Leading centre for aesthetic surgery in this part of Europe

Gynecomastia surgery Zagreb - male breast reduction

Q: Can gynecomastia be resolved with training?

Ako dominira masno tkivo, promjene životnog stila mogu pomoći izgledu, no trening ne može ukloniti žljezdano tkivo. Kirurška korekcija je jedino trajno rješenje kod prave ginekomastije.

Q: Can gynecomastia disappear on its own without surgery?

U pubertetu da, u odrasloj dobi rijetko. Pubertyska ginekomastija spontano se povlači u 40-60% slučajeva unutar 6 do 24 mjeseca. Ako se ne povuče do 18.-19. godine, kirurška korekcija postaje jedino trajno rješenje jer žljezdano tkivo tada fibrozira.

Q: Is gynecomastia surgery painful?

Zahvat se radi u lokalnoj ili općoj anesteziji i nije bolan. U lokalnoj anesteziji osjeti se ubrizgavanje anestetika, no nakon početka djelovanja zahvat nije bolan.

Q: How long does gynecomastia surgery take?

Najčešće oko 1-2 sata, ovisno o metodi (liposukcija, ekscizija ili kombinacija).

Q: Under which anaesthesia is gynecomastia surgery performed?

Zahvat se može raditi u lokalnoj ili općoj anesteziji, ovisno o opsegu zahvata i procjeni kirurga.

Q: What is the difference between unilateral and bilateral gynecomastia?

Obostrana (bilateralna) ginekomastija zahvaća oba prsa i daleko je češća. Jednostrana (unilateralna) zahvaća samo jedno prso i zahtijeva isključivanje malignog uzroka - ultrazvuk grudi preporučujemo kao dio preoperativne obrade.

Q: When can I return to work after gynecomastia surgery?

Kod uredskog posla kroz 2-3 days, dok se teže fizičke aktivnosti odgađaju oko 2 weeks.

Q: How long is the compression garment worn after gynecomastia surgery?

Kompresivni steznik nosi se 3-4 weeks nakon zahvata ispod uobičajene odjeće.

Q: What are the grades of gynecomastia and what determines the surgical method?

Ginekomastija se graduira prema Simon klasifikaciji (Grade I do III). Grade I je malo povećanje bez viška kože - liposukcija ili ekscizija u lokalnoj anesteziji. Grade IIa je umjereno povećanje bez viška kože - ekscizija i liposukcija. Grade IIb je umjereno povećanje s manjim viškom kože - kombinirani zahvat. Grade III je izraženo povećanje s viškom kože i ptozom - kombinirani zahvat uz redukciju kože u općoj anesteziji.

Male breast reduction surgery - a discreet procedure, a natural male contour, a lasting result

Finally – a male breast reduction treatment with a clearly established diagnosis and realistically communicated expectations.

Everything is included in a price starting from just 2,600 euros. Poliklinika Maletić plans every gynecomastia operation individually: after the examination we assess whether it is true gynecomastia or pseudogynecomastia and choose the optimal method – liposuction, gland excision or a combination, with the goal of a natural, symmetrical and masculine result.

Gynecomastia is a benign enlargement of the male breast caused by growth of glandular tissue, fatty tissue or a combination of the two. Although it is not life-threatening, it significantly affects self-confidence, everyday freedom of movement and quality of life – from avoiding changing rooms and the beach to discomfort in intimate relationships.

40–65%

of male adolescents develop gynecomastia during puberty

Nordt and DiVasta, 2008

up to 70%

of men over the age of 50 have some form of gynecomastia

Braunstein GD, NEJM

1 od 4

of cases are idiopathic gynecomastia with no clearly identified cause

Niewoehner CB, 1994

Gynecomastia prices — transparent and with no hidden costs

Gynecomastia surgery at Poliklinika Maletić includes everything — from consultation to postoperative follow-up. The price you see is the price you pay.

