Gynaecomastia Surgery at a Glance
| Item | Detail |
|---|---|
| Procedure | Gynaecomastia surgery, also called male breast reduction |
| Surgeon | Dr Scott J Turner, Specialist Plastic Surgeon (FRACS) |
| AHPRA registration | MED0001654827 |
| Technique | Glandular excision, power-assisted liposuction, skin excision in selected cases |
| Focus areas | Glandular tissue, fatty tissue, nipple-areola contour, chest shape |
| Anaesthesia | General anaesthesia in an accredited private hospital |
| Surgical time | Usually 1 to 2 hours, depending on complexity |
| Hospital stay | Usually day surgery |
| Compression garment | Worn after surgery, with timing set by your plan |
| Return to desk work | Often 1 to 2 weeks |
| Exercise | Heavy lifting and gym generally avoided for 4 to 6 weeks |
| Final contour | Swelling settles over 2 to 3 months or longer |
| Consulting clinics | Manly and Bondi Junction, Sydney |
| GP referral | Required |
| Medicare or private health | May apply where criteria are met, items 31525 or 31526 |
| Cost | Consultation $450, written surgical quote after consultation |
Understanding Gynaecomastia
Gynaecomastia results from an imbalance in the ratio of oestrogen to androgen action at the breast tissue level. This hormonal imbalance causes glandular breast tissue to develop, which differs fundamentally from simple fat accumulation over the chest.
True gynaecomastia involves firm glandular tissue beneath the nipple and areola. It does not respond to weight loss or exercise because it is glandular, not fatty. It is caused by hormonal imbalance and may be related to puberty, age-related testosterone decline, certain medications (including some antidepressants, antihypertensives and anabolic steroids), or various medical conditions.
Pseudogynaecomastia is fatty tissue accumulation over the chest without true glandular enlargement. This type does respond to weight loss and exercise, and is common in men who carry weight across the chest.
Mixed gynaecomastia combines both glandular and fatty tissue, and is the most common presentation in practice. Many men who lose weight find the fatty tissue reduces but a firm mound remains under the nipple. That firm mound is the glandular component, which surgery is required to treat.
This distinction matters for surgical planning: liposuction treats fatty tissue, glandular excision is required for true gynaecomastia, and most cases need both.
Causes and Contributing Factors
Gynaecomastia can develop at different life stages:
- Puberty: affects up to 70 per cent of adolescent boys, and resolves on its own in the majority within one to two years
- Middle age: associated with age-related testosterone decline and increased body fat
- Medications: anabolic steroids, certain antidepressants, antihypertensives and other drugs with known hormonal effects
- Medical conditions: liver disease, kidney failure, hyperthyroidism and others
- Substance use: alcohol, cannabis and illicit drug use
Before recommending surgery, Dr Turner reviews medical history and contributing factors. Where a reversible cause is identified, treating that first is sensible, because surgery on active, hormonally driven gynaecomastia carries a higher risk of recurrence.
Which Treatment Fits Your Anatomy?
The right approach depends on what your chest tissue is made of, which Dr Turner assesses at consultation. The table below is a general guide.
| Main concern | Likely discussion |
|---|---|
| Firm tissue beneath the nipple and areola | Glandular excision |
| Soft, fatty chest fullness | Liposuction, or a weight-management discussion |
| Mixed glandular and fatty tissue | Combined excision and liposuction |
| Significant excess skin | Skin excision may be discussed |
| Pubertal gynaecomastia | Observation or delayed surgery unless severe or distressing |
| Recurrence risk factors | Medical and endocrine review, medication review, weight stability |
When Is Surgery Appropriate?
Surgery is typically appropriate when:
- The condition has been present for more than 12 months and is not resolving
- Glandular tissue has become fibrotic and firm
- Weight loss and exercise have been tried where relevant, but the condition persists
- Physical symptoms such as pain, tenderness or skin irritation are present
- Documented psychological distress is present
- Medical causes and contributing medications have been reviewed
Surgery in adolescence is generally deferred unless the condition is severe or causing significant distress, as pubertal gynaecomastia often resolves without intervention.
Surgical Approach
Dr Turner uses a combination of techniques depending on each patient’s presentation and the grade of their gynaecomastia.
Subcutaneous mastectomy (glandular excision) removes glandular breast tissue through an incision placed along the lower edge of the areola, where it is well concealed. This is the definitive treatment for true gynaecomastia involving firm glandular tissue. The incision allows direct removal of the glandular disc without disrupting the overlying skin or the nipple-areola complex.
Power-assisted liposuction removes the fatty component of the chest wall. Dr Turner uses the MicroAire power-assisted liposuction system, which allows precise fat removal with reduced trauma to surrounding tissue. For mixed gynaecomastia, this is typically combined with glandular excision.
