Gynecomastia is common and treatable. Surgery removes enlarged male breast tissue using liposuction, gland excision or both, chosen by grade and tissue type. In Dhaka, Dr. Chowdhury Rashedul Mughni performs it at EKAGRA Health, Dhanmondi. Most men return to desk work within one to two weeks. This guide covers causes, candidacy, technique, recovery, published risks and cost in Bangladesh, with a private consultation as the next step.
Reviewed by Dr. Chowdhury Rashedul Mughni, BMDC reg. A 41174.
This page is for general educational purposes and is not a substitute for in-person clinical assessment by a qualified plastic surgeon. Treatment decisions depend on individual factors that can only be evaluated during a consultation with Dr. Mughni.
Dr. Mughni: “It’s nothing to be ashamed of.”
To find out whether gynecomastia surgery is right for you, a private consultation with Dr. Mughni is available at EKAGRA Health, Dhanmondi. Enquiries can be made through Dr. Mughni’s contact page or by WhatsApp on 01842-182545.
What is gynecomastia surgery?
Gynecomastia surgery is an operation that removes excess male breast tissue to create a flatter, firmer chest. It treats gynecomastia, a benign enlargement of the male breast that becomes a clinical concern when a man feels he has too much breast tissue.
Gynecomastia is common. A review in the New England Journal of Medicine reported that nearly two in three boys aged 13 to 14 show some breast enlargement, and close to half of men experience it at some point in life. Many cases settle on their own. Others persist into adulthood, and established gland does not respond to diet or exercise.
The surgery is sometimes called male breast reduction. It is not the same as a weight-loss operation, and it does not change the chest muscle. It removes the tissue that sits in front of the muscle: fat, gland or both, and in advanced cases some loose skin.
True gynecomastia vs pseudogynecomastia
True gynecomastia is growth of glandular breast tissue, the firm, rubbery disc that sits under and around the nipple. Pseudogynecomastia is fat alone, with no real gland growth. It is more common in men carrying extra weight.
The difference matters because it decides the operation. Fat responds well to liposuction. Gland does not; it has to be removed directly. Many men have a mix of both. A careful examination at consultation, feeling the tissue under the nipple, usually tells the two apart. Once a fatty chest is confirmed, Mayo Clinic notes that no further testing is normally needed.
What causes it?
Most gynecomastia comes from an imbalance between oestrogen and testosterone activity. Common triggers include puberty, ageing, weight gain, certain medicines, anabolic steroids and conditions affecting the thyroid, kidneys or liver. In adults, roughly half of cases are leftover pubertal tissue or medication-related, and about a quarter have no identifiable cause. The full list of triggers is set out in our guide to what causes gynecomastia in men.
Who is a good candidate for gynecomastia surgery?
Good candidates are healthy men with persistent breast enlargement that bothers them, where a treatable cause has been ruled out first.
The American Society of Plastic Surgeons (ASPS) considers men with moderate to severe enlargement (Grades II to IV) candidates for surgery once other causes have been checked. In practice, that means:
• The enlargement has persisted over time and is not shrinking.
• Medicines, steroids or hormonal conditions have been reviewed and, where possible, treated or stopped.
• Body weight is stable. Losing weight first can reduce the fatty component.
• General health is good enough for surgery. Diabetes, blood pressure and bleeding disorders are checked and controlled.
• Expectations are realistic: a flatter chest, not a sculpted one overnight.
Surgery is usually postponed when the cause is still active. A man still using anabolic steroids, for example, risks the tissue returning. Men with advanced liver disease are generally poor candidates.
Ruling out other conditions
Male breast enlargement is almost always benign. ASPS notes that about 1% is caused by cancer. A hard lump on one side, skin dimpling or redness, or discharge or bleeding from the nipple should be checked promptly, before any cosmetic planning. Blood tests or imaging are arranged only when the history or examination calls for them.
What about teenagers?
