Gynecomastia Surgery

What is gynecomastia?

Gynecomastia is the enlargement of male breast tissue, resulting in a feminine chest appearance. It can be caused by hormonal changes, certain medications, weight gain, or genetic factors. Gynecomastia surgery removes excess breast tissue and/or fat to create a masculine chest contour.

Gynecomastia is among the most common endocrine findings in men; it is transient in many adolescents and resolves spontaneously. However, gynecomastia persisting into or developing in adulthood often requires surgical treatment. The psychological impact can be significant — inability to remove a shirt, avoidance of beach activities, and social anxiety are typical complaints.

Who is a candidate?

Men who are bothered by enlarged breast tissue, are at or near their ideal weight, and whose breast development has stabilized. A hormonal evaluation is performed before surgery to rule out underlying causes.

Pseudogynecomastia (fat only — no true breast tissue) must be distinguished from true gynecomastia (gland tissue present) preoperatively. This distinction determines surgical technique. Underlying causes — hormonal (testosterone deficiency, estrogen excess), medication-related (steroids, certain antidepressants, finasteride, etc.), liver/kidney disease, or tumor — must first be evaluated medically.

How is the surgery performed?

Depending on the severity, gynecomastia surgery may involve liposuction, glandular tissue excision, or a combination of both. In mild cases, liposuction alone may suffice. For significant glandular tissue, a small incision around the areola is made to remove the tissue. The procedure takes 1-2 hours under general anesthesia.

Pull-through technique: Among the advanced techniques preferred in modern gynecomastia surgery. In this method, gland tissue is pulled out through liposuction incisions; no prominent areolar incision is needed, and the resulting scar is minimal.

Grades of gynecomastia

Grade 1: Mild enlargement, no excess skin. Grade 2: Moderate enlargement, slight skin excess. Grade 3: Significant enlargement with skin excess. The surgical approach is planned according to the grade.

The Simon classification is the standard system in clinical practice. Grade 1 and 2A cases may be addressed with liposuction or pull-through technique alone; Grade 2B and 3 cases may require prominent areolar incision with gland excision and skin resection. In Grade 3 cases, free nipple grafting may be required as in breast reduction surgery.

Preoperative preparation

Smoking should be stopped at least 4 weeks before surgery. Preoperative evaluation includes hormone profile (testosterone, estradiol, prolactin, LH, FSH, TSH). Liver and kidney function tests may be requested. All medications (especially steroids and hormonal medications) are reviewed in detail.

Recovery timeline

First week: Compression vest worn 24/7. Office workers return at 5-7 days. Showering possible from day 2.

Weeks 2-4: Compression vest continues. Light walking and daily activities.

Weeks 4-6: Light exercise begins.

Weeks 6-8: Vigorous exercise and upper-body workouts can resume.

Months 3-6: Final result. Skin completes adaptation to its new shape.

Risks and complications

Early-period: hematoma, seroma, infection, transient sensory changes, asymmetry. Late-period: contour irregularity (especially with insufficient/excessive resection), recurrence (in hormonally driven cases), scar issues.

Gynecomastia surgery in Istanbul — Assoc. Prof. Dr. Ayhan Işık Erdal's practice

Dr. Erdal's private clinic is located in central Istanbul, in the Nisantasi district. Address: Teşvikiye Cad. No:9/12, Istanbul. The clinic is easily accessible from major Istanbul hotels and from Istanbul Airport (IST) and Sabiha Gökçen Airport (SAW).

Gynecomastia is a psychologically sensitive surgery for male patients; patient confidentiality and a premium clinic setting are important. Istanbul has become a leading destination for gynecomastia surgery internationally, attracting patients from Europe, North America, the Middle East, and Asia for the combination of board-certified plastic surgeons, modern accredited hospitals, competitive pricing, and structured medical tourism support.

Dr. Erdal's Istanbul practice provides international patients with seamless coordination including video consultation prior to travel, airport-hotel transfer, English-speaking medical team, accommodation at partner hotels, and full postoperative follow-up. The Simon classification is performed in consultation, hormonal evaluation is planned, and surgical technique (liposuction, pull-through, gland excision, skin resection) is determined. Hospital partners are accredited facilities in central Istanbul. Patients typically stay in Istanbul for 7-10 days following gynecomastia surgery. WhatsApp consultations are available at +90 544 850 72 32 for international inquiries.

Frequently Asked Questions