Gynaecomastia refers to enlargement of breast tissue in men. Men have a very small amount of breast tissue compared to women. Gynaecomastia can be on one side (unilateral) or both sides (bilateral) of the chest wall. Overweight males tend to carry more fat on the chest wall, but this is not true gynaecomastia. What causes gynaecomastia? Gynaecomastia is very common in teenage boys as hormone levels begin to change. It may also occur in older men as the relative ratio of oestrogen to testosterone increases with age. Gynaecomastia can also be due to various genetic conditions, liver and kidney problems, a wide variety of medications, or tumours of the testis and adrenal glands. Gynaecomastia is not breast cancer and is not caused by breast cancer. It is still important to remember that while rare, 1% of all breast cancers are diagnosed in men. As such, any new lump in the male breast needs to be investigated. Do I need surgery? Not everyone with gynaecomastia needs surgery. Dr Lancashire will take a thorough medical history, perform a detailed examination, and will organise some tests to ascertain why you have gynaecomastia. In some instances, it may be as simple as changing a medication. What does surgery entail? Gynaecomastia surgery involves removing the disc of breast tissue under the nipple, a procedure called a ‘subcutaneous mastectomy’. In most instances, this is done through a small incision around the areola. Dr Lancashire will explain the procedure in detail if you are recommended surgery for gynaecomastia.