Gynecomastia classic surgery without liposuction 2.800^€

Breast liposuction without gland excision 2.600^€

Gynecomastia excision and liposuction 3.000^€

Gynecomastia classic surgery without liposuction 3.100^€

Breast liposuction without gland excision 2.900^€

Gynecomastia excision and liposuction 3.300^€

What is included in the gynecomastia price

Initial consultation with the surgeon
Preoperative preparation and tests
Surgical procedure
Anaesthesia
Postoperative check-up
Compression dressing and instructions

Not sure which method suits your case? Book a free consultation — together with the surgeon we find the optimal solution.

Book a consultation →

What is gynecomastia and why does it occur?

Understanding the causes - the first step towards a solution

Medical definition

Gynecomastia is an enlargement of the male breast that develops due to excessive growth of fatty tissue, glandular tissue or a combination of the two.

Unlike obesity, in which the breasts are larger because of an increased amount of subcutaneous fat, true gynecomastia involves growth of the glandular breast tissue.

An accurate diagnosis - the key to successful treatment

Even if "enlarged male breasts" look the same in a photograph, in practice they may require a completely different approach and a different surgical method. In some men fatty tissue predominates, while in others there is a genuine enlargement of the glandular breast tissue. An expert examination is crucial - what looks like "the same" can be a completely different condition.

True gynecomastia or pseudogynecomastia - how to tell them apart?

The difference between true gynecomastia and pseudogynecomastia determines the surgical method. True gynecomastia requires removal of the glandular tissue. Pseudogynecomastia can be resolved by liposuction alone.

True gynecomastia (glandular tissue)

True gynecomastia requires removal of the glandular tissue and is clearly distinguished from pseudogynecomastia.

A firmer "rubbery" mass can often be felt behind the nipple
It can be sensitive to touch, sometimes painful
It does not always recede with weight loss or training

Pseudogynecomastia (lipogynecomastia - fatty tissue)

Pseudogynecomastia can be resolved by liposuction alone because fatty tissue predominates.

Soft fatty tissue predominates in the chest area
It occurs more often with excess weight
It can partly improve with a change in lifestyle

Important note

Even if you think you know which type you have, in practice mixed forms are common - a combination of fatty and glandular tissue. In that case a combined procedure is the most precise solution.

The most common causes of gynecomastia

The causes of gynecomastia can be physiological (linked to life stages) or pathological (linked to medications and diseases). In a large number of cases no single clear cause is found – we then speak of idiopathic gynecomastia.

Physiological gynecomastia

Newborns

Transient, due to maternal hormones.

Puberty

Hormonal fluctuations, often transient (usually resolves within 6-24 months).

Older age

Falling testosterone + a higher proportion of fatty tissue (aromatase).

Medications and substances

"I wasn't taking anything in particular" — we often hear this at the examination.

However, some medications and substances can affect the hormonal balance and contribute to the development of gynecomastia. These include certain antiandrogens, some antidepressants, some heart medications, anabolic steroids, and the long-term use of alcohol and marijuana.

At the examination it is important to openly state everything you take - including dietary supplements.

Diseases and conditions

Gynecomastia can be associated with diseases of the liver, kidneys and thyroid, with hypogonadism and, rarely, with tumours that affect the hormonal balance.

Visible enlargement of one or both breasts

Bilateral gynecomastia is more common. The unilateral form is rarer and requires ruling out a malignant cause by ultrasound.

A firmer "rubbery" mass behind the nipple

A characteristic sign of true gynecomastia — enlarged glandular tissue that differs from the soft fatty tissue of pseudogynecomastia.

Tenderness or mild pain of the nipple

Glandular tissue can be sensitive to touch, especially during the phase of active growth. Pain is not necessarily present, but is a common reason for visiting the doctor.

Chest asymmetry

One side may be more pronounced. Asymmetry that exists before the procedure must be documented — surgical correction aims for a symmetrical result but cannot guarantee perfect symmetry.

