Gynaecomastia Treatment

At Harley Street Medical Doctors, we understand that patients want lasting results when undergoing gynecomastia treatment.
The permanence of results depends on the type of treatment and lifestyle factors.

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1. Surgical Treatment (Liposuction / Gland Excision)

• Permanent removal of tissue: Surgery removes glandular tissue and/or excess fat from the chest. Once removed, this tissue does not grow back.
• Long-lasting results: Most patients enjoy a flatter, more masculine chest permanently.
• Factors that may affect results:
  • Significant future weight gain can lead to fat accumulation in the chest area.
  • Hormonal imbalances (for example, caused by medications or medical conditions) may contribute to recurrence in rare cases.

Key point: Surgery provides the most reliable, long-term correction of gynecomastia.

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2. Non-Surgical Treatment (Lifestyle, Hormone Therapy, Non-Invasive Fat Reduction)

• Gradual and variable results: Non-surgical treatments do not remove glandular tissue. Fat reduction or contouring may improve appearance, but results may be partial.
• Maintenance required: Healthy lifestyle, weight management, and hormone optimisation are essential to maintain improvements.
• Potential for recurrence: If underlying causes (e.g., obesity, medications, hormone imbalances) are not addressed, chest enlargement may return over time.

Key Takeaways

• Surgery: Offers permanent results in most cases, especially for glandular tissue.
• Non-surgical options: Can improve appearance, but results require ongoing maintenance and may not be permanent.
• Expert guidance: At Harley Street MD, we provide personalised assessment to recommend the most effective treatment for lasting results and guide patients on prevention of recurrence.

Pre-care Instructions

Proper preparation before gynecomastia treatment is key to ensuring safety, a smooth procedure, and optimal results. At Harley Street Medical Doctors, we provide personalised guidance tailored to each patient’s needs.

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1. Medical Assessment

• Attend a consultation to review your medical history, medications, and any previous chest conditions.
• Undergo physical examination and, if necessary, blood tests or imaging to assess tissue type (fat vs glandular) and rule out underlying causes.
• Discuss current medications and supplements; some may need to be paused before treatment (e.g., blood thinners, certain herbal supplements).

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2. Lifestyle Adjustments

• Stop smoking and vaping at least 2–4 weeks before surgery to improve healing and reduce complications.
• Limit alcohol intake for at least one week before treatment.
• Maintain a healthy diet and hydration to support recovery.

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3. Medication Guidelines

• Your clinician may advise stopping certain medications temporarily, including:
  • Blood thinners (e.g., aspirin, warfarin)
  • Anti-inflammatory drugs
  • Some supplements that increase bleeding risk
• Always consult your doctor before stopping prescribed medications.

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4. Pre-Operative Preparation for Surgery

• Arrange transportation to and from the clinic on the day of surgery.
• Wear loose, comfortable clothing, preferably a button-up or zip-up shirt for easy dressing after treatment.
• Plan for rest at home for at least the first 24–48 hours.
• Follow any specific instructions regarding fasting if sedation or general anaesthesia is planned.

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5. Mental Preparation

• Understand realistic expectations: discuss what surgery or non-surgical treatment can achieve.
• Ask questions about recovery, risks, and post-care instructions—knowing what to expect can reduce stress.

Key Takeaways

• Proper pre-care improves safety, healing, and final results.
• Follow all instructions from your Harley Street MD clinician regarding medications, lifestyle, and pre-operative preparation.
• Arrive prepared, informed, and rested for your procedure to ensure the best possible outcome.

After-care Instructions

Following your gynecomastia treatment, whether surgical or non-surgical, proper after-care is essential for safe healing and optimal cosmetic results. Harley Street Medical Doctors provide tailored guidance throughout your recovery.

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1. Immediate Post-Procedure Care

• You may feel mild discomfort, tightness, or swelling in the chest — this is completely normal.
• Keep the treated area clean and dry for the first 24–48 hours.
• Follow your clinician’s instructions regarding dressings or bandages; do not remove them early unless advised.
• If local anaesthetic was used, you may feel numbness for a few hours. Avoid touching or pressing the area until sensation returns.

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2. Compression Garment

• Most patients will need to wear a compression vest to reduce swelling and support healing.
• Wear it continuously for the first 1–2 weeks, then during the day for an additional period if recommended.
• Do not replace the garment with tighter clothing — only use the medical compression vest provided or approved by your clinician.

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3. Managing Pain & Swelling

• Mild discomfort can usually be managed with paracetamol unless advised otherwise.
• Avoid ibuprofen or other anti-inflammatory medications for the first few days unless your doctor approves them, as they can increase bruising.
• Apply cold compresses to the area for short intervals during the first 48 hours (never directly on the skin).
• Keep your upper body slightly elevated when resting or sleeping to reduce swelling.

