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Chirurgie de la gynécomastie — Dr Pulvermacker, Paris 16

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Gynaecomastia in Paris 16 — male chest surgery

Gynaecomastia is the abnormal development of a visible and palpable breast gland in a man. The improvement obtained by surgery is generally reported as considerable and rapid.

What is gynaecomastia?

It is the development of a genuine glandular nodule beneath the areola, palpable on examination. It must be distinguished from adipomastia, which is a simple excess of fat with no gland and calls for a different treatment; the distinction is made on clinical examination and imaging.

Why is an endocrine assessment compulsory?

An endocrine assessment is compulsory before any surgical treatment.

Gynaecomastia may in fact reveal a hormonal imbalance or an underlying condition, or be induced by certain medicines. Operating without having looked for the cause would amount to treating a symptom while leaving the cause to develop, and would expose the patient to recurrence.

Why consider surgery?

Because having a feminine chest when you are a man can cause genuine psychological distress.

Because you cannot conceal that chest under a T-shirt or in intimacy, despite diets and weight training: glandular tissue responds to neither.

Photo avant gynécomastie - Dr Pulvermacker, Paris

How does the operation proceed?

The operation requires general anaesthesia and lasts between forty-five and seventy-five minutes.

Liposuction is most often combined with it to even out the remaining volume and avoid a depression beneath the areola.

Where is the scar?

A scar at the lower part of the areola is generally sufficient to remove the glandular nodule. Placed at the edge of the areola, it merges with the change in skin colour.

Where there is significant excess skin, particularly after weight loss, that excess skin has to be removed through a horizontal scar on the chest.

What is the recovery like?

The operation causes little pain. A compression garment must be worn for one month. Bruising and swelling are present for at least a fortnight.

Photo après gynécomastie - Dr Pulvermacker, Paris

What should you expect after surgery for gynaecomastia?

A compression vest is worn for several weeks: it is the main constraint, and it governs how well the skin retracts. Nurses at the practice and the clinic deliver local care, with appointments set before surgery. The surgeon sees you within seven days, then between day ten and day fourteen. The anaesthetist follows pain relief, and manual lymphatic drainage at home may be offered where indicated. See post-operative care.

When is the result final?

The result is final from two months. The scar continues to evolve for a year.

What are the risks?

Besides those linked to general anaesthesia, the main risks of bilateral gynaecomastia surgery are haematoma and a collection of lymph, which may require aspiration if significant.

The other risks essentially concern imperfections of result, which may call for a surgical revision — one that should not take place before at least six months.

The other complications are set out in detail in the SoFCPRE information leaflet.

Is gynaecomastia surgery reimbursed?

Gynaecomastia surgery comes under reconstructive surgery and may be eligible for reimbursement by French health insurance, subject to conditions and after prior authorisation. The endocrine assessment forms part of the application.

Last updated: August 2026 · Medical content reviewed by Dr Benjamin Pulvermacker, board-qualified plastic surgeon in Paris 16.

Pour qui cette intervention convient — et pour qui elle ne convient pas

Elle convient aux hommes gênés par un développement de la glande mammaire, après qu'un bilan endocrinien a éliminé une cause hormonale, médicamenteuse ou toxique. Ce bilan conditionne l'indication. Elle ne convient pas tant qu'une cause traitable n'a pas été écartée, chez l'adolescent dont la gynécomastie pubertaire peut encore régresser spontanément, ni lorsque l'excès est purement graisseux chez un patient en surpoids : l'amaigrissement précède alors la discussion chirurgicale.

Limites et risques spécifiques

Selon la part de glande, de graisse et de peau, le geste va de la lipoaspiration isolée à l'exérèse glandulaire avec retrait cutané ; les cicatrices en dépendent. Risques propres : hématome, dépression ou irrégularité du galbe, asymétrie, troubles de la sensibilité de l'aréole, excès cutané résiduel chez les peaux distendues. La pièce d'exérèse est analysée systématiquement. Une prise en charge est possible dans les formes glandulaires vraies, après entente préalable.

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