Gynecomastia Surgery — Male Breast Reduction

Gynecomastia surgery at MUDr. Šimek's Olomouc practice reduces enlarged male breast tissue through two distinct approaches depending on the tissue type involved. Pseudogynecomastia — fat-only breast enlargement — is treated by tumescent liposculpture under local anaesthesia as a same-day outpatient procedure, following the same technique used in MUDr. Šimek's extensive liposuction practice. True gynecomastia — involving glandular breast tissue — requires surgical excision through discreet incisions around the areola edge, typically performed under general anaesthesia. A compression vest with foam padding pads is included in the price and worn for 3–5 weeks post-procedure.

Gynecomastia is the medical term for abnormal enlargement of male breast tissue. It affects an estimated 30–65% of men at some point in their lives, with two significant prevalence peaks: in adolescence (driven by the hormonal imbalance of puberty) and in middle age (associated with declining testosterone, weight gain, and certain medications). Despite being common, gynecomastia causes significant psychological distress for many affected men — particularly avoidance of shirtless activities, self-consciousness about chest shape, and reduced body image confidence. **Distinguishing true gynecomastia from pseudogynecomastia** The first step in MUDr. Šimek's assessment is determining the tissue composition of the enlarged breast. True gynecomastia involves proliferation of the ductal glandular tissue beneath the areola, producing a firm, sometimes tender disc of tissue that cannot be compressed or aspirated. Pseudogynecomastia is composed entirely of adipose (fat) tissue — soft, diffuse, and distributed across the chest in proportion to overall body fat. A mixed form (both glandular and fatty tissue) is also common. **Treatment pathway for pseudogynecomastia (liposculpture)** For fat-only cases, MUDr. Šimek performs tumescent liposculpture under local anaesthesia — the same technique used for other body areas. The fat is infiltrated with the tumescent solution, and fine cannulas remove the excess. This is a fully outpatient procedure with same-day discharge and no general anaesthesia exposure. Recovery follows the standard liposuction protocol: compression vest worn for 3–5 weeks, light activity from day 7–10. **Treatment pathway for true gynecomastia (glandular excision)** For cases with glandular tissue, surgical removal is required. MUDr. Šimek performs this through carefully planned incisions placed along the natural crease at the inferior areola edge — the incision scar is concealed at the boundary of the pigmented areola skin and is typically near-invisible within 6–12 months. The glandular disc is excised directly. This procedure is performed under general anaesthesia, meaning the clinical setting and recovery expectations differ from the liposculpture approach — patients should plan for accompaniment home and a longer day. **Who is a candidate at what age** Adolescent gynecomastia (pubertal) typically resolves spontaneously within 18–24 months. Surgery in adolescents is reserved for cases that persist beyond 2 years, are causing significant psychological impact, and have been confirmed persistent rather than transient. In adults, gynecomastia caused by medications (anabolic steroids, anti-androgens, certain antidepressants, spironolactone) should ideally be addressed by discontinuing the causative agent first — MUDr. Šimek advises on this at consultation. Idiopathic adult gynecomastia in otherwise healthy men is straightforwardly a candidate for surgical correction. **Post-procedure** The compression vest with foam pads is worn for 3–5 weeks. The pads apply even pressure over the excision or liposculpture zone, preventing haematoma formation and supporting skin retraction against the chest wall. Results are visible within a few weeks; final chest contour stabilises at 3–6 months.