Liposuction Contouring and Gland Excision for Enlarged Breast Tissue in a Young Male

A 25-year-old male from Hyderabad presented with bilateral enlarged breast tissue that had been present since his late teens and had not resolved despite a consistent fitness routine. Clinically assessed as Grade II gynecomastia with a mixed glandular and fatty component, the presentation was confirmed on clinical examination and blood workup with no pathological cause identified. Dr. Harikiran Chekuri at Redefine Clinic performed liposuction contouring combined with direct gland excision under general anaesthesia. The procedure was completed in 40 minutes, the patient recovered from anaesthesia immediately, and a flat masculine chest contour was achieved.

He had first noticed it at seventeen. A firmness behind both nipples that did not feel like the chest muscle he was building. He assumed it was a phase of puberty that would pass. By twenty it had not passed. By twenty-three he had accepted it was permanent tissue, not temporary swelling. He had maintained an active gym routine throughout, kept his body fat low, and watched his diet carefully. None of it made any difference to the glandular mound sitting behind each nipple. The lower his body fat dropped, the more prominent the tissue became relative to the rest of his chest.

At 25, the psychological impact was real and daily. He could not wear fitted shirts without the mound showing. He avoided removing his shirt at the gym and had turned down social invitations that involved pools or beaches on more than one occasion. He had tried compression undergarments for a period and found them uncomfortable and ultimately ineffective.

He researched his options and came across gynecomastia surgery in Hyderabad while looking into what a plastic surgeon could achieve for his grade of presentation. He came to Redefine for a consultation to understand whether surgery at 25 was appropriate and what the result would realistically look like.

WHAT WAS ASSESSED DURING THE CONSULTATION

A complete clinical and investigative assessment was conducted before any surgical recommendation was made:

• Physical examination: bilateral Grade II gynecomastia confirmed. Firm glandular disc palpable beneath both nipple-areola complexes. Moderate periareolar fatty component contributing to the mound. No significant skin excess. No ptosis. Skin elasticity excellent at this age.
• Grade assessment: Grade II confirmed bilaterally. High skin elasticity at age 25 means full retraction after liposuction and gland removal is achievable without any skin reduction procedure.
• Hormonal workup reviewed: testosterone, LH, FSH, estradiol, prolactin, and thyroid function all within normal range. No active endocrine cause identified. Idiopathic gynecomastia confirmed.
• Anaesthetist assessment: patient reviewed and cleared for general anaesthesia prior to scheduling.
• Surgical markings documented: midline reference, periareolar gland excision zones, and liposuction contouring zones marked bilaterally in pink and black. Contouring zones extend beyond the mound to include the chest wall and pectoral border for a sculpted result.
• Age-specific counselling: patient advised that surgery at 25 with no active hormonal cause is appropriate. Risk of recurrence after complete gland excision is low in the absence of anabolic steroid use or ongoing endocrine pathology.
• Patient goals confirmed: flat masculine chest consistent with his fitness level, no nipple puffiness, rapid return to normal activity.

WHY LIPOSUCTION CONTOURING WITH GLAND EXCISION WAS CHOSEN

• Grade II gynecomastia with a mixed component requires both liposuction and gland excision. Liposuction addresses the fatty component and sculpts the chest wall. Gland excision removes the firm central disc that no liposuction technique can aspirate.
• Liposuction contouring specifically was planned, not simple liposuction. The zone markings encompassed the full pectoral area and lateral chest wall to produce a defined, masculine result appropriate for an active 25-year-old, not simply a flat result.
• No skin reduction required. Skin elasticity at 25 is at its peak and full retraction over the 6-week compression garment period was confirmed as achievable based on clinical skin assessment.
• Single 40-minute session under general anaesthesia. Immediate anaesthetic recovery and same-day discharge confirmed as appropriate for this patient profile by the treating plastic surgeon during pre-operative assessment.

Pre-operative photographs with surgical markings documented the bilateral Grade II breast mound and the planned liposuction contouring and gland excision zones. Pink hatching indicates the liposuction contouring zones extending across the pectoral area and lateral chest wall. Black circles outline the periareolar gland excision targets bilaterally.

