural-looking masculine chest contour.
True gynecomastia vs. pseudo-gynecomastia
- True gynecomastia: enlargement of the actual mammary glandular tissue, which is firm and disc-like beneath the areola. Glandular tissue cannot be removed by liposuction alone — direct excision is required.
- Pseudo-gynecomastia: excess fatty tissue in the chest without true glandular enlargement. Common in overweight men. Treated effectively with liposuction.
- Mixed gynecomastia: a combination of glandular and fatty excess — the most common presentation. Requires both excision and liposuction for optimal results.
Surgical technique
Gynecomastia surgery is performed under general anaesthesia (or in selected cases under local anaesthesia with sedation) and takes approximately 1–2 hours as a day-case procedure. The approach depends on the degree of glandular and fatty involvement:
- Glandular excision: a periareolar incision (along the lower border of the areola) allows direct removal of the glandular disc. The incision is hidden at the areola-skin junction. A small amount of tissue is always left beneath the nipple to prevent contour depression.
- Liposuction: performed through tiny stab incisions to remove associated fatty tissue, refine the lateral chest borders, and create smooth, natural transitions. Ultrasound-assisted (VASER) liposuction can be particularly effective for fibrous fatty tissue.
- Skin reduction: in cases of significant skin excess (Grade III–IV gynecomastia), additional skin removal may be needed, with incisions planned to be as inconspicuous as possible.
Recovery timeline
- Days 1–3: moderate discomfort controlled with analgesics; compression vest worn continuously
- Day 5–7: most patients feel comfortable resuming light activity and desk work
- Day 10: sutures removed; compression vest continues
- Week 2–4: swelling and bruising gradually resolve; result becoming clearly visible
- Week 4–6: compression vest discontinued; gym and light upper-body exercise can resume
- Month 3–6: scars mature; final chest contour fully established
Contact sports and heavy weightlifting should be avoided for at least 4–6 weeks. Any underlying hormonal conditions or causative medications should be addressed before surgery to prevent recurrence.
Gynecomastia surgery in Italy — why choose Dr. Galati?
Dr. Galati understands the sensitivity of gynecomastia as a condition and approaches each consultation with discretion, empathy and clinical thoroughness. His pre-operative protocol includes a hormonal assessment and breast ultrasound to exclude any underlying treatable cause before planning surgery. With over 20 years of plastic surgery experience and clinics in Lecce, Parma and Milan, he has helped hundreds of men regain confidence and comfort in their bodies. International patients are warmly welcomed — the entire care pathway from consultation to follow-up can be coordinated by our team.
Contact us confidentially at info@clinicachirurgiaplastica.it or call +39 320 300 5007.
Frequently asked questions
Gynecomastia is caused by an oestrogen-testosterone imbalance. Common triggers include puberty, certain medications (anabolic steroids, antihypertensives, antidepressants), recreational drugs (cannabis, alcohol), hormonal conditions, and obesity (pseudo-gynecomastia). A pre-operative hormonal assessment rules out underlying treatable causes before surgery.
True gynecomastia involves enlargement of the mammary gland itself — firm and disc-like beneath the areola — requiring direct excision. Pseudo-gynecomastia is excess chest fat without glandular enlargement, treated with liposuction. Many patients have both.
The glandular excision incision is placed along the lower border of the areola, where it blends naturally with the colour change between areola and skin. Liposuction entry points are 3–4 mm. Both heal to a fine, barely visible line within a few months.
Removed glandular tissue does not regenerate. However, if the underlying hormonal cause is not addressed (e.g., continued steroid use), new breast tissue can form. Significant weight gain can also cause recurrence of fatty pseudo-gynecomastia. Managing lifestyle and underlying causes gives long-lasting results.