Gynecomastia is male breast enlargement when the breast gland tissue swells. Gynecomastia is caused when the male estrogen level is too high in relation to the testosterone level. The hormonal balance is tipped to the development of a female-like breast on a man. Gynecomastia can affect one or both breasts.
What Causes Gynecomastia Breast Gland Tissue?
Gynecomastia is caused by an imbalance between the male hormone testosterone and estrogen that controls female traits. Testosterone causes the development of male traits like body hair and muscle mass. Estrogen controls female characteristics like breast development. However, both sexes have an amount of the opposite hormone. When the balance of these hormones is “off,” different sex characteristics can develop. In the case of men, when the male estrogen level is too elevated or out of balance with testosterone levels, then Gynecomastia, aka man boobs, can develop.
Gynecomastia develops three times in a male’s life.
These time frames are when gynecomastia develops:
Immediately after birth. Newborn males are still carrying extra estrogen from their mothers during development. Over fifty percent of males are born with enlarging breasts; however, this usually resolves in a few weeks after birth.
During puberty or pubertal gynecomastia. Estrogen and testosterone levels change drastically during puberty. This occurs during 12-14 years of age. As much as 70 percent of young men develop Gynecomastia during this time. But, the male breast enlargement usually goes away between 6 months and two years. In about 25% of males, gynecomastia does not resolve completely.
Midlife. Male breast enlargement usually peaks in men between the age of 50 and 80 years of age. Gynecomastia is due to the drop in testosterone levels, aka “low-T.” At this age. Over 65 percent of men are affected. During this time, breast cancer can develop at a rate of less than 1 percent.
There are other less common causes of Gynecomastia, but to mention, the most common are:
Pseudogynecomastia or “fake gynecomastia” is due to being overweight, and weight loss can dramatically help this condition. The enlarged male breasts are due to fatty tissue and not glandular tissue.
Drug-induced gynecomastia caused by anabolic steroids to enhance athletic performance. Gynecomastia caused by anabolic steroids is the second most common cause.
Medications like Finasteride for enlarged prostate/prostate cancer or hair loss, to name a few.
Medical conditions like tumors in the adrenal glands or testicles, liver disease, or hypogonadism, to name a few.
How is Gynecomastia Diagnosed?
The diagnosis of Gynecomastia is based on physical examination, physical symptoms, medical history, and medication review.
Gynecomastia symptoms include breast(s) that may be painful with tenderness and often have a disc shape rubbery tissue that can be easily felt. This tissue is located directly underneath the nipple and mobile within the breast tissue.
Your physician will evaluate your medical history to determine the cause of the Gynecomastia. He will review your supplements, medications, and herbal products. Your doctor will also review your medical history and order the appropriate blood tests to determine if other diseases or medical conditions are the cause of your Gynecomastia.
There are a variety of breast imaging tests that may be used, a mammogram or breast ultrasound to evaluate male breast tissue. These tests are usually ordered to evaluate breast cancer. Your physician may order a blood test like a hormone panel to check for any hormonal changes.
What Is The Treatment for Gynecomastia Breast Tissue?
Treatment for enlarged breasts in men is recommended when there is breast tenderness and discomfort or an aesthetic or cosmetic issue. If a medical illness is causing Gynecomastia, a prescribed medication may need to be given. Gynecomastia usually affects both breasts but can affect one or both breasts.
At times, medicine is the cause, and your physician may advise stopping the drug and changing to another. Your doctor may advise going to an endocrinologist( a physician who specializes in hormone-related issues).
Surgery is recommended for patients with severe pain and tenderness or embarrassment. Male breast reduction surgery or gynecomastia surgery is the surgical treatment of choice for breast tissue removal.
Counseling may be needed for men and boys who find it hard to cope with this medical condition. Gynecomastia can be embarrassing, resulting in shame and avoidance of social situations requiring a bare chest( swimming, public shower, locker room, etc.). This can cause a tremendous amount of stress and depression. Discussing this situation with a professional may be helpful.
Other conditions may look like Gynecomastia but are not true Gynecomastia. A few of the most common are listed below.
Male breast cancer. Cancer of the breast in men is uncommon and occurs in less than 1% of men. It usually affects one breast. The breast is usually no breast pain, and a firm lump may be present which feels attached to the surrounding tissue. The overlying skin may appear indented or dimpled and possible nipple discharge. The lymph nodes may be enlarged.
Fatty breast tissue or pseudogynecomastia. This is common in overweight men. It is due to fat accumulation in the chest. Gynecomastia is due to breast gland development and not fat.