Teenage boys are usually advised to wait. Pubertal gynecomastia often resolves on its own, and Mayo Clinic notes this commonly happens within two years. ASPS guidance suggests deferring surgery for at least a year in adolescents. When the tissue persists, causes distress or is clearly glandular, surgery may be considered after puberty settles. Our page on gynecomastia in teenage boys explains how parents and sons can approach this.
Can it be treated without surgery?
Sometimes. Stopping a responsible medicine, treating a hormonal condition or losing excess fat can reduce enlargement, especially early on. Established gland that has been present for a long time rarely shrinks with medicine or exercise. The options and their limits are covered in non-surgical gynecomastia treatment.
How is gynecomastia surgery performed?
The technique depends on how much fat, gland and loose skin is present. Liposuction removes fat, gland excision (subcutaneous mastectomy) removes gland and skin-reduction techniques manage excess skin in advanced grades.
ASPS describes gynecomastia in four grades. The table below shows how grade typically guides the approach. A detailed breakdown sits in our guide to the four grades of gynecomastia.
| Grade | What it looks like | Usual surgical approach |
|---|---|---|
| Grade I | Small button of tissue around the areola | Often observation; excision if a persistent button bothers the patient |
| Grade II | Moderate enlargement blending into the chest | Liposuction with gland excision |
| Grade III | Moderate enlargement with some loose skin | Liposuction, gland excision, possible minor skin tightening |
| Grade IV | Marked enlargement with loose skin and a feminine shape | Excision with skin reduction |
Liposuction only vs liposuction with gland excision
| Liposuction only | Liposuction with gland excision | |
|---|---|---|
| Suited to | Mostly fatty chest (pseudogynecomastia) | Firm gland under the nipple, with or without fat |
| Incisions | A few small entry points | Small entry points plus a short incision at the lower edge of the areola |
| What it removes | Fat | Fat and glandular tissue |
| Main limitation | Leaves firm gland behind | Small extra scar, usually hidden at the areola border |
A 2020 review in Plastic and Reconstructive Surgery Global Open found that the most common approach in published studies was gland removal through a skin-sparing incision, with or without liposuction. Its authors concluded that the right technique depends on grade and on what the patient prefers. The same two factors guide the choice at consultation.
For dense, fibrous tissue, ultrasound-assisted liposuction has also been described in the surgical literature as an option that leaves smaller scars than open excision, with excision kept for cases with significant loose skin.
On the day
Gynecomastia surgery is commonly done under general anaesthesia, although smaller cases can be managed with local anaesthesia and sedation. Published hospital guidance describes an operation of one to two hours, usually as a day case with same-day discharge. A compression vest is fitted before you leave. A small drain is used in some cases and removed at an early review.
Dr. Mughni will explain at consultation which technique suits your chest, where the incisions will sit and which anaesthesia he recommends.
What does recovery look like?
Most men return to desk work within one to two weeks and to the gym after six to eight weeks. Swelling settles over about a month, and the result can be judged from around six weeks.
The ranges below come from published hospital patient guidance (MedStar Health and Nuffield Health). Your own timeline is set at your follow-up visits.
• First days. Tightness and soreness are greatest early on and ease over about a week. The vest feels snug, like a firm and constant hug, and the chest pulls a little when reaching forward or getting up from bed. The skin around the nipple can feel numb or tingly; sensation usually returns over several weeks. Rest, keep the vest on and walk gently around the home.
• Early recovery (first two weeks). Desk-based work is usually possible. The compression vest is worn day and night. Heavy lifting is avoided.
• Settling phase (around one month). Bruising and most swelling fade. Many men no longer need the vest by about four weeks.
• Return to activity (one to two months). Lighter exercise often resumes from around three to four weeks, while strenuous upper-body effort waits longer. Gym training and sport usually restart at six to eight weeks, building up gradually.
• Longer term (three months onwards). The chest continues to settle and scars soften and fade over many months.
