GYNECOMASTIA → Grade 4
Grade 4 Gynecomastia Surgery in Pune
500+
95–98%
Less Than 1 cm
Intra-Areolar Incision Technique
Grade 4 gynecomastia is the most severe stage on the Simon classification scale. It involves significant glandular and fatty tissue enlargement combined with substantial skin redundancy. The chest visibly resembles a small female breast with skin that hangs below the pectoral muscle line. Grade 4 typically affects men who have had untreated gynecomastia for years, post-bariatric patients with significant chest skin laxity, and men with hereditary tissue patterns.
Dr. Dhruv Chavan, M.Ch. Plastic Surgery
Founder & Lead Surgeon, Dr DC Plastic Surgery, Pune · 500+ gynecomastia surgeries
Why Grade 4 Requires a Different Surgical Approach?
Liposuction alone is insufficient for Grade 4 gynecomastia. Three components must be addressed in the same procedure for a clean chest contour. Dr. Chavan performs all three in a single operative session.
- Liposuction to remove fatty tissue and contour the chest
- Glandular excision through a peri-areolar incision to remove dense breast tissue
- Skin tightening through targeted skin excision when laxity is severe
For Grade 3 cases without significant skin laxity, see Grade 3 Gynecomastia Surgery.
Key Attributes of Grade 4 Surgery at Dr DC
| Factor | Pubertal Gynecomastia |
|---|---|
| Surgical approach |
Combined liposuction + excision + skin tightening |
| Anaesthesia | General |
| Surgery duration |
2.5 – 3.5 hours |
| Hospital stay | Day care or 1 night |
| Cost range | Rs. 1,30,000 – Rs. 180,000 (all-inclusive) |
| Recovery to desk work |
7 – 10 days |
| Full exercise clearance | 8 weeks |
| Compression garment |
6 weeks |
Why Choose Dr DC for Grade 4 Surgery?
Grade 4 cases require advanced surgical judgment in tissue management, scar placement, and skin excision design. Dr. Dhruv Chavan, founder and lead surgeon at Dr DC Plastic Surgery, has performed over 400 aesthetic surgeries and personally handles every Grade 4 case from evaluation through follow-up. The single-surgeon model means the surgeon you consult is the same surgeon who operates and reviews recovery.
Book Your Consultation
To begin the consultation process for Grade 4 gynecomastia surgery with Dr. Chavan at Dr DC Plastic Surgery in Pune, book a slot at any of the six consultation centres across Pune.
Free in-person consultations at 6 locations across Pune.
Frequently Asked Questions
How is Grade 4 gynecomastia different from Grade 3?
Grade 4 gynecomastia involves significant skin laxity and ptosis in addition to glandular and fatty tissue enlargement, while Grade 3 typically presents with moderate enlargement without major skin redundancy. Grade 4 requires skin excision in addition to liposuction and glandular removal, which Grade 3 usually does not. Surgical time and recovery duration are longer for Grade 4 cases.
How much does Grade 4 gynecomastia surgery cost in Pune?
Grade 4 gynecomastia surgery at Dr DC Plastic Surgery in Pune costs Rs. 1,30,000 to Rs. 1,80,000 all-inclusive in 2026. The figure covers the surgeon fee, general anaesthesia, day-care or overnight facility charges, all consumables, compression garment, two weeks of medications, and three post-operative follow-up consultations with Dr. Chavan.
What is the recovery time for Grade 4 gynecomastia surgery?
Recovery from Grade 4 gynecomastia surgery takes 7 to 10 days for return to desk work, 6 weeks of continuous compression garment wear, and 8 weeks for full exercise clearance. The final chest contour settles between 3 and 6 months post-surgery. Recovery is approximately 1 to 2 weeks longer than Grade 1 or Grade 2 cases due to the additional skin tightening component.
Will Grade 4 surgery leave visible scars?
Grade 4 surgery involves longer incisions than lower-grade cases because skin excision is required. Dr. Chavan places incisions along natural skin tension lines and along the inferior areolar margin to minimise visibility. Scars fade significantly over 6 to 12 months but remain partially visible at close range. Final scar appearance is reviewed at the 6-month follow-up.
Can Grade 4 gynecomastia be treated without surgery?
No, Grade 4 gynecomastia cannot be effectively treated without surgery. Non-surgical approaches (medication, weight loss, lifestyle changes) do not address the established glandular tissue or the skin laxity that define Grade 4. Surgical excision combined with skin tightening is the only treatment that produces a permanent flat chest contour for true Grade 4 cases.
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Gynecomastia Surgery in Pune