Male breast reduction surgery is the definitive treatment for gynecomastia. It removes the breast glands permanently.
FAQ’s
Can Gynecomastia Go Away on its Own?
In medical terms, gynecomastia refers to enlarged breasts in men. Teenagers going through the puberty process are likely to experience this condition.
Generally speaking, it will disappear on its own by the age of 21 for most young males, and most often two years after it first develops.
Gynecomastia rarely goes away by itself in adult males, no matter how hard they work, how much they exercise, and how much they diet.
Gynecomastia is primarily caused by hormonal imbalance, steroids, marijuana use, and certain prescription medications. One or both breasts may be affected by gynecomastia, and the condition can be uneven. Gynecomastia is a condition that leaves adult men feeling helpless about their condition.
Gynecomastia is curable. In the majority of cases, enlarged breasts in adolescent boys will disappear once they reach adulthood. Exercise and weight loss may be helpful for men with fatty gynecomastia. Typically, gynecomastia is caused by an excess of fibrous breast tissue that cannot be removed by DIY methods.
With male breast reduction surgery, this form of gynecomastia will be removed permanently and completely. A board-certified plastic surgeon with extensive experience in treating gynecomastia should be sought for gynecomastia surgery. Surgery performed by an unqualified surgeon is often associated with high rates of dissatisfaction. Usually, they rely solely on liposuction. Breast tissue will not be removed with this technique.
How Do You Differentiate Between Gynecomastia and Male Breast Cancer?
Among the most important characteristics that differentiate a male with breast cancer from a male with gynecomastia is symmetry. In men with gynecomastia, for example, both breasts are nearly always swollen. In contrast, men who have breast cancer usually find a lump or swelling only in one breast. Also, breast malignancy may show skin changes like skin dimpling or contraction.
What is The Best Treatment for Gynecomastia?
The following are two options to treat gynecomastia with surgery:
Surgical liposuction. In this surgical procedure, fatty tissue is removed from the breast but not the glandular tissue. This is best used for psueudogynecomastia which is gynecomastia due to excessive fat deposits.
The procedure of mastectomy. The enlarged breast tissue is removed in this procedure. In many cases, only small incisions are needed for the surgery. There is a shorter recovery period following this less invasive type of surgery.
How Can I Reduce Gynecomastia?
To treat gynecomastia effectively for an immediate and permanent solution to the problem of excess breast tissue and fat gynecomastia surgery or male breast reduction surgery is the solution.
These are some of the more popular methods to reduce gynecomastia:
Psuedogynecomastia and gynecomastia are separated by only a few key differences among males. In both cases, there is excess fat or swollen tissue present in the chest region, leading to the appearance of breasts. Males of any age can develop either condition, but newborns, teens, and seniors are most susceptible.
There is no difference in the appearance of breasts between patients with gynecomastia and those with pseudogynecomastia, but the type of tissue differentiates them. There is a number of potential causes of gynecomastia, which is characterized by excessive glandular and stromal tissue. In addition, pseudogynecomastia can be caused by excessive amounts of fat tissue.
There is no medical risk involved with either condition, however, many patients experience emotional distress due to gynecomastia or pseudogynecomastia, as well as issues with self-esteem and shame as a result of showing their bodies. In some cases, gynecomastia may indicate a more serious medical problem, so patients should also consult their general practitioner about possible causes. It is always best to check, even though this is a rare occurrence.
How to Understand Pseudogynecomastia
The condition of pseudogynecomastia is characterized by excess adipose (fat) tissue around, under, and behind the nips. In spite of the word “pseudo”, or something false or masked, “fake gynecomastia” is a very real disorder that can cause physical and psychological difficulties for some men. These physical and psychological issues are common to both pseudogynecomastia vs gynecomastia
Symptoms of Pseudogynecomastia
An appearance of bilateral enlarged breasts on the chest with excess fat.
The only thing that will feel firm is the excess fatty tissue below the chest.
The appearance of fat accumulation around the armpit region.
Pseudogynecomastia Causes
Obesity – Pseudogynecomastia is more straightforward, as it is a result of excess fat. Pseudogynecomastia occurs when a patient has excess chest fat deposition, and this shows up as enlarged breasts.
Treating Pseudogynecomastia
Weight loss is the first line of treatment for pseudogynecomastia. With the loss of body fat, your chest will also tend to become smaller. The majority of men lose weight and shape their chests through a combination of diet changes and increased exercise. Compression shirts are worn by some men to achieve the appearance of a leaner and flatter chest while they are losing weight. Even if a man reaches his goal weight, he may still experience pseudogynecomastia. Depending on the amount of residual fatty tissue and whether there is loose skin, the treatment may vary.