Dhaka’s heat and humidity can make a compression vest uncomfortable. A breathable vest, cool rest periods and keeping the wound clean and dry make the early weeks easier. Protect healing scars from direct sun for several months. A more detailed timeline is in our week-by-week gynecomastia recovery guide.
What are the risks, and how are they managed?
Like any operation, gynecomastia surgery carries risks. The most common in published series are bleeding under the skin (haematoma) and fluid collection (seroma). Most of these are minor and settle without further surgery.
These figures come from published surgical literature, not from any single surgeon’s practice:
• A 2020 review of 17 studies covering 1,112 patients found haematoma was the most frequent complication (5.8%), followed by seroma (2.4%).
• A 2026 study of 71 men treated with liposuction plus gland excision, published in Breast Care, reported complications in 12.7% of patients, including seroma, bruising, haematoma and superficial skin breakdown. Higher body weight was linked to a greater chance of complications.
Other recognised risks include infection, wound separation, asymmetry, contour irregularity, a dip or a pulled-in nipple if too much tissue is removed beneath it, changes in nipple sensation and visible scarring.
How these risks are reduced:
• Careful candidate selection. Treating the cause first and operating at a stable weight.
• Preserving some tissue beneath the nipple, a step described in published surgical literature to avoid a pulled-in nipple.
• Meticulous control of bleeding during surgery, with a drain where the case calls for it.
• Compression and activity limits in the first weeks to reduce swelling and fluid build-up.
• Planned follow-up visits so any problem is found early.
Can gynecomastia come back?
Results are usually permanent when weight and hormone levels stay stable. Steroid use, some medicines or significant weight gain can cause new tissue to grow.
How much does gynecomastia surgery cost in Bangladesh?
At Dr. Mughni’s practice, gynecomastia surgery generally falls within a range of BDT 35,000 to 65,000. The final figure is set only after an in-person assessment.
Where a case sits in that range depends on:
• Whether liposuction alone is enough or gland excision is also needed.
• The grade, and whether loose skin must be removed.
• The type of anaesthesia.
• Length of stay.
• Whether it is a first operation or a revision.
Pre-operative blood tests and investigations are billed separately by the diagnostic centre where they are done. The consultation fee is BDT 1,200 at EKAGRA Health and BDT 1,500 at Cosmetic Surgery Centre. Payment is taken in stages rather than all at once. A fuller breakdown is in the 2026 gynecomastia cost guide for Bangladesh.
Dr. Mughni’s approach to gynecomastia
Dr. Mughni’s approach starts with the conversation, not the operation. Many men live with gynecomastia for years before raising it with anyone, and commonly describe avoiding situations where the chest shows.
Dr. Chowdhury Rashedul Mughni notes:
“I make them realize that it’s totally normal and it’s treatable. It’s nothing to be ashamed of.”
Before liposuction or scars come up, he wants a patient to hear that the condition is common, that it usually has a cause and that it can be treated.
He applies the same principle he uses for all body reshaping surgery: keep the result natural to the patient’s own build. Dr. Mughni adds:
“I prefer preserving cultural features and natural body-structure, for rhinoplasty and also for other body reshaping surgeries. Always a pre-operative discussion with the patient is a must to task for me.”
For the male chest, that means a flat, firm contour that suits his frame, not an overcorrected or hollow look. A gynecomastia consultation typically covers an examination of the chest to separate fat from gland, a review of medicines, supplements and steroid use, and a check for any sign that needs further tests. It ends with an explanation of which technique fits, where the scars will sit and what the chest is likely to look like once healing settles. For some men, waiting, losing weight or treating a cause first is the better answer.
Any images shown in our gynecomastia before and after gallery are published with patient consent, with faces blurred.
Why patients choose Dr. Mughni for gynecomastia surgery
Dr. Mughni is a plastic, aesthetic and reconstructive surgeon with more than twelve years specialising in plastic surgery and over two decades of surgical experience. He holds FCPS, MRCS and MRCSEd qualifications, is a member of ISAPS and serves as Office Secretary of the Bangladesh Society of Aesthetic and Plastic Surgeons. His training and career are set out on Dr. Mughni’s profile page.
