Men who have a feminine chest are often ridiculed for having “man boobs” and this can take a significant hit on their self-esteem. These “man boobs” are either the result of chest fat (a condition called pseudogynecomastia) or gynecomastia. It is important to know the difference between these two conditions since true gynecomastia can cause more adverse symptoms and often requires more extensive treatment.
What is Gynecomastia?
Gynecomastia is the growth of male breast tissue that creates a more feminine-looking chest. Rather than a buildup of chest fat, gynecomastia is the growth of glandular tissue which has more structure and will create a rounded breast, rather than the sagging appearance of excess fat. Chest fat can often be resolved with weight training, but gynecomastia will require liposuction or a larger surgical procedure to fully eliminate the excess glandular tissue. Gynecomastia requires gland excision which often includes liposuction.
The Difference Between Gynecomastia and Chest Fat
If you are uncertain whether you have gynecomastia, the following questions can help you answer that question and determine whether you should schedule a consultation. When you schedule a consultation with Dr. Delgado, a gynecomastia specialist, he may also ask these questions and more to get an in-depth understanding of your symptoms and determine the best course of treatment.
Is Your Chest Sore?
Gynecomastia is often more painful than chest fat unless there are other underlying conditions. If your chest feels swollen, constantly sore, and painful to the touch, this is an indication you may have gynecomastia. Although other conditions can cause your chest to hurt, all these factors combined make it much less likely you are dealing with chest fat.
What Does Your Chest Feel Like?
Chest fat will feel like any other fat on the body: soft to the touch. Gynecomastia feels firm, hard, or rubbery. Sometimes, it may even feel like you have a solid lump under your skin. Fat should not be hard so if you notice these symptoms, it is unlikely your chest’s appearance is being caused by chest fat.
What Does Your Chest Look Like?
While chest fat sags without a defined shape, gynecomastia forms a rounded shape similar to a woman’s breasts. The nipple and/or areola may also project out more than the rest of the chest; this is a condition called puffy nipples.
How Does Your Chest React to Diet and Exercise?
One of the most frustrating things about gynecomastia is that it does not improve with proper diet and exercise. On the other hand, fat will reduce gradually so you should start to notice some reduction in the volume of your chest after a few weeks of exercise. If there is little to no change even after significant weight loss, this is one of the strongest indicators of gynecomastia.
Gynecomastia Surgery
Dr. Delgado classifies gynecomastia by four different grades, depending on the severity of your symptoms and the size of the amount of breast tissue present. Grade 1 and some Grade 2 gynecomastia can be treated with the “pull-through” technique that only requires one small incision or more commonly gland excision and liposuction, more severe cases of gynecomastia in Grades 3-4 will likely require a double incision mastectomy. Even though surgery will leave a scar, these marks fade over time and most men leave satisfied and newly confident without their feminine-looking chest.
Why Choose a Board-Certified Plastic Surgeon for Gynecomastia Surgery?
The revision rate for gynecomastia surgery is high because there are only a few gynecomastia specialists in the country. One of these specialists is board-certified plastic surgeon Dr. Miguel Delgado who has been treating all grades of gynecomastia for over 30 years. He has earned the respect of the medical community and patients who travel from outside the country to experience his expertise.
Dr. Delgado has an in-depth understanding of gynecomastia, how it affects the anatomy of the chest, and how to effectively remove all the excess tissue to prevent the condition from returning. You can schedule a consultation with Dr. Delgado in San Francisco, CA, by filling out an online contact form to effectively diagnose and treat your gynecomastia.
Gynecomastia is the unwanted growth of excess breast tissue in men, and it can have a damaging effect on men of all ages, especially teenage boys who are bullied because of their condition. However, gynecomastia is a surprisingly common medical condition and therefore something that’s not to be ashamed of. Even more surprising is many well-known celebrities have also experienced gynecomastia in their lives, sometimes seeking gynecomastia treatment to achieve a more masculine chest.
