The Management of Gynecomastia | Mr. Gwanmesia Skip to main content

The Management of Gynecomastia

Gynecomastia affects approximately 40% of men over the age 40 years. It can be a source of significant embarrassment for those affected. The condition is seen in patients during their adolescent, teenage and adult years. The cause of the condition could be due to unknown factors, due to physiological conditions that lead to hormonal imbalance or simply from extrinsic factor such as the ingestion of metabolic steroids or certain types of medication. 

In my Practice, I offer a bespoke treatment regimen which comprises of ultrasonic liposuction, the removal of glandular tissue if present, and serial compression. Various treatment regimens have been described, but I find that a combination of ultrasonic liposuction combined with tailored compression is the most effective treatment modality. Other common treatment types that have been described include surgical excision and the use of laser excision. Common complications seen with these other treatment modalities include asymmetries, nipple areolar complex puckering and altered sensibility of the nipples.

The advantages of the above treatment method include a reduction in adverse scarring, the prevention of adverse tethering of the nipple areolar complex, and the preservation of nipple sensibility amongst others.

Following the above treatment regimen, patients can expect to experience some bruising, which usually settles within the first week after surgery, as well as some swelling, which begins to improve by the second week after surgery. Most of the swelling is resolved within the first 3 months after surgery.

As most of the patients I treat are young fit gentlemen, a common question I get from them is how soon can they return to fitness training. My advice is to wait for a good four to six weeks before attempting any heavy lifting or contact sports. The reason for waiting this long is to avoid rebound secondary bleeding which could lead to hematoma formation.

For more information about this condition, please visit my YouTube Channel at


Dr Ivo Gwanmesia

Dr Ivo Gwanmesia is one of Harley Street’s most experienced and renowned craniofacial plastic surgeons. With over a decade of professional experience, he has transformed the lives of countless patients from all over the UK & abroad.

Due to his vast and hands-on training in the UK and the US, Dr Ivo now specialises in more than a dozen different aesthetic, craniofacial and transgender procedures. Some of them include face, neck, and brow lifts, upper and lower blepharoplasty, breast reduction & breast uplift as well as facial feminisation surgery, to name a few.

Dr Gwanmesia has also conducted pioneering research, which led to the development of a new technique for the reconstruction of the middle vault of the nose, known as the ‘Fulcrum Spreader Graft’. He was also part of a study comparing the efficacy of the Sheen Spreader Graft and the Fulcrum Spreader Graft. The study has since been published on PubMed and the Journal of the American Society of Plastic Surgeons.