When one speaks of breast surgery, one always thinks of women, yet men also happen to undergo breast surgery to solve a problem called gynaecomastia. Perhaps not everyone will be familiar with this word and this clinical condition, as it is not talked about much. It is basically a condition characterised by abnormal development of the male breast due to hypertrophy of the glandular component of the breast, which, contrary to what should happen, does not regress spontaneously at the end of puberty. The breasts are thus overdeveloped, giving the chest a typically female appearance. This condition often creates a state of psychological discomfort that generally results in disturbances in the social and sexual spheres.

The causes of its onset are numerous, the main ones being genetic, hormonal, pharmacological or dependent on other pathologies. Depending on its origin, gynaecomastia is classified as:

• Pubertal gynaecomastia: a physiological process typical of pubertal age, when intense hormone production causes excessive development of the mammary glands, which generally regresses within a couple of years.
• Congenital gynaecomastia: due to altered hormone balance, it can be generated by heredity.

• Induced gynaecomastia: due to taking certain drugs that can impair natural hormone function.

In addition, depending on the distinctive features, one can speak of:

• True gynaecomastia: the increase in breast volume is caused by the glandular component
• False gynaecomastia: the increase in breast volume is caused by increased adipose tissue
• Mixed gynaecomastia: the increase in breast volume is caused by both factors.

It can happen that gynaecomastia is confused with an increase in the fatty component of the breast region (false gynaecomastia) caused by weight gain. In those cases, the shape can regress or diminish with diets and constant physical activity. Only if the defect fails to regress with these methods is surgery considered.

The methods adopted for male breast surgery are much less aggressive than those used for female breasts. Generally, liposuction of excess fatty tissue is performed and, if glandular tissue is present, this is removed through a small incision along the lower margin of the breast areola.

The operation is performed under local or general anaesthesia and the post-operative period generally involves a day hospital stay and the need to wear a girdle for about a month, which is why the operation is recommended in the cooler months. The results are however stable and long-lasting.