Boys as young as 8 are seeing plastic surgeons about breast reduction surgery.

The surgery is becoming more common as acceptance and awareness increases, particularly among middle-aged men who need to look good in the competitive corporate job market, Wellington surgeon John Masters says.

"I've seen boys as young as 8 and men as old as 83, and the vast majority of people fall into one or two categories."

He said 75 per cent of boys would develop enlarged breasts during puberty because of their hormones, and in most cases they grew out of it. But for the small amount who did not, they could be left with A cup to C cup breasts, causing them low self-esteem and body image problems.

The other group consists of men in their 30s and 40s who are suffering from middle-aged spread because of a more sedentary lifestyle.

"They've lost a bit of muscle mass and are aware of the looseness in the chest or the fullness in their chest that can be seen under their clothes," Dr Masters said.

His clinic, Plastic Surgical Masters, sees about one new male patient a fortnight wanting a breast reduction. "The group I'm seeing more of is the guys living sedentary lifestyles, in middle-management, they have got a reasonable income, jobs are competitive - they want to look their best, they don't want to be perceived as a couch potato."

Christchurch plastic surgeon Howard Klein confirmed an increase in cases, saying he operated on about 20 men last year - double the number he was performing five years ago. "Last [month] I saw a muscular young man, but he looked like he was developing breasts. He could only wear specific clothes - all the same issues that flat-chested women or women with very large breasts have.

"It can be very damaging psychologically for a man to have small female-type breasts."

Operations - called gynaecomastia surgery - involve the removal of fatty and glandular tissue. They can either be done under local or general anaesthetic, and cost $4000 for a straightforward procedure to more than $15,000 for complicated cases.

On rare occasions, Dr Masters said, he saw men who had enlarged breasts due to recreational drug use - such as chronic marijuana smokers and steroid-popping bodybuilders.

Some of his patients wore women's sports bras to flatten their chests, while most simply wore a couple of layers of clothing.

"They never take their shirts off at the beach or go to swimming pools. I saw a Wellington rugby rep player a couple of years ago who had never changed in front of his team-mates for years."

A Ministry of Health spokesman said a small number of publicly funded male breast reductions were carried out each year for clinical reasons.

Eight male procedures were carried out in 2010-11, compared with 202 on women. Nine male procedures were done in 2009-10.

John de Waal, president of the New Zealand Association of Plastic Surgeons, said it was important for surgeons to establish the difference between young boys feeling insecure about extra breast tissue and cases that could pose health risks. "Some boys are very shy about it and don't even mention it to their parents, others think they have a serious disease. It can be thought of cosmetic, but in reality be of medical concern. Equally it can be thought of as medical, but really be cosmetic."

Full consultations, sometimes including tissue samples, were important to establish whether the reductions were required for health reasons, Dr de Waal said.

"Men can get breast cancer just as women can, so men who have abnormal lumps in their breast tissue need it checked."

Embarrassed builder opts to have a moob job

An offhand comment in the bedroom was the last straw for Ben*.

"That's a bit funny looking," his date said, staring at his chest.

Ben, 24, had hated his chest since developing excess breast tissue in his mid-teens.

His breasts were smaller than an A-cup, but bigger than what was expected for the average man, he said.

The Christchurch builder had no idea why it had happened and had tried exercising more and losing weight to get rid of it.

"I wasn't overweight. I'm very healthy. I even got down to 6 per cent body fat . . . but nothing really helped."

He did not go swimming often and was careful about what he wore.

"It's more mental than anything else. You would see that you were different for a start."

Most people did not seem to notice, but he did get the "occasional look" and was sometimes teased by male friends.

It was the comment that his chest was "a bit funny looking" that really stung, though. "It was embarrassing," he said.

He inquired about breast reduction surgery and spent two years saving for the $10,000 procedure. He underwent the surgery a few weeks ago, telling his boss he had to take a week off work because of an injury.

Although his body was still healing physically, he already felt "more confident".

"I'm kicking myself that I didn't get it done sooner. It was money well spent."

He had not told anyone he had undergone breast reduction surgery, including his mother and sisters. "It's not really something I would have talked about with other people. It's a bit of a taboo subject."

He wished it was something people could discuss openly, but did not want to be named publicly. "I'd rather put the whole thing behind me at this stage, [but] it should be talked about so people feel better about it and so they don't feel abnormal."

*Name has been changed.