Gynecomastia: understanding and treating enlarged breasts in men
Gynecomastia — the development of breast tissue in men — affects a significant proportion of the male population at some point in their lives. Often experienced as a profound source of embarrassment, it remains a taboo subject even though surgical correction is today reliable and well-codified. This article covers the causes, types of gynecomastia, the surgical technique, and the conditions for coverage.
Glandular, fatty, or mixed?
Correctly identifying the nature of the excess is the key to a good result, because each form calls for a different technique.
True (glandular) gynecomastia
This is genuine development of mammary gland tissue, palpable beneath the areola as a firm nodule. Liposuction alone is insufficient: the gland must be surgically removed through a small peri-areolar incision.
Adipomastia (pseudo-gynecomastia)
Here, the excess is purely fatty with no glandular component. It is often linked to weight gain and can be treated effectively by liposuction alone, leaving virtually invisible scars.
Mixed form
The most common presentation: a combination of gland and fat. Treatment then combines liposuction (for the fatty envelope and contour harmonisation) with excision of the central gland.
What are the causes?
Gynecomastia results from an imbalance between oestrogens and androgens. Several factors may be involved: hormonal fluctuations during puberty or andropause, certain medications, cannabis or anabolic steroid use, and, more rarely, an underlying medical condition.
A medical work-up is therefore carried out systematically before any surgery: it rules out a cause that could be treated by other means and confirms that the gynecomastia is stable.
French Social Security coverage
This is one of the distinctive features of this procedure: true glandular gynecomastia can be covered by the national health insurance. A file documenting the glandular nature (and sometimes a hormonal work-up) is required, along with prior approval.
Key point: the purely fatty or aesthetic component is not reimbursed. The consultation will determine what may be eligible for coverage and what remains at your expense, with a clear written quote.
Frequently asked questions
What is the difference between gynecomastia and adipomastia?+
True gynecomastia refers to the development of mammary gland tissue, felt as a firm nodule behind the areola. Adipomastia (or pseudo-gynecomastia) is a simple excess of fat, with no glandular component. Many cases are mixed. The distinction is essential because it determines the technique: liposuction alone for fat, glandular excision when gland tissue is present.
Is gynecomastia surgery covered by French Social Security?+
True glandular gynecomastia may be covered by the national health insurance, subject to a documented file (confirmed glandular nature, sometimes a hormonal work-up) and prior approval. The purely fatty or aesthetic component is not reimbursed. The surgeon assesses your eligibility during the consultation.
What are the causes of gynecomastia?+
Causes are varied: hormonal imbalance (puberty, andropause), certain medications, cannabis or anabolic steroid use, specific underlying conditions, or weight gain in the case of adipomastia. A work-up is therefore carried out systematically before any surgery to rule out a treatable cause and confirm that the gynecomastia is stable.
Is the gynecomastia scar visible?+
When glandular excision is required, the incision is placed at the lower border of the areola at the junction with the surrounding skin: it blends into the colour-transition zone and becomes very discreet. When liposuction alone is performed, the only marks are the tiny cannula entry points.
How long is recovery after gynecomastia surgery?+
Return to work is generally possible in 3 to 7 days. A compression garment (vest) is worn for several weeks to limit swelling and encourage skin retraction. Sport resumes progressively from 3 to 4 weeks. The definitive result is assessed at 3–6 months, once all swelling has fully resolved.
Consult for gynecomastia in Paris
The consultation determines the type of gynecomastia, the most appropriate technique, and your eligibility for coverage. Dr. de Clermont-Tonnerre sees patients in complete confidentiality, in Paris 16th and in Pontoise.