Skin excision is occasionally required in men with significant skin laxity after a larger volume of tissue has been removed. It is less common, and is discussed specifically where the anatomy indicates it may be needed.
Surgery is performed under general anaesthesia as a day procedure in an accredited private hospital in Sydney. Most cases take one to two hours. Patients return home the same day wearing a compression garment.
Grades of Gynaecomastia
Gynaecomastia is commonly classified using the Simon Classification:
- Grade I: small enlargement with no excess skin
- Grade IIa: moderate enlargement without excess skin
- Grade IIb: moderate enlargement with minor excess skin
- Grade III: significant enlargement with excess skin, which may require skin excision
The grade influences the combination of techniques used, and is assessed during consultation.
Reviewing Gynaecomastia Before and After Photos
Before-and-after photographs help you understand what surgery can and cannot do, provided they are reviewed carefully. When looking at gynaecomastia results, it helps to consider:
- Front, oblique and side views: the chest reads differently from each angle, so all three matter
- Nipple and areola position: that the nipple sits naturally on the chest and is in proportion
- Chest contour: a flat, even contour without obvious dips or residual fullness
- Skin laxity: how the skin has settled, particularly after a larger volume of tissue was removed
- Symmetry and scar placement: comparing both sides, and noting where the periareolar incision sits
- The starting point: whether the case involved glandular tissue, fat, skin excision or a combination, since that shapes what is achievable
You can view examples on the gynaecomastia before and after gallery. Photographs show individual results only, and are not a prediction of your own outcome, which Dr Turner will discuss against your anatomy at consultation.
Gynaecomastia Surgery Recovery
Recovery is often manageable with structured aftercare, but the timeline varies depending on the extent of gland removal, liposuction, skin excision and individual healing.
| Stage | What many men can expect |
|---|---|
| Day of surgery | Day procedure, home the same day in a compression garment, with someone to stay the first 24 hours |
| Days 1 to 5 | Chest tightness, swelling and mild discomfort, managed with medication, garment worn continuously except for showering |
| Weeks 1 to 2 | Many with desk-based work return, and the garment is usually worn for around two weeks |
| Weeks 2 to 6 | Light activity resumes gradually, with gym and heavy lifting avoided |
| 2 to 3 months | Swelling continues to settle and the chest contour becomes clearer as the skin settles |
Scarring from the periareolar incision is usually well concealed and fades over six to twelve months, though individual healing varies. Full recovery detail is available in the recovery after male breast reduction surgery guide.
Gynaecomastia Surgery Cost in Sydney
The cost of gynaecomastia surgery depends on whether the procedure involves glandular excision, liposuction, skin excision, or a combination, along with hospital fees, anaesthetist fees and the compression garment. The consultation fee is $450, and after your consultation Dr Turner provides a detailed written quote covering all surgical fees. Where strict criteria are met, Medicare items 31525 or 31526 and a private health rebate may reduce the out-of-pocket cost, though a significant gap usually remains. Purely cosmetic cases, without documented symptoms, are less likely to attract a rebate. Indicative pricing is discussed at consultation.
Medicare Eligibility
Medicare item numbers 31525 (unilateral) and 31526 (bilateral) may apply to gynaecomastia surgery where specific clinical criteria are met. The criteria require that the condition is glandular rather than purely fatty, that it has been present for a defined period, and that physical or psychological impairment is documented.
Purely cosmetic cases, where the primary concern is appearance without documented symptoms or distress, are less likely to attract a rebate. Even where Medicare coverage applies, a significant out-of-pocket gap remains. Private health insurance with appropriate hospital cover may also contribute a partial rebate on facility fees. A GP referral is required for any Medicare rebate to apply, and Dr Turner’s team can help you understand your eligibility at consultation. For more detail, see will Medicare cover my gynaecomastia surgery.
Risks and Complications
As with any surgical procedure, gynaecomastia surgery carries risks. Dr Turner provides thorough information about potential complications during consultation, including:
- Haematoma, a blood collection under the skin, which may require drainage
- Infection, uncommon, and managed with antibiotic protocols
- Seroma, a fluid collection, which may require aspiration
- Changes in nipple or skin sensation, usually temporary
- Contour irregularities or asymmetry during healing
- Scarring, where individual healing varies
- Skin necrosis, rare, with the risk significantly increased in patients who smoke
- Recurrence, uncommon but possible with significant weight gain or an unresolved hormonal cause
- The need for revision surgery
Dr Turner will discuss all risks relevant to your specific presentation, and more detail is available on the risks and complications page.
The Consultation Process
Your consultation with Dr Turner begins with a detailed history, including the duration of the condition, any contributing medications, relevant medical history, and your concerns and goals. He assesses the chest anatomy to determine the grade of gynaecomastia and the likely tissue composition, which directly informs the surgical approach.
