Gynaecomastia Surgery | Male Breast Reduction Sydney, Australia

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.

Pseudogynecomastia is fatty tissue accumulation over the chest without true glandular enlargement. This type does respond to weight loss and exercise. It is common in men who carry weight across the chest area.

Mixed gynaecomastia combines both glandular and fatty tissue. This is the most common presentation in practice. Many men who lose weight find that fatty tissue reduces but a persistent firm mound remains under the nipple — this is the glandular component, which surgery is required to address.

This distinction matters for surgical planning: liposuction addresses fatty tissue; glandular excision is required for true gynaecomastia; most cases require both.

Causes and Contributing Factors

Gynaecomastia can develop at different life stages:

• Puberty — affects up to 70% of adolescent boys; resolves spontaneously 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, addressing that first is sensible — surgery on active, hormonally-driven gynaecomastia carries a risk of recurrence.

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 — 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 individual 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 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 performed in combination with glandular excision.

Skin excision is occasionally required in patients with significant skin laxity following removal of a larger volume of tissue. This is less common and is discussed specifically during consultation where the anatomy indicates it may be necessary.

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 (may require skin excision)

The grade influences the combination of techniques used and is assessed during 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 payment remains. Private health insurance with appropriate hospital cover may also contribute a partial rebate on facility fees.

Dr Turner’s team can assist with understanding Medicare eligibility specific to your situation at the time of consultation. A GP referral is required for any Medicare rebate to apply.

For more detail, see: Will Medicare Cover My Gynaecomastia Surgery?

Recovery

Recovery after gynaecomastia surgery is generally straightforward for most patients.

Day of surgery: Performed as a day procedure — you return home the same day. You’ll wake from surgery wearing a compression garment. Someone must drive you and stay with you for the first 24 hours.

Days 1–5: Chest tightness, swelling and mild discomfort are expected and managed with prescribed medication. The compression garment is worn continuously except for showering.

Week 1–2: Most men with desk-based work return within one to two weeks. The compression garment is typically worn for approximately two weeks.

Weeks 2–6: Light activities are gradually resumed. Gym training and heavy lifting should be avoided for four to six weeks.

2–3 months: Swelling continues to resolve. The final chest contour becomes clearer as swelling reduces and the skin tightens and settles. Most patients see the primary improvement within six to eight weeks.

Scarring from the periareolar incision is typically well-concealed and fades over six to twelve months. Individual healing varies.

Full recovery detail is available at: Recovery After Male Breast Reduction 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 — blood collection under the skin; may require drainage
• Infection — uncommon; managed with antibiotic protocols
• Seroma — fluid collection; may require aspiration
• Changes in nipple or skin sensation — usually temporary
• Contour irregularities or asymmetry during healing
• Scarring — individual healing varies
• Skin necrosis — rare; risk is significantly increased in patients who smoke
• Recurrence — uncommon but possible with significant weight gain or unresolved hormonal causes
• Need for revision surgery

Dr Turner will discuss all risks relevant to your specific presentation during consultation.

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 will assess 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 (effective 1 July 2023):

• 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
• A mandatory cooling-off period must be observed before surgery is booked

Dr Turner conducts all consultations personally. The consultation fee is $450. Following your consultation, you’ll 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 individual presentation
• Accredited facilities — all surgery in fully accredited private hospitals in Sydney
• Continuity of care — Dr Turner conducts all consultations and follow-up personally
• Multiple consulting locations — Sydney (Manly and Bondi Junction), Brisbane, Canberra, Gold Coast and Newcastle

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 Face and 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
• Pseudogynecomastia vs True Gynaecomastia
• Recovery After Gynaecomastia Surgery
• Teenager with Gynaecomastia
• Exercise and Enlarged Male Breasts