Simon Cowell
Simon Cowell is proof that men can have a toned figure after gynecomastia surgery to treat enlarged male breasts. He did not hide his condition while experiencing male breast growth and is actually well-known for the tight shirts he wore while a star judge on American Idol and America’s Got Talent.
Dwayne “The Rock” Johnson
“The Rock” has been candid about his struggles with gynecomastia despite most people’s assumption that someone who looks like him would never expect him to suffer from male breast tissue growth considering his muscular tone. Even though the growth of swollen breast tissue is unnoticeable today, it is only because of surgery he had to remove excess breast tissue earlier in life. This is a common treatment option even for guys and bodybuilders who look like him.
Jack Nicholson
Jack Nicholson did not start developing man boobs until his mid-50s, likely as the result of a natural hormonal imbalance that occurs as people age. Up to 60% of older men will develop some level of breast tissue or sagging pectorals and Jack Nicholson is proof that this condition can affect men of all ages.
Arnold Schwarzenegger
Like “The Rock,” Arnold Schwarzenegger’s breast enlargement may be due to steroid use during his bodybuilding years. He has openly expressed a dislike for his body and lack of confidence, showing that even the biggest names in Hollywood can struggle with their mental health and body image. Fortunately, there are many cosmetic surgery options available for people struggling with increased breast growth, and the physicians at Gynecomastia.org are here to help get you educated about your options.
Jack Black
Jack Black is a kind of poster child for male body positivity and has fought back against any negativity associated with gynecomastia. He has gone shirtless proudly in several films including Nacho Libre and Tropic Thunder, something that can be incredibly difficult for men with non-traditionally masculine figures. He acknowledges that his weight isn’t a problematic part of his comedic or personal identity, including having larger-than-normal pecs.
Treatment for Gynecomastia
Gynecomastia is commonly treated with a combination of liposuction and surgery, depending on what grade or level of gynecomastia the patient has. Sometimes the problem can be resolved by simply removing the breast fat or excess tissue but in more severe cases, excess skin may need to be removed to better contour the chest.
Before and After
Pre-Op
4 years after a series of two surgeries and hormone therapy
Schedule a Consultation
If you have been struggling with self-confidence due to gynecomastia, schedule a consultation with Dr. Delgado to determine which type of surgery is best for you.
Steroid induced gynecomastia can be caused by drugs such as Anadrol and Dianabol (used for medical conditions) and anabolic steroids taken by bodybuilders. Men taking steroids for medical reasons should consult their prescribing physician if they notice any changes in nipple size and tenderness or swelling in the chest area.
Gynecomastia is the medical term for the growth of breast glandular tissue in men’s chest area. Breast enlargement in men is often unknown, although steroid use is a known cause of bodybuilder gynecomastia. Gynecomastia symptoms can present as puffy nipples and a slight increase in chest size, through to full, feminine-looking breasts or man boobs.
Do Steroids Cause Man Boobs?
The leading cause of gynecomastia is hormonal imbalance. Steroid use disrupts hormonal balance and may cause higher estrogen levels, which can lead to gynecomastia symptoms. Longer-term steroid use may worsen the symptoms, which is why many bodybuilders develop man boobs.
When steroid use is stopped, gynecomastia will not simply go away. The breast glandular tissue growth is permanent. The only recognized way to resolve bodybuilder gynecomastia is with surgery.
Can I Prevent Gynecomastia?
The only way to prevent steroid induced gynecomastia is to not use steroids. If you require steroids for medical conditions, speak to your physician about your concerns.
Do Antiestrogens Prevent Man Boobs?
Bodybuilders often use antiestrogens to prevent man boobs, including Tamoxifen (Nolvadex® or Soltamox®) and Arimidex®. These drugs are not FDA-approved gynecomastia medications and although they do work for some men, when they don’t work, it’s too late to do anything as the breast glandular tissue will have already started to grow. Bodybuilders who take steroids should also consider that antiestrogens have a range of side effects, including weight gain and erectile dysfunction, and some more severe side effects such as reduced bone density, leading to bone fractures and stroke.