His reconstructive background shapes how he treats the male chest. The aim is natural form and function: a chest that looks male, not hollow or overcorrected. For men weighing other chest procedures, how male breast surgery differs from gynecomastia correction is explained separately, and his wider breast surgery practice in Dhaka covers related operations.
Patients who want to hear from others can read accounts on the patient testimonials page. For an overview of the full range of procedures he performs, see plastic surgery with Dr. Mughni in Dhaka. Men combining chest surgery with abdominal contouring may also find the tummy tuck guide useful.
Where is gynecomastia surgery performed?
Consultations and surgery are available at both of Dr. Mughni’s chambers in Dhanmondi, Dhaka.
• EKAGRA Health, Dhanmondi, Wahab Point, Floor 7, House 13, Road 2, Dhanmondi, Dhaka 1209. Saturday, Monday and Thursday, 4:00 PM to 8:00 PM; Sunday, Tuesday and Wednesday, 9:00 AM to 2:00 PM.
• Cosmetic Surgery Centre, Satmasjid Road, 5th floor, Shankar Plaza, 72 Satmasjid Road, Dhanmondi R/A, Dhaka 1209. Consultation times are arranged by contacting the practice.
Surgery itself takes place at the chamber or an admitting hospital, with no major change to the cost range.
If you would like to discuss gynecomastia surgery in private, you can arrange a consultation with Dr. Mughni at EKAGRA Health, Dhanmondi. The practice can be reached by phone or WhatsApp on 01842-182545.
Frequently asked questions
Is gynecomastia surgery permanent?
Yes, for most men the result is permanent. Removed gland does not grow back on its own. New tissue can develop if a man gains significant weight, starts anabolic steroids or takes certain medicines. Keeping weight stable and avoiding steroids protects the result over the long term.
How do I know if it is gynecomastia or just fat?
A clinical examination is the reliable way to tell. True gynecomastia feels like a firm, rubbery disc under the nipple. Fat feels soft and spreads evenly across the chest. Many men have both. The tissue is examined at consultation, and tests are ordered only when something needs further checking.
Will there be a visible scar?
Scars are usually small. Liposuction leaves a few tiny entry points, and gland excision adds a short incision along the lower edge of the areola, where the colour change helps hide it. Grade IV cases with loose skin need longer incisions. Scars soften and fade over many months.
Is gynecomastia surgery painful?
The operation itself is done under anaesthesia, so you feel nothing during it. Afterwards, most men describe tightness and soreness rather than sharp pain. Discomfort is greatest in the first few days and usually eases over about a week with prescribed pain relief and the compression vest.
When can I go back to the gym?
Published hospital guidance suggests gym training and sport can usually resume around six to eight weeks after surgery. Walking can start within days, and lighter exercise often resumes from around three to four weeks. Heavy chest and upper-body work comes last. Dr. Mughni confirms your timeline at follow-up.
Can gynecomastia go away without surgery?
Sometimes. Pubertal gynecomastia often settles within two years, and enlargement caused by a medicine may shrink once it is stopped. Losing weight reduces fatty tissue. Long-standing firm gland rarely disappears with diet, exercise or medicine, which is when surgery is usually considered.
How long does the operation take?
Published hospital guidance describes an operation of about one to two hours, depending on how much tissue is removed. Most men go home the same day. More extensive surgery, such as Grade IV correction with skin removal, may take longer and occasionally needs an overnight stay.
More answers are collected in the full gynecomastia question and answer page.
Gynecomastia is common, it is treatable and it is nothing to be ashamed of. The right first step is an honest assessment of what is causing it and whether surgery will help. If you are ready for that conversation, a private consultation with Dr. Mughni is available at EKAGRA Health, Dhanmondi.