Operation Guide: Gynaecomastia Surgery with VASER Liposuction


Dr Bernard Beldholm

If you have large male breasts that won’t go away with diet or exercise, you might have a medical condition known as gynaecomastia.

Gynaecomastia is surprisingly common. Experts say it affects up to 50% of men.

Enlarged male breasts can prevent you from wearing the clothes you prefer, such as slim-fit shirts and singlets. It may also cause you to avoid social activities that require you to go shirtless, such as trips to the beach, pool or gym.

Thankfully, there is a way to get rid of man boobs surgically.

Gynaecomastia surgery is a procedure that fixes male chest enlargement in one day. In this article, you will learn about each step of Doctor Bernard’s gynaecomastia surgery.

Download our free guide: “Do I have Gynecomastia? Find out in 3 Easy Steps”

3 Steps to Identify if you have gynecomastia Handbook

What is gynaecomastia?

If you are a man with large breasts, it may be your chest gland that is to blame. An overactive gland causes breast tissue to grow excessively. To make matters worse, some men store excess chest fat, which makes breasts look bigger. The result is a feminine-looking chest.

What is gynaecomastia surgery?

Gynaecomastia surgery is a procedure that fixes man boobs in approximately two hours. The operation works by cutting out the chest gland and shaping a square, masculine chest with liposuction. Dr. Bernard Beldholm, FRACS has performed the operation on hundreds of men over the last decade.

Gynaecomastia surgery is an effective way to get rid of man boobs

Once you have surgery to remove the gland, it is unlikely that your gynaecomastia will come back. While surgery is no guarantee for permanent results, men who choose to have the surgery tend to report long lasting results.

Doctor Bernard performs surgery with two benefits. First, he removes your chest gland to stop breast growth. His operation also has the added benefit of VASER liposuction for removing excess fat. Removing the gland and shaping your chest wall creates a flatter chest with a more masculine appearance. The operation takes about two hours.

Is VASER liposuction really necessary?

Simply removing the gland can cause a saucer deformity. Your chest gland is located behind your nipple. With the gland removed, your nipple may dent inward, which looks bad cosmetically.

Therefore, Doctor Bernard strongly recommends gynaecomastia surgery with VASER liposuction and gland removal. Both can be done in one surgery. By using liposuction on your chest and removing fat with VASER, he shapes the tissue around your gland to minimise the risk of saucer deformity. VASER also defines your pec muscles. It gives your chest a squared shape — which is the hallmark of a masculine chest.

What happens during the operation?

In this article, you will learn about each step of Doctor Bernard’s gynaecomastia surgery. The operation includes:

  • Pre-op appointment
  • Sterilisation
  • Anesthesia & intubation
  • VASER liposuction to melt fat
  • Chest gland removal
  • Closing the incision
  • Drain placement
  • Bandages
  • Recovery

How to perform gynaecomastia surgery with VASER liposuction

Each step of Doctor Bernard’s qynaecomastia procedure is designed to improve the appearance of your chest.

Step 1: Pre-op appointment

On surgery day, you’ll meet with Doctor Bernard to go over any last-minute questions. During your pre-op appointment, he draws on your skin with a special marking pen. This allows him to plan the incisions. He marks your skin to show where the gland is located and how much fat should be removed.

The goal of the markings is to ensure you have an even result on both sides. Doctor Bernard may ask you to flex your pec muscles so that he can mark out the edge of your muscle. This allows him to highlight your pecs for the liposuction part of the operation.

Step 2: Sterilisation

Before your operation begins, everything must be sterilised. First, a nurse applies Betadine prep to sanitise your skin. Sterile drapes are placed above and below you on the operating table. This is done to prevent contamination. Keeping everything sterile is vital. It lowers your risk of developing an infection, which can occur during any surgery.

Step 3: Anaesthesia & intubation

Gynaecomastia surgery is performed while you are under general anaesthesia. You will have no memory or sensation of the surgery. This ensures total comfort during your operation.

A highly trained anesthesiologist provides you with a controlled dose of sedatives through an IV. In moments, you’ll begin to feel sleepy.

A mask is placed over your mouth. This provides you with oxygen while you are asleep. Next, a breathing tube is inserted to help you breathe during the operation. This is known as intubation.

The operation begins once you are safely sedated and intubated. You are in good hands with a team of qualified medical professionals by your side. During your surgery, the anaesthetist monitors your vitals until the moment your surgery ends.

Step 4: VASER liposuction

The operation starts with VASER liposuction. This removes fat from the chest area.

Wetting solution

Doctor Bernard starts the VASER process by applying a wetting solution to your fatty chest tissue. The solution makes it easier to target fat cells with the VASER.

Doctor Bernard first creates tiny incisions in your chest. A thin cannula (hollow tube) is passed through your skin and into your chest. Through the cannula, Doctor Bernard applies a liquid wetting solution. This prepares your fat cells for removal.