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4. Activity & Exercise

• Rest for the first 24–48 hours after treatment.
• Avoid strenuous activities, heavy lifting, or chest workouts for 2–4 weeks, depending on the procedure performed.
• Light walking is encouraged from the first day to support circulation and healing.
• Avoid stretching or putting pressure on the chest until your clinician confirms it is safe.

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5. Wound Care (Surgical Patients Only)

• Keep incisions clean and dry. Your clinician will advise when you may shower — usually after 24–48 hours.
• Do not submerge the chest in baths, pools, saunas, or steam rooms for at least 2–3 weeks.
• Avoid applying creams, oils, or deodorants near the incision sites unless prescribed.
• If you notice any unusual discharge, redness, or heat around the wounds, contact the clinic promptly.

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6. Medication & Prescriptions

• Take all prescribed medications exactly as directed, including antibiotics (if given).
• Avoid restarting blood thinners, supplements, or gym-related hormonal products until your doctor approves.
• If you experience nausea or side effects, notify Harley Street MD so your treatment plan can be adjusted.

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7. Skin & Tissue Care

• Bruising may appear in the days following treatment — this will gradually fade.
• Small lumps or firmness under the skin can occur as the tissue heals; gentle massage may be recommended after the initial healing phase, but only start if your clinician advises it.
• Protect the chest from direct sun for at least 6 weeks to avoid pigmentation changes.

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8. Lifestyle Recommendations

• Avoid smoking and vaping during recovery, as they slow healing and increase complication risks.
• Limit alcohol for the first week.
• Maintain a balanced diet rich in protein, vitamins, and hydration to support tissue repair.
• Continue any weight-management or hormonal advice provided during your consultation if relevant.

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9. Emotional Wellbeing

Many patients feel a boost in confidence after treatment, but it’s also common to experience temporary:

• Tightness or uneven swelling
• Anxiety about early results
• Concern about bruising or asymmetry

These early changes are normal. Final results can take 8–12 weeks, and your clinician will guide you through each stage.

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10. Follow-Up Appointments

• Attend your scheduled reviews so your doctor can monitor healing and adjust your care plan.
• Additional check-ups may be arranged if you underwent surgical gland removal or liposuction.
• Contact the clinic sooner if you experience:
  • Increasing pain
  • Significant swelling on one side
  • Fever
  • Fluid leakage
  • Sudden changes in chest shape

“We support you from your first consultation through to full recovery. Our goal is safe healing and natural, confident results.”
— Harley Street MD, London

Quick Reference

• Compression garment: Wear continuously as advised (usually 1–2 weeks)
• Activity: Rest 48 hrs; avoid heavy exercise 2–4 weeks
• Pain relief: Paracetamol preferred unless instructed otherwise
• Wound care: Keep clean & dry; avoid soaking for 2–3 weeks
• Lifestyle: No smoking/vaping; limit alcohol
• Follow-up: Attend all scheduled appointments

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Gynaecomastia (also spelled gynecomastia) refers to the enlargement of breast tissue in men. It can affect one or both sides of the chest. It’s commonly caused by a hormonal imbalance (particularly between testosterone and oestrogen) and can also be influenced by factors such as weight gain, certain medications or steroid use, ageing, or underlying health conditions.

At Harley Street MD, this condition is described under “man-boobs” and highlighted as something that can cause self-consciousness and discomfort.

What happens at Harley Street MD?

Harley Street MD offers a tailored approach to male chest aesthetics, including gynaecomastia. Their blog outlines that:

• We begin with a comprehensive consultation, including medical history, physical examination, and discussion around cause and goals.
• We emphasise distinguishing true glandular gynaecomastia from simple fatty chest tissue (often called pseudogynecomastia), because the treatment differs.
• We provide options for non-invasive approaches (in mild cases) and surgical interventions when necessary.
• Our multidisciplinary team approach, set in a central London clinic, reflects high standards of care, comfort, and confidentiality.

1. Lifestyle & non-surgical measures

Before surgery, or in mild cases, Harley Street MD and others recommend:

• Optimising weight and body composition: losing excess fat can reduce “false” gynaecomastia (fat over gland).
• Avoiding or addressing modifiable causes such as medication side-effects, anabolic steroid use, excess alcohol, or hormonal disorders.
• In selected cases, medications such as selective oestrogen receptor modulators may be used (though surgery is often the definitive treatment).