Can Supplements Prevent Man Boobs?
Numerous companies advertise supplements as estrogen blockers. However, not only are they extremely unlikely to make any difference, supplements have been found to contain dangerous ingredients. Supplements are not regulated by the FDA and are usually produced in countries with little or no regulations.
Gynecomastia Surgery For Steroid Induced Gynecomastia
Gynecomastia surgery is a fast and safe way to eliminate man boobs caused by steroid use. Gynecomastia symptoms are divided into four grades that determine how severe the symptoms are. Grade 1 and some grade 2 gynecomastia can be treated with surgery requiring only a small incision at the edge of the periareolar, called the pull-through technique.
Grade 2 gynecomastia that can not be effectively treated with the “pull through” technique can be treated with standard gynecomastia surgery. This only requires a slightly larger incision at the edge of the areola. Both types of surgery leave small scars that are well hidden by the change in skin color from the areola to the surrounding skin. Once healed (within a few months), the scar will start to fade. After around six months, the scar will be difficult to detect.
Grade 3 gynecomastia can sometimes be resolved with a two-stage procedure which involves the pull-through technique, followed by standard gynecomastia surgery four to six months later. This is the preferred gynecomastia surgery option for men who are concerned about scars and all incisions are made at the outer edge of the periareolar. This means that once healed the scars will be well hidden and hard to see.
In the case of more severe grade 3 and 4 gynecomastia symptoms, a double incision mastectomy is usually recommended. This will create larger scars across the chest. Most men prefer scars that fade and become less evident over time than living with man boobs. The patient satisfaction rate is high for all types of gynecomastia surgery, and unlike medications, results are reliable and always permanent (as long as steroid use is avoided).
Why Choose a Board-Certified Plastic Surgeon for Gynecomastia Surgery?
Gynecomastia surgery can be performed by any physician with a medical license. Gynecomastia surgery cost may be a consideration. However, many plastic surgery companies offer reduced rates by employing surgeons without appropriate training or experience. Unfortunately, the revision rate for gynecomastia surgery is high, and poor results may not be reversible.
Not all board-certified plastic surgeons specialize in gynecomastia, and many will only perform a few gynecomastia procedures each year. Board-certified plastic surgeon and gynecomastia specialist Dr. Miguel Delgado has been providing gynecomastia surgery for all grades of gynecomastia for over 30 years. Over 40% of his patients come to him unhappy with the results of gynecomastia surgery performed elsewhere. Whether you are considering initial gynecomastia surgery orgynecomastia revision surgeryfollowing unsatisfactory results, Dr. Miguel Delgado always discusses your concerns and explains the surgical options available. All gynecomastia surgery is performed at the Gynecomastia Center of Excellence — Marin Cosmetic Surgical Center*, with the highest level of patient safety and care.
*Federal and state-accredited surgical facility.
For personalized information about gynecomastia plastic surgery procedures, please complete Dr. Delgado’s inquiry form.
Miguel Delgado, M.D, F.A.C.S is a world-renowned Board-Certified Plastic Surgeon granted by the American Board of Plastic and Reconstructive Surgery and a member of the American Society of Plastic Surgery and Aesthetic Society. Dr. Delgado has a surgical practice solely dedicated to cosmetic plastic surgery. He specializes in gynecomastia surgery and is the medical director of Gynecomastia.org, the oldest and largest gynecomastia forum dedicated to supporting, educating, and providing solutions for men with breast enlargement. Dr. Delgado celebrates 30 years of practice in San Francisco, California. He was voted the “Best Plastic Surgeon of 2017-2021.”
Often referred to as man boobs, this medical condition is called gynecomastia by the medical community, and is usually caused by a hormonal imbalance. Research has shown that a high level of estrogen found in men is usually the cause of gynecomastia symptoms. Hormonal imbalance can happen for various reasons, including anabolic steroid use. The high associated risk that steroids cause gynecomastia is a huge concern in the bodybuilder community.
