Chennai, September 2026: MGM Healthcaresuccessfully performed open surgical chest contouring on a 44-year-old man diagnosed withGrade 3 gynaecomastia and Stage 1 liver failure.Gynaecomastia is characterised by significantenlargement of male breast tissue and, in this case, was associated with excess skin and early-stage liver dysfunction.
The patient, a police officer recently approached the hospital after his enlarged breasts began significantlyaffecting his daily life and professionalresponsibilities. He found it difficult to run and wasunable to change comfortably at his workplaceleading to public embarrassment, low confidence, and reduced self-esteem.
The medical team at the hospital also diagnosed himwith liver cell failure. In this case, it remains uncertainwhether the gynaecomastia was idiopathic (with noidentifiable cause) or secondary to liver cell failure. Considering the patient’s bleeding abnormalities secondary to hepatic failure, the team decided not to perform liposuction or other conventionaltechniques. Instead, we opted for open surgical chestcontouring, a procedure commonly performedfollowing massive weight loss or as part of gender-affirming surgery for female-to-male (FTM) transition.
The surgical team headed by Dr. S. Narayanamurthy, Senior Consultant and Head of Department for Plastic, Aesthetic and ReconstructiveMicrosurgery and Dr. Suresh Rajendran, SeniorConsultant, Department of Plastic Surgery andsupported by Dr. Senathi Nanda Kishore, ClinicalDirector, Senior Consultant C Clinical Lead,Anaesthesiology and Surgical ICU, and Dr.
D. Babu Vinish, Senior Consultant, MedicalGastroenterologist.
During the three-hour surgery, the team performeda double-incision mastectomy with free nipplegrafts after conducting an upper gastrointestinalendoscopy to assess and minimise the risk of gastrointestinal bleeding before and after surgery. Liver-friendly anaesthetic agents were used duringthe procedure. The entire gland was excised toachieve a flat, masculine chest contour. The teammaintained symmetry on both sides and ensuredthat the chest contour was in harmony with thepatient’s overall body proportions. The scar followedthe natural crease of the inframammary fold,maintaining a gentle, natural curve.
In his comments, Dr. S. Narayanamurthy said,“Gynaecomastia is relatively common among men,but this case presented a unique surgicalchallenge because the patient also had liver dysfunction and associated bleeding abnormalities. Given these concerns, conventional approachessuch as liposuction were not considered appropriatebecause it can be tricky with higher risk of bleeding during or after surgery. We therefore opted for an open surgical approach, which allowed us to remove theexcess glandular tissue and skin while carefullycontrolling the surgical field. Our goal was not only toaddress the physical condition but also to achieve awell-proportioned, masculine chest contour thatwas in harmony with the patient’s overall body structure. The procedure required meticulousplanning and coordination among the surgical, anaesthesia, and medical teams to ensure thepatient’s safety.”Although gynaecomastia cannot always be prevented, itcan be identified and treated at an early stage. Liverfailure, testicular failure, thyroid abnormalities, andhormonal imbalances are among the major causesassociated with this condition. Therefore, men withenlarged breasts should undergo periodic medicalevaluations to identify and address gynaecomastia at anearly stage.