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2. Surgical / procedural treatment

When lifestyle and non-surgical treatments aren’t enough, or when there is a significant glandular component, surgery is considered. According to Harley Street MD:

• The procedure may involve liposuction (to remove fatty tissue) and/or excision of glandular tissue and excess skin, depending on individual anatomy.
• A combination of techniques is common: ideal results often require both fat removal and gland removal or skin tightening.
• Recovery is typically straightforward: patients often go home the same day (day-case basis), though a short rest period is advised.

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3. What you can expect

• Pre-operative assessment will cover your goals, realistic outcomes, risks, and recovery schedule.
• Post-operatively, you’ll likely wear a compression garment for a period, experience some swelling or bruising, and see gradual contour improvement over weeks to months.
• The result is typically a flatter, more traditionally masculine chest contour, improved clothing fit, and increased confidence.

• Bespoke male-health and aesthetic focus: They address not only the cosmetic chest concern but also investigate hormonal, lifestyle, and health factors (important in gynaecomastia).
• Central London (Harley Street) clinic: Care is delivered by experienced doctors with a holistic approach to men’s aesthetic health.
• Transparent patient education: Clear information on their blog and website demonstrates a commitment to education and patient autonomy.

You may be a good candidate if:

1. You have persistent chest enlargement

• Your chest remains enlarged despite maintaining a healthy weight, exercising regularly, and having a balanced diet.
• The swelling feels firm or rubbery (glandular tissue), not just soft fat.

2. It causes physical or emotional discomfort

• You feel self-conscious about your chest shape and may avoid fitted clothing, swimming, or intimacy due to appearance.
• You experience tenderness or mild pain around the breast tissue.

3. You are in good overall health

• You don’t have uncontrolled medical conditions (such as severe heart, liver, or kidney disease).
• You are not currently taking medications or substances (e.g. anabolic steroids, certain antidepressants, or anti-ulcer drugs) that may be causing the problem — or you are willing to stop or change them under medical supervision.

4. Your weight is stable

• Ideal candidates are close to their target body weight, as significant weight loss after surgery could alter results.
• If the enlargement is mainly due to fat (pseudogynecomastia), weight management alone may resolve it without surgery.

5. Your breast growth has stabilised

• Particularly important for younger men, as pubertal gynaecomastia often resolves on its own.
• Surgery is best considered once breast size has been stable for at least 12 months.

6. You have realistic expectations

• Gynaecomastia surgery can flatten and reshape the chest, but no procedure can guarantee perfect symmetry.
• The aim is a natural, masculine contour and improved confidence.

You may not yet be ready for treatment if:

• Your gynaecomastia has developed very recently (less than 6–12 months) and may still regress naturally.
• You are actively using steroids, recreational drugs, or medications known to cause hormonal imbalance.
• Your main concern is excess fat rather than glandular tissue, which may respond to diet and exercise first.
• You have an untreated hormonal disorder or medical condition that should be corrected before surgery.

Next step:

At Harley Street Medical Doctors, your suitability is confirmed during a comprehensive consultation, which includes:

• A physical examination
• Review of your medical and medication history
• Possible blood tests to assess hormone levels
• Discussion of expectations and the most appropriate treatment plan (non-surgical vs surgical)

This ensures treatment addresses both appearance and underlying cause, helping achieve safe, long-lasting results.

1. Initial Contact & Pre-Consultation

• You can book a consultation online or by phone.
• Before your visit, you may be asked to complete a brief medical history form, detailing:
  • Any medications, supplements, or steroids you use
  • Past medical conditions or surgeries
  • Lifestyle factors such as exercise, diet, and alcohol intake
• Photos of your chest may be requested for documentation and planning.

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2. Face-to-Face Consultation

Once at the clinic, you’ll meet with an experienced doctor specialising in men’s aesthetic and hormonal health. The consultation focuses on three areas:

‍Medical & Lifestyle Review

• Review of hormones, medications, and any contributing factors.
• Assessment of lifestyle factors such as weight, diet, and exercise.

Physical Examination

• The doctor examines your chest to determine:
  • Whether the enlargement is glandular (true gynaecomastia) or fatty (pseudogynecomastia)
  • Skin elasticity and any asymmetry
  • Nipple position and overall chest contour
• The tissue may be palpated to check for firmness or lumps.

Discussion of Goals & Expectations

• You’ll discuss what you hope to achieve, such as a flatter chest, improved symmetry, or greater confidence.
• The doctor explains which treatment options are realistic for your situation (lifestyle, non-surgical, or surgical).