What Is Gynecomastia?
The medical term for man boobs is gynecomastia, which causes excess growth of breast glandular tissue in the male chest. Gynecomastia symptoms are often a combination of glandular tissue and fatty tissue. Another condition, pseudogynecomastia, is the growth of only fatty tissue in the chest area in overweight and older men. This is not true gynecomastia and is rarely experienced by men who are not overweight.
Women and men produce estrogen and testosterone. In women, the estrogen levels are higher than the testosterone levels, and in men, the testosterone levels are higher than the estrogen levels. This is why estrogen is often referred to as the female hormone and testosterone as the male hormone.
Causes of Gynecomastia
There are various known causes of gynecomastia symptoms, and it is crucial to have an accurate diagnosis. Dr. Miguel Delgado can diagnose gynecomastia with a physical examination and the gynecomastia pinch test. When there is no known cause of gynecomastia symptoms, blood tests may be requested, to check for any other underlying medical problems.
The Male Menopause or Andropause
Men between 50 and 60 years old will typically experience the male menopause or andropause. When this occurs, testosterone levels naturally start to decrease, which may cause glandular tissue growth. During the menopause, the body ratio of muscle to fat will normally change. Both of these developments can cause gynecomastia symptoms and man boobs.
Pubertal Gynecomastia
During puberty, estrogen levels are higher than testosterone levels, which often causes glandular tissue to grow and results in man boobs. This is likely to be more pronounced if an adolescent is overweight. Pubertal gynecomastia will usually resolve within two to three years, although occasionally, it will remain.
Prostate cancer usually occurs in men over 50 (the incidence is less than 1% in men below 50). Gynecomastia symptoms can be caused by hormone treatment for prostate cancer.
Bodybuilders can rarely achieve significant size using exercise, diet and weightlifting, to produce the muscle mass needed to compete professionally. This has led to a high incidence of anabolic steroids use in the professional bodybuilder community. Steroids help men increase muscle mass faster and induce larger muscles when combined with weightlifting.
Recognized by the world as one of the top professional bodybuilders, seven-time Mr. Olympia winner and four-time Mr. Universe winner Arnold Schwarzenegger admitted he used steroids when competing. Although at the time he was competing, steroids were legal, the lack of testing is still a controversial issue for many bodybuilders. The International Federation of Bodybuilding Professional League (IFBB) rules state that steroid use is not allowed, and all competitors are subject to IFBB random drug testing. Yet tests do not routinely take place. Even though steroids are now illegal in the US, it is generally accepted by the bodybuilding community that bodybuilders who want to compete in more challenging competitions, will take steroids.
Anabolic steroids cause gynecomastia by disrupting the endocrine system that regulates hormones, increasing the enzyme responsible for converting testosterone into estrogen. In many men, this leads to the growth of breast glandular tissue and man boobs. One of the main issues caused by anabolic steroid use is gynecomastia. In the bodybuilding community, gynecomastia symptoms are often referred to as “bitch tits” and are a real problem for many men. Even when steroids are no longer used, gynecomastia will not go away.
Gynecomastia Symptoms
The most obvious gynecomastia symptoms are the appearance of man boobs or moobs, which vary in size. The difference is defined by gynecomastia grades, a system adopted by the American Society of Plastic Surgeons.
There are five gynecomastia grades:
Grade 1 gynecomastia symptoms refer to a slight increase of glandular tissue and often cause the appearance of puffy nipples.
Grade 2 gynecomastia symptoms cause a more significant growth of glandular tissue, resulting in small man boobs and a more feminine appearance of the male chest.
Grade 3 gynecomastia symptoms will produce feminine-looking breasts with a slight mammary (breast) crease.
Grade 4 gynecomastia symptoms are the most severe and result in extremely feminine-looking breasts that are full and noticeable, with a significant drop and mammary crease.
