At MACS Clinic, we often see young men who seek treatment for gynecomastia—a condition marked by the enlargement of male breast tissue. In most cases, particularly when glandular tissue is thoroughly excised, the results are long-lasting and recurrence is uncommon. But as this case shows, rare exceptions do exist.
Let’s explore a fascinating case that sheds light on why gynecomastia may occasionally return—even years later—and how it can be managed effectively.
A Rare Recurrence:
- A healthy Mediterranean man underwent successful surgical removal of steroid-induced gynecomastia 7 years ago.
- At the time, he had tender, glandular enlargement on both sides which caused discomfort and pain during his exercise and particularly while hugging as the Gynecomastia were tender on touch . The Gynecomastia was removed and his postoperative recovery was uneventful.
- Recently, he returned to MACS Clinic with new painful lumps on both sides of his chest.
What we found:
During re-exploration, Mr. Shailesh Vadodaria discovered dense, fibrous bands of tissue stretching laterally from beneath the areola toward the chest wall, closely adherent near the serratus anterior muscle. The tissue was described as “like a thin banana”—rubbery, firm, and clearly abnormal.
Histology confirmed that this was residual breast tissue with dense fibrosis.
After careful re-excision, the patient’s symptoms resolved completely.
Why Can Gynecomastia Recur?
Although true recurrence is rare, there are a few key factors that explain why it can happen:
- Glandular vs Fatty Tissue
- When glandular tissue is completely removed, recurrence is unlikely.
- But in cases where the gynecomastia is predominantly lipomatous (fatty), regrowth is more common—especially if only liposuction was performed initially and the patient gains significant amount of weight following the operation .
- Hormonal Influence & Anabolic Steroids (AAS)
- Previous use of anabolic steroids can alter the estrogen-androgen balance, encouraging gland formation.
- Even after stopping steroids, residual glandular tissue may persist and can gradually grow quietly and later become painful.
- Time Factor
- Long-standing gynecomastia evolves over time.
The tissue often becomes hyalinized or fibrotic, leading to a firm, rope-like texture that may be painful, especially when compressed or moved.
Symptoms That May Indicate Recurrence
If you’ve had gynecomastia surgery in the past and experience any of the following, it may be worth getting re-evaluated:
- Pain or tenderness in the chest when pressed, hugged, or during exercise
- Firm or rubbery lumps beneath the nipple
- Discomfort with movement or clothing contact
How We Manage This at MACS Clinic
At MACS Clinic, we follow individualised approach to recurrent or persistent gynecomastia:
- Thorough history and examination, especially discussing any previous steroid or medication use
- Imaging or hormone tests, when clinically indicated
- Targeted surgical re-excision of painful or recurred fibrous tissue
- Post-operative care focused on:
- Maintaining a healthy, stable weight
- Avoiding medications or supplements that can trigger recurrence
- Clear aftercare guidance to optimise long-term results
Take-Home Message
- Recurrence after a proper glandular excision is rare, but it can happen—particularly when regrowth occurs years later.
- It is treatable, and patients can achieve full relief through precise re-excision and appropriate follow-up.
If you are experiencing pain or lumps after a previous gynecomastia surgery, contact our team at MACS Clinic.
- Phone: 020 7078 4378
- WhatsApp: 07792 648 726
- Email: enquiries@macsclinic.co.uk
- Website: macsclinic.co.uk
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