To treat pseudogynecomastia the fat deposits can be removed by liposuction alone or greatly improved by weight loss. In addition to liposuction of the residual fat, reducing (removing) a skin component may also be required to tighten the skin. Where the incision is placed will be determined by how much loose skin is present. Additionally, the areola is also reshaped to conform to the new chest contour. Many patients are concerned with the appearance and embarrassment of the areola (the darkly pigmented skin surrounding the nipple). The difference of treatment between pseudogynecomastia vs gynecomastia is liposuction.
How to Understand Gynecomastia
Pseudogynecomastia and gynecomastia differ primarily in the kind of excess breast tissue seen that causes them to appear enlarged and feminine. A male chest area with male breast enlargement will have excess glandular breast tissue (and possibly fat tissue as well). In comparison to fat tissue, the glandular tissue of the breast is firmer and more fibrous, and it does not respond to changes in diet or exercise. A hormonal imbalance is usually responsible for symptoms; however, certain medications (e.g., steroids) and illegal substances, such as marijuana, may also be responsible. These are the primary differences between pseudogynecomastia vs gynecomastia.
There is a lump or disc of glandular tissue in the chest that is firm and hard to the touch
A soft, fatty tissue may be present beneath the chest
Sensitivity to touch or breast tenderness
Causes of gynecomastia
Hormones – Changes in hormone levels are frequently responsible for the development of gynecomastia. It can occur in a variety of ways. In newborn children with this condition, gynecomastia is caused by estrogen being passed onto the baby via the placenta. In general, hormone-induced gynecomastia in infants resolves over time. Puberty causes teenagers to undergo hormonal changes, and sometimes their testosterone levels drop so low that existing estrogen causes breast tissue to grow. Finally, older adult males are more likely to develop gynecomastia due to a decreased production of testosterone as a result of aging.
Medications – In certain cases, specific medications can contribute to the development of gynecomastia. Gynecomastia is more likely to occur in patients taking antidepressants, steroids, or medications for heart conditions, ulcers, or prostate issues. Antibiotics can also cause problems. In the event that medication contains estrogen or impacts estrogen levels, gynecomastia may result.
Alcohol and Liver Disease – Individuals who struggle with excessive alcohol consumption and suffer from cirrhosis are at higher risk of developing gynecomastia than their peers.
Thyroid issues: The thyroid gland, which is located in the throat, is a hormone-producing gland. Patients suffering from thyroid-related issues are occasionally affected by gynecomastia.
Narcotic Use: Narcotics, such as cannabis and heroin, are believed to be responsible for the development of gynecomastia.
Kidney failure – Gynecomastia can result from kidney failure although this is extremely rare. A physician should be consulted immediately if gynecomastia symptoms are present.
Testicular disease – Gynecomastia can occasionally indicate a serious testicular problem, including infection or cancer. Gynecomastia patients should seek medical attention if they experience various symptoms of testicular dysfunction.
Klinefelter syndrome – An extra X-chromosome is a characteristic of the Klinefelter syndrome. Gynecomastia can occur in patients with Klinefelter Syndrome.
For patients who are seeking treatment for their condition, it can be helpful to determine the source of their disease. There is a difference between gynecomastia and pseudogynecomastia in terms of causes.
Gynecomastia may have a number of causes, while pseudogynecomastia has only one.
Gynecomastia Treatment
The best treatment option for true gynecomastia is male breasts reduction surgery or gynecomastia surgery to remove the glandular tissue. In the course of the operation, the gynecomastia surgeon performs surgical excision techniques in order to remove the glandular tissue; your plastic surgeon may also use liposuction to eliminate fat tissue. You can remove excess skin and tighten the remaining skin if necessary to attain the desired chest contour.
The approach to treatment is typically performed by creating a small incision around the areola. Due to the small incision size and location, noticeable postoperative scarring is rarely a problem. The operative goal is to treat gynecomastia so the chest is contoured to a natural flat shape.
How to Know if You Have Gynecomastia or Pseudogynecomastia
Gynecomastia and pseudogynecomastia are both relatively easy to diagnose. Both of these conditions show up as excess tissue that appears breast-like on the chest. Gynecomastia and pseudogynecomastia are often recognized early on and cause men to harbor insecurity about their appearance.
Furthermore, these conditions are associated with other, less-recognized symptoms as well. In addition to the recognizable chest tissues, both gynecomastia and pseudogynecomastia have a number of symptoms that may confirm the diagnosis.