Treatment for Gynecomastia
Treatments for gynecomastia fall into three types: natural supplements, medications, and gynecomastia surgery. Numerous companies sell a range of supplements they claim will inhibit estrogen production, which prevents and reduces gynecomastia. There is no scientific research to back up these claims, and supplements are not regulated by the Food and Drug Administration (FDA).
Treatment for Gynecomastia With Tamoxifen (Nolvadex® or Soltamox®)
Tamoxifen (Nolvadex® or Soltamox®) is widely used by bodybuilders to prevent and reverse gynecomastia. Research shows that men only experience a partial reduction of gynecomastia with tamoxifen, and the associated severe side effects of tamoxifen include stroke, vision impairment, and liver disease. To date, the FDA has not approved any medications for gynecomastia treatment.
Gynecomastia Surgery for Steroid Induced Gynecomastia
Gynecomastia surgery is the only guaranteed way to eliminate man boobs from steroid use. It is highly advisable that bodybuilders wait until they have stopped using steroids before having gynecomastia surgery. Otherwise, the symptoms are likely to return. Grade 1 and some grade 2 gynecomastia symptoms will usually require standard gynecomastia surgery, with gland excision to remove the excess breast tissue. This requires a small incison on the edge of the areola of around 2.5 to 3 cm. Once healed the scar will normally be well hidden by the change in skin color between the areola and chest skin. Another type of gynecomastai surgery that is often referred to as scarless gynecomastia surgery is the pull-through technique.
The pull-through technique is normally only suitable for grade 1 gynecomastia and only requires a small incision of around 5 to 10 mm cm in length, made at the edge of the periareolar, which means the scar will be almost invisible when it has healed.
Dr. Miguel Delgado performing the pull-through gynecomastia surgery technique
Grade 3 and grade 4 gynecomastia symptoms will generally require a double incision mastectomy or a two stage procedure. This is due to excess skin that needs to be removed for tight, masculine chest contours, as well as glandular and fatty tissue. Patient satisfaction for gynecomastia surgery is high, with research showing that 98% of bodybuilders receiving gynecomastia surgery are pleased with the results.
For personalized information about gynecomastia plastic surgery procedures, please complete Dr. Delgado’s inquiry form.
Miguel Delgado, M.D, F.A.C.S is a world-renowned Board-Certified Plastic Surgeon granted by the American Board of Plastic and Reconstructive Surgery and a member of the American Society of Plastic Surgery and Aesthetic Society. Dr. Delgado has a surgical practice solely dedicated to cosmetic plastic surgery. He specializes in gynecomastia surgery and is the medical director of Gynecomastia.org, the oldest and largest gynecomastia forum dedicated to supporting, educating, and providing solutions for men with breast enlargement. Dr. Delgado celebrates 30 years of practice in San Francisco, California. He was voted the “Best Plastic Surgeon of 2017-2021.”
Gynecomastia.org does not provide medical advice, treatment, or diagnosis.
Man-boobs are a very common condition, and worldwide gynecomastia symptoms affect approximately one in three men. This condition causes excess breast glandular tissue, which is often combined with fatty tissue, causing the appearance of female breasts. For many men, living with man boobs causes embarrassment and low confidence. This can lead to avoiding activities that involve going shirtless, such as swimming and trips to the beach, and missing out on spending time with family and friends. Men often feel too uncomfortable to visit the gym or exercise, which can result in weight gain and increase the size of man boobs.
Although the cause of gynecomastia is not always known, some of the more common causes include weight gain and obesity, anabolic steroid abuse, and male menopause. Whatever the cause, if enlarged male breasts are destroying your confidence, there is usually no need to continue living with man boobs.
Having plastic surgery may seem drastic or daunting, but with modern surgical options, getting rid of man boobs has never been safer. For the best possible outcome, the most important thing you can do is choose a plastic surgeon that specializes in gynecomastia surgery.