Enlarged areola or protrusion towards a feminine appearance

In pronounced cases the nipple and areola may be lowered or enlarged. Areola reduction is possible as part of the same surgical procedure.

Symptoms that do not respond to weight loss

If the breast enlargement persists despite weight loss and training, glandular tissue that surgery must remove is almost certainly present.

When to seek a doctor immediately: Rapid enlargement of one breast, more intense pain, a firm immobile lump or discharge from the nipple require urgent medical evaluation to rule out male breast cancer.

Diagnostics - the first step is an accurate assessment of the tissue

Before deciding on the procedure it is important to confirm whether it is true gynecomastia, pseudogynecomastia or a combination. Poliklinika Maletić assesses the tissue, the skin and the chest symmetry and, if necessary, recommends additional work-up.

What does the examination include?

Medical history:

Duration, changes, medications, habits - a complete medical picture of your condition

Clinical examination and palpation:

A physical assessment of the tissue beneath the skin

Assessment of the proportion of fatty and glandular tissue:

Determining the right treatment method

Assessment of excess skin and nipple position:

Planning the surgical approach

If needed:

Breast ultrasound and laboratory/hormonal status - confirmation of the diagnosis

Surgical methods for correcting gynecomastia - which one is right for you?

There is no one-size-fits-all approach that “works for everyone”. The optimal method depends on the type of tissue, the amount of excess skin and the desired chest contour.

The surgical method depends on the grade of gynecomastia according to the Simon classification — a standard medical scale that takes into account the amount of tissue and the presence of excess skin. Poliklinika Maletić assesses the grade at the first examination and chooses the optimal technique based on the findings.

Grade	Clinical picture	Typical surgical method	Anaesthesia
I	Slight enlargement of glandular tissue, no excess skin. The chest is slightly protruding, the nipple is not displaced.	Liposuction Excision	Local
IIa	Moderate enlargement with no excess skin. Protrusion above the plane of the chest, the skin is elastic.	Gland excision + Liposuction	Local or general
IIb	Moderate enlargement with minor excess skin. The skin begins to lose elasticity, mild ptosis.	Combined procedure	Local or general
III	Pronounced enlargement with excess skin and ptosis. The nipple may be lowered below the inframammary line.	Combined procedure + Skin reduction	General anaesthesia

Classification according to: Simon BE, Hoffman S, Kahn S. Classification and surgical correction of gynecomastia. Plast Reconstr Surg. 1973.

1. Liposuction

When fatty tissue / pseudogynecomastia predominates

Liposuction removes excess fatty tissue with thin cannulas through minimal incisions of a few millimetres. The thin cannulas allow precise shaping of a flatter, masculine chest contour. Poliklinika Maletić uses special vibrating probes that allow more efficient removal of fatty tissue. The vibrating probes allow the use of a laser, which contributes to better skin tightening after the procedure. The laser shortens the time the compression garment must be worn after surgery compared with the classic technique without a laser.

2. Excision of glandular tissue

True gynecomastia

In true gynecomastia we remove the enlarged gland, most often through a discreet incision along the edge of the areola. An incision along the edge of the areola keeps the scar as inconspicuous as possible.

3. Combined procedure

The most common scenario

In many cases we combine liposuction and removal of glandular tissue in the same procedure – because the tissues are often mixed.

4. Procedures with skin reduction

For pronounced excess skin

If there is significant excess skin, additional surgical tightening or removal of skin is sometimes needed so that the result is aesthetically and functionally acceptable.

What does the gynecomastia surgery protocol at Poliklinika Maletić look like?

A transparent process from examination to recovery.

1. Examination and planning

Poliklinika Maletić assesses the type of gynecomastia, the symmetry and the skin quality at the first examination. We define realistic expectations and propose the optimal method.

2. Preoperative work-up

Before the procedure, standard tests are required according to the agreement and the anaesthesia protocol, together with an assessment of general health.

3. Surgery

The procedure is performed under local or general anaesthesia (depending on the extent) and is not painful. It usually lasts about 1-2 hours. The goal is to remove the excess tissue and shape a natural male contour.