Under AHPRA cosmetic surgery regulations, a GP referral is required before your first specialist consultation, a minimum of two personal consultations with Dr Turner are required, a psychological assessment must be completed, and a mandatory cooling-off period must be observed before surgery is booked. Dr Turner conducts all consultations personally. The consultation fee is $450, and following your consultation you receive a written quote covering all surgical fees.
Why Patients Choose Dr Scott J Turner
- FRACS qualification: the highest level of specialist plastic surgery training in Australia
- Male surgery expertise: gynaecomastia surgery is a core part of Dr Turner’s dedicated practice in male procedures
- Combined technique approach: glandular excision and power-assisted liposuction, adapted to each presentation
- Accredited facilities: all surgery in fully accredited private hospitals in Sydney
- Continuity of care: Dr Turner conducts all consultations and follow-up personally
- Sydney consulting clinics: Manly on the Northern Beaches and Bondi Junction in the Eastern Suburbs
Frequently Asked Questions
What is the difference between true gynaecomastia and pseudogynecomastia?
True gynaecomastia involves firm glandular tissue beneath the nipple and areola, caused by a hormonal imbalance. It feels firm, does not respond to diet or exercise, and needs surgical excision for definitive treatment. Pseudogynaecomastia is fatty tissue over the chest without true glandular tissue, and it does respond to weight loss. Mixed gynaecomastia, which combines both, is the most common presentation. Dr Turner assesses your tissue composition at consultation to determine the right approach.
Do I need liposuction, gland removal or both?
It depends on what your chest tissue is made of. Liposuction treats the fatty component, and glandular excision treats the firm tissue of true gynaecomastia. Most men have a mix of both, so the two are commonly combined in the one operation. A firm disc that remains under the nipple after weight loss is usually glandular and needs excision rather than liposuction. Dr Turner determines the combination at consultation.
Can gynaecomastia come back after surgery?
Recurrence is uncommon once the glandular tissue has been removed, but it is possible. The main risk factors are significant weight gain, anabolic steroid use, and an unresolved hormonal or medical cause. This is why Dr Turner reviews contributing factors before surgery and, where a reversible cause is found, treats that first. Keeping a stable weight and avoiding steroids lowers the risk.
How long do I need to wear a compression garment?
You wake from surgery in a compression garment, and it is usually worn for around two weeks, continuously except for showering. The garment helps control swelling and supports the chest as it settles. The exact timing depends on your procedure and how you are healing, so follow the specific instructions Dr Turner gives you after surgery.
When can I return to the gym after gynaecomastia surgery?
Most men return to desk work within one to two weeks, but the gym waits longer. Heavy lifting, chest exercises and hard training are generally avoided for around four to six weeks, and resumed gradually once Dr Turner has cleared you. Going back too early raises the risk of bleeding, swelling and affecting the result, so it is worth being patient.
Is gynaecomastia surgery covered by Medicare?
Medicare items 31525 (one side) or 31526 (both sides) may apply where strict criteria are met: the tissue must be glandular rather than purely fatty, present for a defined period, and causing documented physical or psychological impairment. Purely cosmetic cases are not covered. Even where a rebate applies, a significant out-of-pocket gap remains, and a GP referral is required. Dr Turner’s team can help you understand your eligibility at consultation.
What does gynaecomastia surgery cost in Sydney?
The cost depends on whether the surgery involves glandular excision, liposuction, skin excision or a combination, plus hospital, anaesthetist and garment fees. The consultation fee is $450, and Dr Turner provides a detailed written quote covering all surgical fees after your consultation. Where strict criteria are met, Medicare items 31525 or 31526 and a private health rebate may reduce the out-of-pocket cost, though a gap usually remains.
How many consultations are required before gynaecomastia surgery?
Under AHPRA cosmetic surgery regulations, a minimum of two personal consultations with the operating surgeon is required before any cosmetic procedure. You also need a GP referral, a psychological assessment, and a cooling-off period before surgery is booked. Dr Turner conducts all consultations personally at his Sydney clinics in Manly and Bondi Junction.
Book a Consultation
If you are considering gynaecomastia surgery, the first step is a GP referral and then a consultation with Dr Scott J Turner at his Manly or Bondi Junction clinic in Sydney.
Contact Dr Turner’s practice to arrange your consultation.
Related Procedures and Resources
- Male Procedures Overview
- Male Facelift
- Male Neck Lift
- Male Rhinoplasty
- Male Blepharoplasty
- Will Medicare Cover My Gynaecomastia Surgery?
- Gyno Surgery Sydney: Your Treatment Options
- Gyno Surgery Cost in Australia
- Gynaecomastia FAQs
- Pseudogynaecomastia vs True Gynaecomastia
- Recovery After Gynaecomastia Surgery
- Teenager with Gynaecomastia
- Exercise and Enlarged Male Breasts