• Patient positioned supine under general anaesthesia. Surgical markings reviewed and confirmed by Dr. Harikiran Chekuri before incision.
• Tumescent solution infiltrated bilaterally into the breast mound, chest wall, and periareolar fat to reduce bleeding and optimise fat aspiration.
• Liposuction contouring performed through 3mm access ports. Fat aspirated across the full marked zones including the pectoral border and lateral chest to create a sculpted, defined masculine contour beyond simple volume reduction.
• Periareolar incision made at the inferior areolar border bilaterally. Glandular disc dissected and excised completely as a single specimen through the periareolar access on each side.
• Complete gland removal confirmed by palpation on both sides. No residual firmness detected.
• Wounds closed in layers with absorbable deep sutures and fine subcuticular absorbable suture at skin level within the periareolar border on each side.
• Compression garment applied in theatre immediately following wound closure.
• Total operative time 40 minutes. The liposuction contouring and gland excision were completed without complication. Patient recovered from general anaesthesia immediately and was discharged the same day.

Recovery was uncomplicated and faster than average given the patient’s age and baseline fitness. Even with early post-operative swelling the chest was visibly flatter at the day 3 follow-up. Wound healing was clean on both sides. Discomfort had resolved by day two without requiring the full prescribed analgesic course. At the one-week review the periareolar wounds were healing cleanly within the areolar border and swelling was reducing ahead of the expected timeline. The patient had returned to desk work by day four and reported wearing a fitted shirt to his office for the first time in years. At the six-week review the chest was flat and well-defined, the periareolar scars were imperceptible within the areolar skin texture, and the pectoral contouring achieved during surgery was clearly visible. The patient confirmed the result had exceeded his expectations.

Feedback recorded at the 6-week follow-up visit at Redefine, Hyderabad.

Google Review

★ ★ ★ ★ ★  5.0

Verified Patient (Name withheld for privacy)

“I have had this since I was a teenager. I went to the gym consistently, kept my diet clean, and still the tissue was there. If anything it looked worse when I lost fat because the gland stood out more. I was worried about getting surgery at 25 but Dr. Harikiran explained clearly why it was the right time and what the low risk of recurrence looked like for my case. The procedure was 40 minutes. I was home the same evening and back at my desk by day four. Six weeks later I wore a fitted shirt to a work event and nobody said a thing, which is exactly what I wanted. The result is clean and natural and matches how I train. I genuinely wish I had done this two years ago.”

Profile: Male, 25 years, Hyderabad

Procedure: Grade II Gynecomastia Surgery with Liposuction Contouring, Redefine Gachibowli, July 2026

Doctor: Dr. Harikiran Chekuri, Redefine

Note: Due to privacy regulations, the patient’s name is not displayed. This review has been shared with the patient’s written consent.

• Wear compression garment continuously for 6 weeks, preferably 24 hours a day as instructed at discharge.
• Take prescribed analgesics for discomfort in the first 3 days as directed. Do not exceed the stated dose.
• Apply antiseptic ointment to the periareolar incision sites as instructed until the one-week review.
• Take prescribed multivitamin daily throughout the recovery period.
• Maintain a high protein diet throughout recovery to support wound healing and skin retraction after liposuction.
• Keep surgical sites dry for 7 days. No bathing, swimming, or direct water contact on incisions before the one-week review.
• No upper body exercise, lifting, or pushing for 4 weeks. Light lower body and cardio permitted from week 2 with surgeon clearance.
• Light walking permitted from day 2. Desk work from day 4. Normal daily activity from week 2.

DISCLAIMER

This case study is for informational purposes only and does not constitute medical advice. Individual results may vary based on the grade of gynecomastia, body composition, skin elasticity, age, and individual healing response. A thorough hormonal workup and anaesthetic assessment are required before any gynecomastia surgery is undertaken. Gynecomastia surgery at 25 is appropriate when a pathological cause has been excluded and the condition has been stable. Consult a qualified plastic surgeon to assess your specific condition. Patient identity withheld per confidentiality guidelines. Feedback published with written consent.