Gynecomastia Diagnosis and Surgery

The Gynecomastia Journey

Diagnosis, Surgery, & Recovery

3 Weeks Post Operation.

Gynecomastia is a condition that affects men of all ages, and understanding its classification, causes, and treatment options is essential for selecting the right approach. 

At our center, we believe that every patient should feel fully informed and confident about their treatment. From diagnosis to surgery and recovery, we’ll take the time walk you through every step of the process so you know what to expect.

At our center, we believe that every patient should feel fully informed and confident about their treatment.

From diagnosis to surgery and recovery, we’ll take the time to walk you through every step of the process so you know what to expect.

BOOK A CONSULTATION

3 Weeks Post Operation.

Diagnosis of Gynecomastia

The Gynecomastia patient’s journey begins with diagnosis – to establish their grade and severity of Gynecomastia. This process always begins with a comprehensive medical history and physical examination (See below). 

Plastic surgeons in Canada use either the Webster or Simon classification system. Both classification systems have similar definitions and divide gynecomastia into three enlargement grades, but the Simon system adds detail to Grade 2.

Grade 1

Grade 1 – Small glandular enlargement without excess skin

Grade 2

Grade 2a – Moderate glandular enlargement without excess skin

Grade 2b – Moderate glandular enlargement with some excess skin

Grade 3

Grade 3 – Significant glandular enlargement with excess skin

Gynecomastia Classifications:

  • Grade 1 – Small glandular enlargement without excess skin
  • Grade 2a – Moderate glandular enlargement without excess skin
  • Grade 2b – Moderate glandular enlargement with some excess skin
  • Grade 3 – Significant glandular enlargement with excess skin

Medical History

There are a number of factors that can contribute to an underlying cause of Gynecomastia. 

Each patient begins with a thorough evaluation of personal history, symptoms, medications, and lifestyle factors that may contribute to gynecomastia. 

1

Personal History

We will inquire about your age, gender, and any noticeable changes in glandular tissue size and shape. We will also ask about the duration of gynecomastia symptoms and whether the condition is stable, worsening, or improving over time.

Symptoms

Any associated symptoms, such as gland tenderness, pain, discharge from the nipples, or changes in nipple appearance.

2

3

Medications

Any current medications, including prescription drugs, over-the-counter medications, and herbal supplements. Some medications can contribute to gynecomastia as a side effect or by altering hormone levels. It is important to provide a complete list of all medications being taken.

4

Substance Use

Any use of substances known to be associated with gynecomastia, such as anabolic steroids, marijuana, alcohol, or illicit drugs.

5

Family History

Any family history of gynecomastia or other conditions that could be related, such as cancer.

6

Psychological Impact

Any psychological distress or impact on self-esteem caused by gynecomastia.

Physical Examination

Following the history, a physical examination will be performed. In general, a complete history and physical is enough to work up a patient who presents to us.

Should we suspect non physiologic cause, we may order further investigations, such as blood tests, hormone level assessments, imaging studies (e.g., ultrasound, mammogram), or a biopsy, to determine the underlying cause or rule out any other potential conditions.

Upon the conclusion of the physical examination, we can determine the best treatment plan, whether that involves liposuction, glandular excision, or a combination of techniques to achieve the most natural and aesthetically pleasing results.

1

Visual Inspection

Looking for any visible enlargement or swelling of the glandular tissue, noting the size, symmetry, and contour of the chest. This includes with and without a T Shirt on. The skin is also evaluated for judging it’s quality, amount and changes, such as redness or dimpling.

2

Palpation

Feeling for the amount, density and location of glandular tissue versus fat.

3

Nipple Evaluation

The nipples and areolas are assessed for any changes in size, shape, or color.

4

Testicular Examination

Finally, some cases require a Testicular Examination. Since certain hormonal disorders can cause gynecomastia, if we suspect this may be a case that is pathological in origin, we may perform a testicular examination to assess the size, consistency, and any tenderness or masses in the testicles. This is infrequently performed since most cases are physiologic in nature.

AFTER THE FULL MEDICAL EXAMINATION, YOU ARE READY TO BE BOOKED FOR SURGERY

At the conclusion of the medical examination - the patient is ready to book their surgery.

Surgery

Once your gynecomastia has been classified, we tailor the surgical approach to meet your specific needs.

Our No-Scar Technique (For Mild to Moderate Cases)

✔ Minimally invasive with no visible scars
✔ Two tiny poke holes (2-3mm) hidden in the armpits
✔ Power-assisted liposuction (PAL) to remove excess fat
✔ Precise glandular excision through the same small poke holes

This technique provides the best results for patients with mild to moderate gynecomastia who want an undetectable surgical outcome.

Traditional Surgical Techniques (For Severe Cases)

For cases with significant excess glandular tissue or loose skin, other surgical techniques may be used:

  • Pull-Through Technique: A small poke hole at the areolar border to remove glandular tissue.
  • Periareolar Technique (Webster Method): A semi-circular poke hole along the lower areola for larger gland removal.

Gynecomastia surgery is a same-day outpatient procedure, meaning you can go home the same day.

✔ Duration: 1-2 hours
✔ Anesthesia: Local anesthesia with sedation or general anesthesia
✔ Recovery Time: Most patients return to normal activities within a few days

Gynecomastia treatment risks include bleeding, infection, and uneven chest contours, but these are rare and manageable with proper care.

Recovery and Post-Operative Care

What to Expect After Surgery:

  • Mild swelling and bruising for the first 1-2 weeks
  • Compression garment worn for 4-6 weeks to help shape the chest
  • Limited physical activity for 2 weeks, with full exercise resuming around 4-6 weeks

Our team will closely monitor your progress and ensure you have a smooth recovery with the best results possible. With proper post-operative care and follow-up, patients can enjoy long-lasting, natural-looking results and a newfound sense of confidence.

1

What to Expect After Surgery

  • Mild swelling and bruising for the first 1-2 weeks
  • Compression garment worn for 4-6 weeks to support healing and shape the chest
  • Minimal discomfort, typically managed with over-the-counter pain medication
  • Numbness or sensitivity changes around the chest area, which gradually improves
  • Sutures (if used) are dissolvable and do not require removal

2

Activity and Mobility Guidelines

  • First 24-48 hours: Rest and avoid strenuous movement
  • First 1-2 weeks: Light activities only, no heavy lifting or exercise
  • After 2 weeks: Gradual return to normal activities, avoiding chest exercises
  • After 4-6 weeks: Resume full workouts, including weightlifting and cardio

3

Scar Care and Healing

  • No visible scars with our no-scar technique (for most patients)
  • For other techniques: Small poke holes may heal with minimal, barely noticeable scars
  • Use of silicone scar gel or sheets (if recommended) to minimize scarring
  • Avoid sun exposure on poke hole sites to prevent darkening or pigmentation

4

When to Contact your Surgeon

  • Unusual swelling or excessive bruising beyond expected levels
  • Signs of infection (redness, warmth, pus, or persistent pain)
  • Fluid buildup or seroma formation
  • Any sudden or severe pain that does not improve with medication

5

Long Term Results and Outcomes

  • Visible improvements within 1-2 weeks
  • Final results seen 3-6 months post-surgery as swelling fully subsides
  • Once glandular tissue is removed, gynecomastia will not return, unless influenced by hormonal factors or significant weight gain

Patient Gynecomastia Surgery Results

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2920 Dufferin St, Suite 202, Toronto, Ontario M6B 3S8

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Monday - Friday

7:00 AM – 5:00 PM

Saturday
10:00 AM – 4:00 PM