4. Postoperative period

A compression garment is worn for 3-4 weeks after the procedure under ordinary clothing. Office work is possible again after just 2-3 days. More strenuous physical activity and demanding work with the arms should be avoided for about 2 weeks after the procedure. We close the wounds with self-dissolving sutures.

Recovery after gynecomastia surgery - what to expect?

Even if you are nervous about recovery, the protocol is clear and predictable:

The first few days

Swelling, tightness and mild soreness are expected

2-3 days

A return to office work is possible

About ten days

Bruising may be visible

2 weeks

Avoiding heavier physical exertion

3-4 weeks

Wearing the compression garment

2-4 months

Assessment of the final result

Risks and possible complications of gynecomastia surgery

Like any surgical procedure, gynecomastia surgery carries certain risks. Poliklinika Maletić places emphasis on correct indication, sterile conditions, precise technique and postoperative follow-up.

Bleeding, haematoma or seroma

Infection

Temporarily reduced nipple sensation

Contour irregularities (dents/unevenness)

Asymmetry (sometimes pre-existing before the procedure)

Visibility of scars (individual)

Other complications related to local or general anaesthesia and to surgical procedures

At the examination we explain in detail what is realistic to expect in your case — without hiding the risks.

Why do patients choose Poliklinika Maletić for gynecomastia correction?

Many years of experience in gynecomastia surgery

Dr Ana Maletić, a specialist in plastic, reconstructive and aesthetic surgery, has been performing gynecomastia operations since 1998 — with more than 25 years of experience in surgically shaping the male chest contour. Dr Maletić plans every procedure individually: by liposuction, excision of glandular tissue or a combination, depending on the precise diagnosis of the tissue.

Since 1998.

Individual assessment and method selection based on the findings

Liposuction, excision or a combination – depending on what is needed for a natural result. No one-size-fits-all approach of “one method for everyone”.

An individual approach

An operating theatre equipped to the highest international standards

Our operating theatres are equipped for procedures under general and local anaesthesia, with air recuperators that purify the air inside the operating room and thereby reduce the possibility of postoperative complications. We also have vibrating probes for liposuction and a laser, thanks to which we can offer every patient the technique that is the best choice for him.

World standards

A discreet surgical approach

Incisions are planned so that scars are as inconspicuous as possible – usually along the edge of the areola or minimal incisions of a few millimetres.

An experienced doctor

An expert article on gynecomastia published in Lider magazine

Dr Ana Maletić wrote about gynecomastia in Lider magazine, emphasising that enlarged male breasts are often not only an aesthetic challenge but can affect self-confidence and everyday functioning.

Surgical correction of gynecomastia delivers a discreet but powerful result — a return of the sense of masculinity, self-confidence and control.

DR. ANA MALETIĆ Lider magazine

Results of gynecomastia surgery at Poliklinika Maletić

Below you can see examples of our patients’ results

Fotografija prsnog koša pacijenta nakon operacije ginekomastije u Poliklinici Maletić

Before

After

Additional results of our patients

Frequently asked questions about gynecomastia (FAQ)

Answers to the questions that patients most often ask before deciding on gynecomastia surgery at Poliklinika Maletić.

Will gynecomastia come back after surgery?

In most cases the results are permanent, especially when the glandular tissue that causes the true form of gynecomastia is removed.

If the cause is related to medications, hormonal changes or weight gain, it is important to address the cause as well and maintain a stable body weight.

Can gynecomastia be resolved with training?

If fatty tissue predominates, lifestyle changes can help the appearance, but very often fat is lost in other regions first and only later in the areas where men tend to accumulate fat, such as the breasts.

If there is enlarged glandular tissue, training cannot remove the gland — in that case surgical correction is the only permanent solution.

Can gynecomastia disappear on its own without surgery?

