Short answer
The options for gynaecomastia (enlarged breast gland tissue in men) range from waiting and treating the cause, to medicines, to surgery. Many cases need no treatment: gynaecomastia during puberty usually settles by itself, and cases caused by a medicine or another condition often improve once that is addressed. Surgery, usually liposuction, removal of gland tissue or both, is generally considered when the enlargement has lasted and other measures have not helped.
Key points
- Gynaecomastia is common and often harmless.
- Pubertal gynaecomastia usually resolves within 6 months to 2 years.
- Medicines, anabolic steroids, weight and some medical conditions can cause it.
- Medical treatment is unlikely to help once it has been present for about a year.
- Surgery may use liposuction for fat, excision for gland tissue and skin, or both.
What gynaecomastia is, and what it is not
The NHS describes gynaecomastia as men having bigger breasts than usual, and notes it is common, often harmless, and can affect one or both sides.1 Strictly, it means growth of the breast gland tissue. Pseudogynaecomastia is different: the chest is fuller because of fat, with no gland enlargement.2
The distinction matters because it shapes the options. On examination, true gynaecomastia usually shows a firm rim of tissue more than 0.5 cm across under the nipple; pseudogynaecomastia does not.2 Fat responds to weight loss and liposuction, while gland tissue usually has to be cut out if it is to be removed.5
Finding the cause first
The NHS lists hormone changes, being overweight, certain medicines, conditions such as an overactive thyroid, kidney disease or cirrhosis (liver scarring), and drug use including anabolic steroids.1 It is common during puberty and in men over 50.1
In adult men, the commonest causes are pubertal gynaecomastia that has persisted, cases with no identifiable cause, and medicines; spironolactone (a diuretic), anabolic steroids and anti-androgen drugs are well-known examples.2 Less common causes include low testosterone and testicular tumours, which is why a clinician will usually examine the testes as well as the chest.2
The main options
| Option | When it may be considered | Limitations |
|---|---|---|
| Watchful waiting | Puberty-related or recent gynaecomastia2 | May not resolve in adults with long-standing tissue |
| Stopping a causative medicine or treating a condition | Where a drug or condition is identified12 | Medicine changes must be agreed with the prescriber |
| Weight loss | If overweight1 | Reduces fat, not gland tissue |
| Medicines (such as tamoxifen) | Troublesome pain and tenderness2 | Not always effective; unlikely to help after about 12 months2 |
| Surgery | Persistent enlargement when other measures have not helped14 | Scars, risks of surgery; may not be NHS-funded1 |
Puberty-related gynaecomastia usually resolves within 6 months to 2 years, and most cases need no specific treatment.2 Where a medicine is the cause, enlargement often settles after it is stopped, though anabolic steroids may be an exception.2
Some clinicians use tamoxifen (a hormone-blocking medicine) for very troublesome pain and tenderness, but the MSD Manual notes it is not always effective, and medical treatment is unlikely to help once gynaecomastia has been present for 12 months.2 The evidence for medicines in long-standing gynaecomastia is Limited.
What surgery involves
The American Society of Plastic Surgeons (ASPS) describes two techniques. Liposuction, using a thin tube (cannula) through small cuts, is used mainly where the enlargement is mostly fat. Excision, cutting out tissue, is used when gland tissue or excess skin must be removed, or when the areola (the darker skin around the nipple) needs reducing or the nipple repositioning. Many operations combine both.5 The operation is done under general anaesthesia or intravenous sedation (medicine through a vein to make you drowsy).5
ASPS suggests suitable candidates are healthy, at a relatively normal weight, non-smokers and non-drug users, whose condition cannot be corrected by other medical treatment and whose breast development has stabilised. Teenagers may benefit, but further surgery may be needed if breast development continues.4
Risks of surgery
A 2022 systematic review of 94 studies and 7,294 patients found that haematoma (a collection of blood under the skin) was the most common complication. Complications were reported in about 15% of liposuction-only cases, 31% of excision-only cases and 12% of combined cases.6
Those figures need care. Excision tends to be used for more severe cases, which may explain part of its higher rate, and the studies used different classifications and techniques.6 The comparison between techniques is therefore Limited evidence rather than proof that one method is safer.
When to seek medical advice
The NHS advises seeing a GP if you have a lump in the breast or nipple, discharge or bleeding from a nipple, breast or nipple pain that is not going away, or skin changes such as a rash, dimpling or redness.1 Features that raise concern for male breast cancer include a hard lump on one side away from the nipple, tissue fixed to the skin, nipple retraction and swollen glands in the armpit.2
Common questions
Will exercise get rid of gynaecomastia?
Exercise and weight loss can reduce chest fat, but they do not remove enlarged gland tissue.12
Should a teenager have surgery?
Usually not early on, because pubertal gynaecomastia often resolves within 2 years.2 If surgery is done before development has stabilised, further surgery may be needed later.4
Is gynaecomastia surgery available on the NHS?
It may not be; the NHS notes surgery may not be available on the NHS.1
Is gynaecomastia a sign of cancer?
Usually not; it is common and often harmless.1 A hard, one-sided lump, nipple changes or swollen armpit glands should still be checked, and ASPS notes gynaecomastia itself can follow hormonal changes, heredity, obesity or certain drugs.23
Bottom line
Gynaecomastia is often temporary or linked to a cause that can be addressed, so assessment comes before treatment. Surgery is an option for persistent enlargement, with the technique chosen according to whether fat, gland tissue or skin is the main problem.
Related reading
- Plastic surgery overview
- Liposuction guide
- What does breast reduction surgery involve?
- Why compression garments are worn after surgery
- What is a seroma after surgery?
Sources
- NHS. Gynaecomastia. NHS website. https://www.nhs.uk/conditions/gynaecomastia/. Accessed 5 November 2026.
- Jimbo M. Gynecomastia. MSD Manual Professional Edition; 2025. https://www.msdmanuals.com/professional/endocrine-and-metabolic-disorders/male-reproductive-endocrinology-and-related-disorders/gynecomastia. Accessed 5 November 2026.
- American Society of Plastic Surgeons. Gynecomastia surgery. ASPS. https://www.plasticsurgery.org/cosmetic-procedures/gynecomastia-surgery. Accessed 5 November 2026.
- American Society of Plastic Surgeons. Gynecomastia surgery candidates. ASPS. https://www.plasticsurgery.org/cosmetic-procedures/gynecomastia-surgery/candidates. Accessed 5 November 2026.
- American Society of Plastic Surgeons. Gynecomastia surgery procedure steps. ASPS. https://www.plasticsurgery.org/cosmetic-procedures/gynecomastia-surgery/procedure. Accessed 5 November 2026.
- Innocenti A, Melita D, Dreassi E. Incidence of complications for different approaches in gynecomastia correction: a systematic review of the literature. Aesthetic Plastic Surgery; 2022;46:1025–1041. doi:10.1007/s00266-022-02782-1. https://link.springer.com/article/10.1007/s00266-022-02782-1
Article history
- — First published.