It is important that the wetting solution is applied evenly to the fatty tissue. The more evenly it is distributed, the better your chest lipo results.

Fat melting with VASER

VASER is a handheld wand that melts fat with ultrasonic energy. It liquefies solid fat until it becomes like hot butter. That way, it is easier to remove the fat later.

The VASER wand gets hot while it goes to work melting your excess chest fat. Doctor Bernard places a small plastic port into your skin. This protects your skin from getting heat damage from the VASER.

Next, he inserts the VASER probe through your skin. He moves it back and forth to reach every fat cell.

The VASER probe comes in different sizes. The size Doctor Bernard chooses is based on how much chest fat you need removed. A five-ring probe is excellent for removing large amounts of fat. A one or two-ring probe is great for defining fatty tissue around your chest gland.

The VASER melts fatty tissue on and around your pectoralis major muscle and the gland as well. Doctor Bernard works on the lateral sides of your chest to give your chest a squared shape. This is a trait seen in masculine chests.

Once the fat melting is done, he checks to make sure everything look nice and even. He looks at the center line of your chest to ensure it is straight. He looks at your pec muscles to ensure they appear sculpted and defined. He makes small adjustments with the VASER to ensure you have a great result.

It is important to remove just the right amount of fat — not too much, not too little. In his 10+ years of experience, Doctor Bernards has found that leaving a small padding of fat on the pec muscle is a good idea. This makes your surgery results look more natural.

Fat removal with traditional liposuction

Now that Doctor Bernard has melted the fat with VASER, it’s time to remove it. The melted fat is removed from your chest with traditional liposuction. Liposuction uses a machine to remove fat with suction.

Aggressive liposuction is often necessary in men with gynaecomastia. It provides a nicely shaped chest wall, especially on the sides of your chest and around the muscles.

Once your excess chest fat is gone, your chest will look more manly and defined.

Step 5: Chest gland removal

The next step is gland removal. There is a gland in each breast. Once the faulty gland is removed, it is unlikely to grow back. That is what makes gynaecomastia surgery one of the most effective ways to get rid of man boobs.


First, Doctor Bernard makes a small incision just below your nippple. The incision follows the curve of your areola. Once it heals, the scar won’t be obvious. The nipple areola complex is lifted so he can see the gland, which is located just behind each nipple.


Doctor Bernard makes small cuts with a surgical scissor to dissect the tissue that is in front of your chest gland. This is known as dissection. Now, Doctor Bernard can access the gland so it can be surgically removed.

Cutting out the gland

If you can feel a hard, rubbery lump behind your nipple, it may be gynaecomastia. This is the gland that is removed during your gynaecomastia surgery.

The next step of the surgery is removing your chest gland. The gland is easy for Doctor Bernard to see because it is hard, rubbery, and white. He cuts the tissue to separate the gland from the surrounding tissue. The gland is firmly tethered in place, so it takes quite a bit of effort to remove it.

The end of the gland is attached to subcutaneous tissue. Doctor Bernard aims to remove the gland only, leaving the healthy tissue intact.

Each breast has its own breast gland. He repeats the process on both sides of your chest. Once the gland is gone, it is unlikely to come back. This is a huge relief for men that have struggled with gynecomastia for years.

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Step 6: Closing the incision

Your surgery is almost finished. Once your chest gland is removed, Doctor Bernard closes the incision. He reattaches your nipple areola complex. He may use a combination of stitches and dissolving sutures to close the wound.

Step 7: Drain placement

Doctor Bernard places drains into your chest to prevent fluid buildup, which is your body’s natural response to surgery. Drains are hollow tubes that pass through your skin. Any fluid that collects at the wound site drains out. The next day, you’ll meet with Doctor Bernard to remove the drains.

Step 8: Bandages

The final step of surgery is placing a bandage on your skin. This keeps the wound clean and free of infection. Doctor Bernard also puts a compression garment on your chest. The garment provides constant, gentle pressure to reduce swelling after gynaecomastia surgery. You may wear the garment for several weeks.

Step 9: Recovery

After surgery, you will wake up in the recovery room at the hospital. Most men go home from surgery the same day. It is normal to feel sleepy for up to 24 hours after general anaesthesia. You can rest and take it easy the first day.

The next day, Doctor Bernard meets with you to remove the drains and ensure that you are healing well.

It takes several weeks to fully recover from gynaecomastia surgery. Patients should avoid vigorous exercise for up to six weeks.

Your gynaecomastia surgery is now complete.

Bernard Beldholm Logo


30 Belmore Rd
Lorn NSW 2320


This website contains adult content. You must be 18 years or over to read. All surgery carries risks. You should seek a second opinion before proceeding. Results vary from patient to patient. See our disclaimer.
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