How to Check Your Surgeon Is a Plastic Surgeon
In the U.S., the only requirement to practice plastic surgery is a medical license from a state medical board. This can be obtained once a medical degree and postgraduate training are completed. However, this does not mean the physician has experience in any form of surgery.
There is a lot of confusion around board certification and how to check if a plastic surgeon is qualified. The first thing to be aware of is a Board Certified Surgeon is not always a Board Certified Plastic Surgeon. The American Board of Medical Specialties recognizes 14 individual surgical specialties. This is why you need to check that your surgeon is not only board-certified but is board-certified by the American Board of Plastic Surgery.
Another issue is understanding the difference between a cosmetic surgeon and a plastic surgeon. Many people wrongly assume that if a surgeon is certified by the American Board of Cosmetic Surgery (ABCS), they will have received the same training and passed the same exams as a plastic surgeon. This is not the case. To apply for board certification from the American Board of Plastic Surgery, a surgeon must have completed at least six years of training and passed an accredited residential training program, with three years committed entirely to plastic surgery procedures. They are also subject to continuous assessment and exams.
A surgeon certified by the American Board of Cosmetic Surgery only needs to complete one year of surgical training, and there are no continuous assessments once they are certified. In California, the Medical Board of California has prohibited ABCS diplomates from calling themselves “board-certified.”
Gynecomastia surgery is the fastest and most effective solution to permanently get rid of gynecomastia. Usually, this is a one-time surgical procedure with a high patient satisfaction rate.
2. What happens during gynecomastia surgery?
Gynecomastia surgery involves the removal of glandular tissue and/or fatty tissue. Liposuction sculpts the chest area for a smooth and contoured masculine-looking chest.
3. Can gynecomastia surgery be performed under local anesthetic?
Gynecomastia surgery can be performed under a local anesthetic. However, Dr. Delgado prefers to use a light general anesthetic for standard gynecomastia surgery. This gives him more control and also provides a more comfortable experience for the patient.
4. When can I shower after gynecomastia surgery?
You can shower the day after the drains are removed normally within 3 days of gynecomastia surgery. Dr. Delgado advises to gently pat incisions and then put your compression garment back on.
5. When will I be able to return to work after gynecomastia surgery?
Most men return to non strenuous work and light daily activities within 5 days of having gynecomastia surgery. For more strenuous work you will need to wait between 7 to 10 days before returning to work. Lower body light aerobic exercise can be started four weeks and full workouts six weeks following surgery.
6. How soon can I swim after gynecomastia surgery?
You should avoid exercise and swimming for six weeks following gynecomastia surgery. This is to prevent contaminants causing infection and arm movements pulling on the incision sites.
7. How long does it take to see the results of gynecomastia surgery?
You will see results immediately after surgery. Swelling and bruising will decrease over the following 10 days and by six months, the final bit of swelling will have gone, and the final results will be evident.
Boost your confidence and feel free to enjoy life with gynecomastia surgery. Dr. Delgado provides free virtual consultations so that you can share your goals and expectations. If you have any questions, feel free to get in touch !
For personalized information about gynecomastia plastic surgery procedures, please complete Dr. Delgado’s inquiry form.
Miguel Delgado, M.D., F.A.C.S is a world-renowned Board-Certified Plastic Surgeon granted by the American Board of Plastic and Reconstructive Surgery and a member of the American Society of Plastic Surgery and Aesthetic Society. Dr. Delgado has a surgical practice solely dedicated to cosmetic plastic surgery. He specializes in gynecomastia surgery and is the medical director of Gynecomastia.org, the oldest and largest gynecomastia forum dedicated to supporting, educating, and providing solutions for men with breast enlargement. Dr. Delgado celebrates 30 years of practice in San Francisco, California. He was voted the “Best Plastic Surgeon of 2017-2021”.
Gynecomastia.org does not provide medical advice, treatment, or diagnosis.