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3. Investigations (if needed)

To ensure safety and identify underlying causes, your doctor may recommend:

• Blood tests – to check hormone levels (testosterone, oestrogen), liver and kidney function, and thyroid markers.
• Imaging – in some cases, ultrasound or mammogram to differentiate glandular tissue from other causes.
• Medication review – to identify any drugs or supplements contributing to chest enlargement.

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4. Treatment Planning

After assessment, the doctor will create a personalised plan, which may include:

• Lifestyle & medical optimisation – weight management, stopping or switching medications, hormone correction.
• Non-surgical treatments – rare, but may include short-term medication in selected cases.
• Surgical options – tailored to tissue type, chest contour, and desired outcome:
  • Liposuction (fat removal)
  • Gland excision
  • Combination procedures for optimal contouring

You’ll also receive a recovery plan explaining what to expect immediately after the procedure and over the following weeks.

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5. Patient Support & Education

Harley Street MD emphasises patient comfort and confidence:

• Written information and aftercare guidance are provided.
• Doctors discuss risks, possible complications, and expected outcomes.
• A follow-up schedule is arranged to monitor healing and results.

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6. Key Takeaways

• Every treatment plan is personalised — there is no one-size-fits-all approach.
• The goal is not only physical improvement but also emotional confidence and long-term satisfaction.
• Harley Street MD’s multidisciplinary approach ensures both appearance and underlying causes are addressed.

Step 1: Initial Consultation (Week 0)

• Meet your doctor for a full assessment.
• Discuss medical history, lifestyle, medications, and goals.
• Physical examination of your chest.
• Decide if further tests (bloods or imaging) are needed.
• Treatment options and next steps are explained.

Step 2: Pre-Procedure Preparation (1–3 Weeks)

• Complete any recommended blood tests or imaging.
• Adjust medications or supplements if needed.
• Plan for surgery day (time off work, arranging support).
• Stop smoking and optimise health if advised.

Step 3: Procedure Day

• Arrive at the clinic (often day-case; no overnight stay).
• Surgery performed: liposuction, gland removal, or a combination.
• Compression garment applied to support healing.
• Usually go home the same day with post-operative instructions.

Step 4: Early Recovery (Weeks 1–2)

• Expect swelling, bruising, and mild discomfort.
• Wear the compression garment as instructed.
• Limit heavy lifting or intense exercise.
• Attend a follow-up appointment to check healing.

Step 5: Intermediate Recovery (Weeks 3–6)

• Swelling gradually decreases.
• Light exercise can usually resume, but avoid chest-intensive workouts until cleared.
• Scars begin to mature; continue wearing the garment if advised.

Step 6: Full Recovery & Results (Weeks 6–12+)

• Chest contour stabilises.
• Most swelling resolves and the final shape becomes visible.
• Normal activities, including full workouts, are usually resumed.
• Follow-up appointments ensure optimal healing and symmetry.

Quick Tips

• Results are long-lasting, especially if weight and lifestyle are maintained.
• Scar appearance improves over several months.
• Full satisfaction often comes once swelling has fully subsided (around 3 months).

When NHS treatment might be available

• According to the NHS website, male breast reduction surgery is said to be “not usually available” but may be funded if:
  • The condition has been present for a long time.
  • It has not responded to other treatments (e.g., medication, lifestyle changes).
  • The enlargement is causing considerable pain or distress (physical or psychological).
• Some local NHS policies specify extra criteria. For example:
  • The patient’s BMI must be within a certain range and stable.
  • Other causes (such as drug- or hormone-induced) must have been evaluated and/or corrected where possible.

Why most cases are not covered

• The NHS treats surgery for gynaecomastia as cosmetic in many cases, rather than medically necessary.
• Many Clinical Commissioning Groups (CCGs) have policies stating that male breast reduction is not routinely commissioned.

Key takeaway

If you are considering NHS treatment for gynaecomastia, expect that:

• Approval depends on local policy (your ICB/CCG) and whether you meet strict criteria.
• You’ll likely need to demonstrate that:
  • The condition is persistent and not likely to resolve by itself.
  • You’ve tried non-surgical options (weight loss, stopping causative medications, etc.).
  • There is significant physical or psychological impact.
• If you don’t meet those criteria, the NHS will likely decline to fund surgery, and you may need to consider private treatment.

• Yes — non-surgical treatment can be appropriate for gynecomastia in selected cases, but it is not guaranteed to be sufficient in all cases.
• The success of non-surgical approaches depends strongly on the proportion of fat vs glandular tissue, skin quality, underlying causative factors, and patient commitment to lifestyle change.
• At Harley Street MD we pride ourselves on offering honest, patient-centred consultations: if non-surgical treatment is unlikely to give you the result you want, we will tell you so — and guide you through the surgical options without pressure.
• Early assessment is wise. The sooner you investigate causes, optimise any hormone issues, or modify lifestyle, the greater chance non-surgical approaches may succeed.

