Gynecomastia Surgery in Cyprus

Gynecomastia is the medical term for abnormal enlargement of the male breast. It involves the development of actual breast tissue, not simply excess fat — and that distinction is the whole of the surgical decision.

Up to 70% of males experience some degree of breast enlargement at some point in their lives. It carries no physical health risk in itself, and its correction is not a medical necessity, but it is a common source of distress: patients avoid exposing the chest at the gym or on the beach, and avoid close-fitting shirts.

Breast enlargement during puberty commonly resolves on its own. Up to 70% of adolescent males between 13 and 17 have bilateral enlargement, and it usually settles within six months to two years as hormone levels stabilise. In adults, by contrast, it rarely resolves with time.

Gynecomastia and pseudogynecomastia

The two conditions look similar and are treated differently.

Pseudogynecomastia

Pseudogynecomastia is an accumulation of fat in and around the nipple and breast, which gives the male chest a female contour. There is no excess glandular tissue.

It is treated with power-assisted liposuction. Small incisions are made near the breast or beneath the areola, a cannula is introduced, and suction is used to remove fat cells and sculpt the area. Liposuction does not remove or tighten skin, so it is appropriate only where breast development is minimal to moderate. It leaves minimal scarring on the chest, which becomes less noticeable over time. Drains are placed on each side to collect excess blood and fluid, and are removed the following day without pain.

True gynecomastia

True gynecomastia is excess glandular breast tissue, and it requires surgical excision combined with liposuction. Fibrous glandular tissue is stronger and more compact than fatty tissue, so liposuction removes the fat and leaves the denser gland behind.

A small semi-circular incision is made around the areola. The firm breast tissue and the fat beneath the areola and across the breast are removed. The scar sits in the outline of the areola.

Where there is loose skin, it is excised and redraped, and the nipple-areola complex is resized and repositioned higher on the chest. In selected cases some of the removed fat is reinjected to sculpt the chest — a small amount of fat grafting directly beneath the nipple-areola complex and in areas prone to later contour deformity.

Symptoms

• Accumulation of fat around and behind the nipples
• Swelling or protrusion of the nipples
• Asymmetry or disproportion between the two sides
• Excess glandular tissue
• Breast tenderness

What causes gynecomastia

Hormonal imbalance

The most common cause is an imbalance between oestrogen, which drives breast development, and testosterone. Periodic surges in oestrogen production occur during puberty and again after the age of 50, and these trigger temporary growth of the breast gland. As men age they produce less testosterone and retain more fat in the chest.

Obesity

Significant weight gain produces excess fat in the chest. Fat deposits alter hormone balance and stretch the skin over the pectoral muscles. Regular exercise and diet may help, but they do not always improve the condition.

Health conditions

• Hyperthyroidism, where the thyroid produces increased levels of thyroxine
• Hypogonadism, including Klinefelter syndrome, which disturbs testosterone
• Kidney failure — gynecomastia occurs in patients on dialysis
• Liver cirrhosis, and the medication used to treat it
• Malnutrition, where inadequate nutrition lowers testosterone
• Tumours
• Weak oestrogenic activity, which can be enhanced by herbal products such as tea tree and lavender in shampoos, soaps and body lotions

Substance use

Anabolic steroids lead to breast enlargement as the body converts them to oestrogen, and the gynecomastia persists after the steroids are stopped. Chronic alcohol intake causes weight gain and so excess fatty tissue. Regular use of amphetamines, cannabis, heroin and methadone damages the liver and kidneys and reduces the body’s ability to metabolise oestrogen.

Prescription medication

Gynecomastia can be a side effect of medication for prostate conditions and anxiety, of anti-androgens, antibiotics, cardiac drugs, ulcer treatments and chemotherapy.

Recovery

An overnight stay is sometimes required. A supportive vest-like garment is worn for four weeks after surgery to reduce swelling and support the chest contour.

Bruising and swelling are expected. Discomfort is usually minimal and manageable with oral pain medication, resolving within two to three weeks. Most patients return to work in under a week, resume light exercise at two to three weeks, and strenuous activity such as overhead lifting after five weeks.

The result is typically visible immediately. Fine scars may still be slightly pink at around six weeks, and settle until they are almost invisible by a year after surgery.

Keep the incisions out of direct sun for at least six months to a year — tanning causes hyperpigmentation, a semi-permanent darkening of the scar. Sunblock should be applied even under clothing. Maintaining a stable weight protects the long-term result.

Where the surgery takes place

Dr. Stavrou performs gynecomastia surgery in accredited medical centres in Cyprus, Greece and Malta. After the procedure the patient is transferred to the recovery suite and monitored by the clinical team.