Gynaecomastia
ABOUT GYNAECOMASTIA
Gynaecomastia is the enlargement of breast tissue in males, resulting in a chest that appears fuller, rounder, or softer than desired. It is more common than many men realise — affecting a significant proportion of adolescent boys and adult men at some stage of life — yet it remains a source of considerable embarrassment and self-consciousness for those who live with it. Many men avoid swimming, change privately, or limit intimacy because of concerns about their chest appearance.
The condition may involve excess glandular tissue, excess fat, excess skin, or a combination of all three. True gynaecomastia involves a firm, disc-like glandular component beneath the nipple, whereas pseudogynaecomastia refers to fatty enlargement without a significant glandular component. The distinction matters because it determines the appropriate surgical approach.
Mr Ibrahim takes a thorough approach to assessment, ensuring that any underlying hormonal, pharmacological, or systemic cause has been identified and addressed before surgery is considered. In adolescents, he generally advises waiting until breast development has stabilised — typically into the late teenage years — before proceeding.
Causes & Assessment
Gynaecomastia can arise from a range of causes including hormonal imbalance, anabolic steroid or recreational drug use, certain medications, liver disease, or simply idiopathic change with no identifiable cause. Mr Ibrahim will take a detailed medical and medication history and may arrange blood tests or imaging to rule out an underlying condition requiring separate treatment. Surgery addresses the cosmetic result; any underlying cause must be managed alongside or prior to it.
Gynaecomastia - Surgical Techniques
The surgical approach is tailored to what is present — glandular tissue, fat, skin excess, or a combination:
Glandular excision: Where true glandular tissue is the primary concern, Mr Ibrahim makes a small incision at the lower border of the areola and excises the glandular disc directly. This is the most reliable method for removing firm breast tissue that does not respond to liposuction alone.
Liposuction: Where fatty tissue is the predominant component, liposuction through small, discreet incisions achieves a smooth and natural chest contour with minimal scarring. Vaser or power-assisted liposuction may be used to improve precision and skin retraction.
Combined approach: Most commonly, Mr Ibrahim uses both glandular excision and liposuction together to address the full extent of the enlargement and achieve a well-defined, flat chest contour.
Skin reduction: In cases of significant skin excess — typically following major weight loss or in more advanced gynaecomastia — additional skin excision may be required. Mr Ibrahim will discuss the trade-off between scar length and the improvement in contour that skin reduction achieves.
Surgery is performed under general anaesthetic, typically as a day procedure or with one overnight stay.
Your Recovery
Most men return to desk-based work within one to two weeks. A compression vest is worn for four to six weeks to support healing and optimise skin retraction. Swelling is normal and will gradually resolve over three to six months before the final result is evident. Strenuous activity and heavy lifting should be avoided for four to six weeks. Most patients find recovery straightforward and are pleased with the improvement in confidence well before full resolution of swelling.
Risks & Complications of Gynaecomastia Surgery
Haematoma or seroma requiring drainage
Infection
Asymmetry between the two sides
Contour irregularity or residual tissue
Changes in nipple or chest skin sensation, which are usually temporary
Scarring at the areolar border, which typically fades well
Skin looseness if significant skin excess is not fully addressed
Recurrence if an underlying cause — such as ongoing steroid use — is not resolved
Frequently Asked Questions
Is gynaecomastia covered by health insurance?
Gynaecomastia surgery is generally considered a cosmetic procedure and is not routinely covered by private health insurers in Ireland. In cases where there is a significant glandular component with documented physical or psychological impact, it may be worth checking with your individual insurer, as cover can vary by policy. Mr Ibrahim's rooms can provide the relevant documentation to support any insurance query you wish to make.
Will the results be permanent?
Provided the underlying cause is addressed, results are long-lasting. Recurrence can occur if anabolic steroids or other causative medications are resumed, or if significant weight is regained.
Will there be visible scarring?
Incisions are placed at the lower areolar border, where they tend to heal inconspicuously. Where liposuction is used alone, access incisions are very small and placed in discreet locations. Mr Ibrahim takes care with closure technique and will advise on scar management post-operatively.
Can exercise and diet resolve gynaecomastia?
Pseudogynaecomastia - where the enlargement is predominantly fatty - may improve with weight loss. True gynaecomastia involving glandular tissue does not respond to diet or exercise and requires surgical removal.
MR SAFWAT IBRAHIM
Gynaecomastia Surgery in Dublin
If you are troubled by the appearance of your chest and would like to understand your options, contact Mr Ibrahim's rooms to arrange a consultation. He will assess the nature and extent of the gynaecomastia, discuss the most appropriate surgical approach, and give you a clear picture of the result that can realistically be achieved.