If the gynaecomastia is mostly caused by excess fatty tissue, liposuction techniques alone may be used. If the problem is actual breast tissue, it is more likely that excision techniques will be needed. Small incision lines are made under each nipple and then the excess breast tissue and fat is removed to create a flatter and more masculine looking chest.

The procedure takes about two hours to complete. Sometimes, a combination of both excision and liposuction is used to achieve the best result.

Many of these operations are carried out using a general anaesthetic, although local anaesthetic and sedation is sometimes used. Mr Henley will discuss the anaesthetic options available to you.

Risks for this procedure are the same as in any surgery and include the risks associated with an anaesthetic, bleeding, bruising, wound infection, chest infection and blood clots in the leg (known as a deep vein thrombosis), although these risks are uncommon.

Any surgical treatment to correct gynaecomastia will require cuts (incisions) to be made, so there will be some scarring. While most incision lines are concealed within natural contours of the body, they can be visible and occasionally scars can become very noticeable.

Rarely, the skin of the nipple area may die. Although this sounds very bad, in reality once new skin has grown and healing is complete, the end result is normally very satisfactory. Dressings will need to be applied to the affected area whilst the healing process takes place.

A further complication is either over or under correction of the gynaecomastia, which may need further treatment to correct this.

Decreased sensation in the nipple and breast area can occur, although this is very uncommon. If liposuction is used, irregularities or uneven contours in the breast tissue can occur, such as lumpiness or bumpiness.

Development of a seroma is the most common, significant complication; this is a collection of fluid. This fluid can, however, be removed easily by using a needle and syringe during the first four to six weeks after the surgery; the procedure may need to be repeated on more than one occasion. This is the reason why patients wear a compression dressing after surgery, as it minimises the chances of this occurring.

All the risks will be discussed in detail at your consultation. You will also be provided with detailed written information to help you make an informed decision about any surgery.

People who have had this surgery say that it’s not really painful – more of a soreness. For those of you who go to the gym, it’s been described as the same feeling you get after a heavy work-out. The chest will be swollen and bruised for a while, so it will take a little time to gauge the result of the surgery.

Ideally, a compression garment is worn on the chest for six weeks to reduce any swelling and minimise the risk of seroma. Exercise is limited for about three to four weeks.  

To reduce the risk of poor scar formation, it is important that you do not subject the wounds to excessive force, abrasion, or motion during the time of healing.

As well as the physical recovery, the psychological scars of gynaecomastia start to heal too. Many men report feeling much happier about themselves, feelings of shame and self-consciousness being replaced by increased optimism and self- confidence.

If your gynaecomastia was due to excessive weight and you gain weight, the problem may return. If your condition is caused by the use of steroids or marijuana, using those drugs can cause it to come back. If your condition is hormonal, then the problem may come back. However, in the majority of cases the problem doesn’t have a cause and in those situations, it doesn’t come back.