In puberty — yes, in adulthood — rarely. Pubertal gynecomastia resolves spontaneously in 40–60% of cases within 6 to 24 months, as hormone levels stabilise. If it does not resolve by the age of 18-19, surgical correction becomes the only permanent solution because the glandular tissue then becomes fibrotic.

True gynecomastia with enlarged glandular tissue does not respond to exercise or weight loss — it is the only type of tissue in the body that requires surgical excision.

Is gynecomastia surgery painful?

The procedure is performed under local or general anaesthesia and is not painful.

If it is performed under local anaesthesia, the injection of the local anaesthetic is felt, but once the local anaesthetic takes effect the procedure is not painful.

How long does gynecomastia surgery take?

Usually about 1-2 hours, depending on the method (liposuction, excision or a combination).

Under which anaesthesia is gynecomastia surgery performed?

The procedure can be performed under local or general anaesthesia, depending on the extent of the procedure and the assessment.

What is the difference between unilateral and bilateral gynecomastia?

Bilateral gynecomastia affects both breasts and is far more common. A certain degree of asymmetry between the two sides is a normal variation.

Unilateral gynecomastia affects only one breast and requires ruling out a malignant cause — we recommend a breast ultrasound as part of the preoperative work-up.

When can I return to work after gynecomastia surgery?

For office work within 2-3 days, while heavier physical activity is postponed for about 2 weeks.

How long is the compression garment worn after gynecomastia surgery?

A compression garment is worn for 3-4 weeks after the procedure under ordinary clothing.

What are the grades of gynecomastia and what determines the surgical method?

Gynecomastia is graded according to the Simon classification (Grade I to III), which takes into account the amount of excess tissue and the presence of excess skin:

Grade I — slight enlargement with no excess skin, liposuction or excision, local anaesthesia
Grade IIa — moderate enlargement with no excess skin, excision and liposuction
Grade IIb — moderate enlargement with minor excess skin, combined procedure
Grade III — pronounced enlargement with excess skin and ptosis, combined procedure with skin reduction, general anaesthesia

The grade is assessed by the surgeon at the first examination. A photograph can indicate the grade, but does not replace the clinical examination that distinguishes fatty from glandular tissue.

Criteria for choosing a clinic for gynecomastia surgery

If you are considering gynecomastia surgery, it is important to pay attention to several key factors when choosing a clinic.

Is a detailed tissue assessment performed (fatty vs glandular)?

Without it the wrong method is often chosen – liposuction when excision is needed, or vice versa.

Who performs the procedure?

Gynecomastia surgery should be performed by a surgeon experienced in aesthetic chest procedures – not just a general surgeon.

Does the clinic present realistic expectations and transparent risks?

Overly “idealised” messages without medical facts are not a good sign. A good clinic also talks about the risks, not only about perfect results.

Is there a clear recovery and follow-up protocol?

A good clinic guides the patient through the entire process – not only through the day of surgery.

Is the facility equipped for procedures under local and general anaesthesia, and does it use vibrating probes and a laser?

It is very important that the facility is equipped with all the necessary apparatus so that the technique that is the best choice in his particular case can be selected for each patient.

Poliklinika Maletić meets all the criteria:

Before the procedure we carry out a detailed assessment of the ratio of fatty to glandular tissue in order to select the correct method – liposuction, excision or a combination of the two. The operation is performed by a specialist in plastic, reconstructive and aesthetic surgery experienced in shaping the male chest contour. We clearly communicate realistic expectations, possible risks and the course of recovery to patients. Procedures are performed in an operating theatre equipped for local and general anaesthesia, with precise surgical technique and a structured protocol of postoperative check-ups. Safety, an individual approach and medical expertise are the foundation of every procedure at Poliklinika Maletić.

Book a gynecomastia examination at Poliklinika Maletić

The first step towards a flatter, natural male chest contour is an expert assessment. Poliklinika Maletić determines whether it is true gynecomastia or pseudogynecomastia, proposes the optimal method and clearly communicates expectations, recovery and price.