NP Aesthetics
Gynaecomastia treatment in Zurich
Enlargement of the male breast is not in every case a purely aesthetic matter. It can cause symptoms and have a medical cause. The starting point is therefore the question of what the tissue consists of and why it has changed — not the choice of a procedure.
Consultations and surgery are performed by Dr. med. Michael W. Payne or Dr. med. Dr. Phil. Annemarie Nijboer at Klinik Selnau, Zurich.
What the enlargement consists of
Glandular tissue
True breast glandular tissue usually lies centrally behind the areola, is firmer than fat and can be tender to pressure.
Fatty tissue
Soft subcutaneous fat is distributed broadly across the chest region and often occurs with excess weight.
Mixed form
In many cases, glandular and fatty tissue occur together; their proportion determines the approach.
Excess skin
With marked findings or after weight loss, skin may be excessive and helps determine the contour after tissue removal.
What can lead to enlargement of the male breast
Possible factors include hormonal changes during puberty or with increasing age, certain medications, anabolic steroids, alcohol, diseases of the liver, kidneys, thyroid or testicles, and excess weight. In some cases the cause remains unclear.
When a medical investigation is needed
Investigation is carried out particularly with rapid or one-sided growth, pain, secretion, palpable hardening outside the areola, or anything unusual in the medical history. Depending on the findings, this includes laboratory tests, ultrasound or a joint assessment by endocrinology or radiology.
If a treatable cause is present, it is addressed first. Surgery is only planned once the findings are stable and investigated.
True gynaecomastia and pseudogynaecomastia
True gynaecomastia refers to an increase in glandular tissue. Pseudogynaecomastia is predominantly fatty tissue without a relevant increase in glandular tissue.
The distinction is decisive: fat can be removed by liposuction, glandular tissue generally cannot. If only liposuction is performed when glandular tissue is present, the central bulge behind the areola remains.
Surgical options
Liposuction
Suitable with a predominantly fatty component and good skin quality. The contour is evened out via small incisions.
Gland removal
The glandular tissue is removed through an incision at the lower edge of the areola. A thin layer of tissue is deliberately left beneath the areola to avoid a sunken contour.
Combined treatment
With mixed findings, liposuction and gland removal are combined: the area is contoured, the central glandular tissue removed.
Excess skin
If marked skin remains after tissue removal, additional incisions and thus longer scars are required. Sometimes this step is deliberately moved to a second session, after the skin has retracted.
Incision placement
Approaches usually lie at the lower edge of the areola and in the lateral chest fold; with marked excess skin they are extended.
Anaesthesia
Depending on the extent, local anaesthesia with sedation or general anaesthesia.
Recovery
Compression vest
It is worn for several weeks and supports the skin in settling and the subsiding of swelling.
Everyday life
Office work is often possible after a few days; swelling and a feeling of pressure persist longer.
Sport
Light movement early; chest and strength training considerably later and only after medical clearance.
Final contour
A reliable assessment is usually only possible after several months.
Risks and limitations
Contour irregularities
Dents, steps or a depression behind the areola are possible, as is a remaining residual finding.
Sensation
Changes in feeling in the nipple and areola are common and can remain permanent in individual cases.
Scars
The scar at the edge of the areola is usually inconspicuous; thickening or widening is nevertheless possible.
Recurrence
If the triggering cause persists, the enlargement can occur again.
Further risks
Postoperative bleeding, haematoma, seroma, infection, asymmetry, wound healing problems, and the risks of anaesthesia. Removed tissue is examined histologically.
Costs and personal consultation
The medical consultation for surgical procedures costs CHF 250. If you subsequently book an operation with us, the consultation fee is credited in full against the price of the operation. Following the examination, you will receive an individual cost breakdown that clearly states which services are included.
Questions worth asking before surgery
Is a medical investigation needed before surgery?
In many cases, yes. Enlargement of the male breast can have hormonal, medication-related or internal medical causes. Depending on age, course and findings, the investigation includes medical history, a physical examination, and where appropriate laboratory tests and imaging.
Is gynaecomastia always a purely cosmetic issue?
No. It can cause symptoms such as a feeling of tension or sensitivity to touch, and it can be an expression of a treatable underlying condition. Investigation therefore comes before the question of surgery.
How long do I wear the compression vest?
Usually several weeks, around the clock in the first weeks. The exact duration is determined at follow-up appointments.
Can the enlargement come back?
If a triggering cause persists — such as hormonal changes, certain medications or renewed weight gain — a recurrence is possible.
Will scars remain visible?
With liposuction alone, only scars a few millimetres in size remain. If glandular tissue is removed, the scar usually lies at the lower edge of the areola. With excess skin, longer scars are required.
Treating physicians
- Dr. med. Michael W. Payne
Specialist in Plastic, Reconstructive and Aesthetic Surgery
- Dr. med. Dr. Phil. Annemarie Nijboer
Specialist in Surgery
A good decision begins with a conversation.
The initial consultation is about clarification, not selling. It does not necessarily end with a surgery date — often it brings the realisation that a different approach, or no procedure at all, is the right choice.
The consultation process
- 01
Discussion
We listen to your concerns, medical history, expectations and what you would like to change about your appearance.
- 02
Examination
A careful clinical examination and assessment of your underlying anatomy.
- 03
Options
Possible procedures, alternatives, limitations and risks — explained clearly and without time pressure.
- 04
Time to reflect
You decide in your own time. Any outstanding questions can be addressed in a further consultation.
Request a consultation
Leave your contact details. Our practice team will call you back during practice hours to arrange a consultation at Klinik Selnau.