Male breast enlargement, known medically as gynaecomastia, is caused by an increase in glandular breast tissue, often combined with excess fatty tissue in the chest.

Gynaecomastia can range from a small amount of tissue beneath the nipple to more noticeable breast enlargement. It may affect one or both sides, most commonly both. Some men experience tenderness or discomfort, although this is not always present.

Most cases are related to hormonal changes, but there are several possible causes:

Hormone imbalance
An imbalance between testosterone and oestrogen can lead to breast tissue growth. While weight loss and exercise are important for general health, they do not always resolve gynaecomastia as the condition is not purely due to fat.

Puberty
Temporary breast enlargement is common during adolescence and usually resolves as hormone levels stabilise.

Older age
As men age, testosterone levels fall and body fat may increase, leading to higher oestrogen levels and breast tissue growth.

Rarer causes
Less commonly, gynaecomastia may be linked to medical conditions or certain medications. In some cases, examination and blood tests are required.

Gynaecomastia can affect confidence and body image. Some men feel self-conscious about their chest and may avoid certain clothing or social situations, including swimming or going topless.

• During puberty, gynaecomastia often improves naturally over time

• Weight loss may help if excess fat is contributing

• Medications or substances that affect hormones should be reviewed

• Surgery may be considered if reversible causes have been excluded and the condition persists

Surgery is not offered to patients under 18 years of age.

Surgical management may include:

• Liposuction

• Removal of firm glandular tissue

• Removal of excess skin

These techniques are often combined, depending on individual needs.

Liposuction works best when skin quality is good and the underlying tissue is soft. If firm glandular tissue is present beneath the nipple, liposuction alone may not be sufficient.

When firm glandular tissue remains after liposuction, it can be removed through a small incision along the lower edge of the nipple. This allows precise removal while keeping scars as discreet as possible.

Skin excision may be required in cases of significant enlargement with loose or stretched skin, often following major weight loss. While effective, this approach results in more noticeable scarring, which will be discussed fully beforehand.

At Merchant City Medical Group, we provide careful assessment, clear advice, and personalised treatment plans for patients with gynaecomastia. Our focus is on patient safety, informed decision-making, and achieving natural-looking results using appropriate, evidence-based techniques.