Gynecomastia is the development of “woman-like breasts” in men. Breast hypertrophy, or abnormal glandular breast overgrowth, afflicts as many as 65% of adolescent males and 10-15% of adult males. The disorder’s prevalence is reflected by the American Society of Plastic Surgery’s ranking of the Surgical Treatment of Gynecomastia as one of the top five cosmetic surgery procedures performed on men.

No longer do men with Gynecomastia have to hide their chests or be ridiculed for having “man-boobs”. In fact, Male breast reduction is being increasingly performed for all groups of men who suffer from Gynecomastia. They no longer need be embarrassed when wearing form-fitting shirts, t-shirts, or even avoid take off their shirts at the pool or the beach!

Breast tissue naturally grows in all adolescent boys during normal development as a result of hormonal changes. It is estimated that as many as 65% of teenage boys experience enlarged breast tissue or Gynecomastia. For the fortunate majority of these boys, Pubertal Gynecomastia resolves in a matter of months, or with the end of adolescence. For a significant portion, however – an estimated 10-15%, the symptoms remain through adult life.

Unlike Pubertal Gynecomastia, adult-onset Gynecomastia can be caused by a range of things. The potential causes of Gynecomastia in adults include some common medications, Anabolic steroids, herbal or growth supplements, natural or synthetic estrogen hormone derivatives, marijuana, alcohol abuse, chronic liver failure, and renal failure. There are also some tumors that secrete female hormones which stimulate breast gland growth in males. Therefore, it is important that newly recognized adult-onset Gynecomastia be investigated by an endocrinologist in order to rule out possible serious underlying causes.

Another cause of Gynecomastia which has recently become more prevalent is Obesity. Fat cells, especially those in large numbers, convert the male hormone testosterone into female hormone estrogen, which stimulates breast growth. With Aging some men experience a deficiency in Testosterone levels which leads to the development of Gynecomastia.

Adult onset Gynecomastia is usually irreversible unless corrected through a variety of surgical treatments such as Male Breast Reduction, Mastectomy, and/or Liposuction.

Male breast reduction involves making an incision at the periphery of the areola and surgically removing the glandular breast tissue. In those who have more fatty breast tissue, this can be accomplished via small stab incisions with Liposuction. In severe forms of Gynecomastia there is significant excess of sagging breast skin which is removed by several methods; Inverted-T or Peri-Areolar Breast Reduction. It is not infrequent to need subsequent surgery to further reduce the size of the areola and nipple, or to further lift and reduce the hanging breast skin.

What are some of the Diagnostic Tests for Gynecomastia?

In addition to a complete medical history and physical examination, you will probably undergo blood tests for liver function, hormone levels, thyroid function and urinalysis. A physician such as an endocrinologist who specializes in hormonal issues will analyze your tests and examinations in order to determine the underlying causes of Gynecomastia. There are times when further testing including CT scan, PET scan, and even biopsies are used to assist in making a diagnosis. Fortunately, a majority of cases of Pubertal Gynecomastia are benign and do not need any medical treatments.

What are the classifications of Gynecomastia?

In the 1930's, Gynecomastia was classified into three categories. One was glandular, referring to an overabundance of thick glandular breast tissue as opposed to fatty tissue. In this case, surgical removal of the breast gland is required.

A second type is "fatty glandular," where there is a combination of fatty and glandular breast tissue over-development. In such cases, surgery is combined with Liposuction for better contouring of the breast.

The third type is "simple fatty" where very little fibrous breast tissue exists, so that breasts can simply be reduced in size with Liposuction.

What are the Causes of Gynecomastia?

Breast tissue naturally grows in all adolescent boys during normal development. It presents as a tender mass beneath the areola (the colored area that surrounds the nipple) that is one to five centimeters in diameter. Frequently adolescents complain of pain in their breasts, particularly when they are wearing binding clothing.One estimate is that as many as 65 percent of teenage boys experience enlarged breast tissue or Gynecomastia. For the fortunate majority of these males, this condition resolves in a matter of months, or with the end of adolescence.