At Harley Street Medical Doctors, patient safety and transparency are our top priorities.
While gynecomastia treatments, whether surgical or non-surgical, can significantly improve chest appearance and confidence, it’s important to be aware of potential risks and side effects.

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1. Surgical Treatment Risks

Surgery is often the most effective method for removing excess glandular and fatty tissue.
The main surgical approaches include liposuction (for fat removal) and excision (for gland removal).

Potential risks and side effects include:

• Pain and discomfort: Mild to moderate pain is common in the first few days after surgery.
• Swelling and bruising: Usually temporary, lasting from a few weeks up to a month.
• Scarring: Small scars are typically hidden around the areola, but scarring is possible.
• Asymmetry: Slight differences between sides can occur.
• Changes in nipple sensation: Temporary or, rarely, permanent numbness or heightened sensitivity.
• Infection or bleeding: Rare, but may require antibiotics or, very rarely, surgical intervention.
• Fluid accumulation (seroma): Occasionally fluid may collect under the skin, which may need draining.
• Skin irregularities: Uneven chest contour, dimpling, or loose skin may occur, particularly in patients with poor skin elasticity.

Most of these risks can be minimised by choosing an experienced surgeon and following post-operative care instructions carefully.

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2. Non-Surgical Treatment Risks

Non-surgical options, such as lifestyle interventions, hormone therapy, or non-invasive fat reduction (e.g., cryolipolysis, radiofrequency), generally carry fewer risks but still have considerations:

• Temporary swelling or redness: Common after non-invasive fat-reduction treatments.
• Mild discomfort or tenderness: Usually short-lived.
• Skin changes: Rarely, temporary skin sensitivity or minor bruising.
• Incomplete results: Non-surgical treatments cannot remove glandular tissue, so some chest prominence may remain.
• Hormone therapy risks: If prescribed, can include mood changes, acne, or other side effects depending on the medication.

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3. How We Minimise Risk at Harley Street MD

• Personalised assessment: We carefully evaluate whether surgery or non-surgical treatment is the safest and most effective approach for your chest type.
• Experienced clinicians: Our surgeons and physicians have specialist expertise in male chest aesthetics and men’s health.
• Comprehensive aftercare: Detailed post-treatment instructions and follow-up visits to monitor healing and outcomes.
• Open discussion: We explain all potential risks, side effects, and realistic expectations so you can make an informed choice.

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Key Takeaway

Gynecomastia treatment is generally safe when performed by qualified professionals, but like any medical procedure, it carries potential risks. Choosing the right approach for your chest type, understanding what to expect, and following professional guidance significantly reduces complications and improves outcomes.

At Harley Street Medical Doctors, we understand that recovery is just as important as treatment.
The duration and experience depend on whether you undergo surgical or non-surgical treatment.

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Surgical Recovery (Liposuction / Gland Excision)

Immediate (First few days):

• Mild to moderate pain, swelling, and bruising.
• Pain controlled with prescribed medication.
• Compression garments worn to support the chest.

1–2 Weeks:

• Light daily activities can usually be resumed.
• Swelling and bruising start to decrease.
• Avoid strenuous exercise and heavy lifting.

3–6 Weeks:

• Swelling continues to subside.
• Moderate physical activity can often be resumed gradually.
• Chest contour starts becoming noticeable.

3–6 Months:

• Final results apparent as residual swelling resolves.
• Scars fade and soften naturally.
• Full return to all activities, including intense workouts.

Following post-operative instructions and wearing compression garments helps achieve optimal results.

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Non-Surgical Recovery (Lifestyle, Hormone Therapy, Non-Invasive Fat Reduction)

Immediately After Treatment:

• Mild redness, tenderness, or swelling at treatment sites.
• No downtime: normal activities can usually continue.

Weeks to Months:

• Gradual improvement in chest contour.
• Multiple sessions may be needed for best results.
• Lifestyle or hormone interventions take time to show full effect.

Non-surgical treatments are most effective for fatty chest tissue rather than glandular tissue.

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Factors Affecting Recovery

• Extent of treatment
• Age and overall health
• Skin elasticity
• Adherence to post-treatment guidance

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Key Takeaways

• Surgical: Noticeable improvement in 3–6 months; minimal downtime for daily activities.
• Non-surgical: Little to no downtime; results appear gradually over weeks to months.
• Expert guidance: At Harley Street MD, we provide personalised care and follow-up to ensure a safe, smooth recovery.