The pinch test is a common self-exam that you can perform to evaluate the tissue.
What is gynecomastia is a question frequently asked. The condition called gynecomastia causes men and boys to develop enlarged breast tissue. This may occur if two hormones in your body are thrown out of balance. In the case of enlarged breasts caused by fat deposits, you have a different condition known as pseudogynecomastia. In contrast to women, men do not develop breast tissue the way they do, all boys are born with a small amount of breast glandular tissue.
During puberty, testosterone is the main hormone produced by a boy’s body, which controls his sexual development. Additionally, males also produce some estrogen, which is the hormone responsible for promoting sexual growth in females.
In puberty or when the body of an older man produces less testosterone, the balance between these two hormones changes.
This can lead to male breast tissue swelling when a higher percentage of estrogen is present. The prevalence of this condition varies from half of the adolescent boys to two-thirds of men over the age of 50.
Symptoms of Gynecomastia
Gynecomastia can first be detected by a lump of breast tissue under the breasts. There might be tenderness or soreness in this lump. This may affect one or both breasts and can be established by a medical history and physical exam.
If you are experiencing these symptoms you may wonder whether you have breast cancer, which does occur in some men. In general, gynecomastia is not indicative of cancer, but your doctor may run some tests to confirm that it is not the result of cancer.
Breast enlargement may occur unevenly, with one breast growth larger than the other. Additionally, you may experience tenderness in your breasts.
If you notice swelling, burning, or tenderness in your enlarged breasts, or if you notice a discharge from the breast nipple, see your physician.
It is difficult to pinpoint the exact cause of the hormonal imbalance that leads to the growth of male breasts, and often the exact trigger is unknown.
Aside from normal body changes such as puberty and aging, gynecomastia can be caused by a number of factors such as:
Injuries or diseases that affect the testicles and result in testosterone production
Thyroid problems. since hormones from that gland control growth and sexual development
Obesity increases estrogen levels
A wide range of illegal drugs, including anabolic steroids, marijuana, and heroin
Kidney disease or kidney failure (when your blood cannot be cleaned and filtered)
Diseases of the liver
Pituitary gland tumors
Infant boys may briefly experience gynecomastia when they are still receiving hormones from their mothers.
Certain drugs can result in gynecomastia, including:
Anti-androgens medications. These drugs are used for the treatment of prostate enlargement and prostate cancer
Synthetic anabolic steroids and androgens. In order to enhance their athletic performance, athletes may use these drugs illicitly. Some of the drugs are also used to treat legitimate medical conditions.
Anti-HIV drugs. In some cases, gynecomastia may be a side effect of HIV treatment, also known as highly active antiretroviral therapy.
Anti-anxiety medications. Medicines such as diazepam (Valium ) can sometimes cause gynecomastia.
Medicines for the heart. In some cases, drugs such as digoxin (Lanoxin) or calcium channel blockers can cause gynecomastia.
Medications are used to eliminate the contents of the stomach. Metoclopramide (Reglan ) may cause gynecomastia as a side effect.
Medications for ulcers. Some medicines that you buy over the counter for ulcers can lead to gynecomastia, such as cimetidine (Tagamet). Antibiotics may also result in gynecomastia. Additionally, some cancer treatments and tricyclic antidepressants may have these effects.
Treatment of Gynecomastia
The majority of cases resolve on their own without treatment.
You might be referred to a specialist known as an endocrinologist when you suffer from gynecomastia. Endocrinologists treat problems relating to hormones and how they affect your body.
The gynecomastia treatment you receive will depend largely on your age, your health, the length of time your condition may last, and your response to certain medications.
The majority of cases of gynecomastia occur during puberty, and they usually disappear on their own. The process may take anywhere between six months and three years.
In the event that your hormonal balance is out of whack due to another health issue, you should treat that condition. Blood tests may be required to establish gynecomastia diagnosis.
You may be prescribed medication to treat the hormonal imbalance that is causing your breast tissue to grow.
In some cases, surgery may be necessary. The following techniques may be prescribed by your physician:
Liposuction (removing excess fat from the breast) Mastectomy ( removing the breast gland tissue). Plastic surgeons perform these procedures.
Guidelines for Preventing Gynecomastia
The likelihood of developing gynecomastia can be reduced by taking certain steps. The list includes items such as:
Please refrain from using drugs such as steroids, androgens, amphetamines, marijuana, and heroin, as they are illicit and recreational.
Drink alcohol in moderation or not at all.
Your doctor should review the list of your medications. When taking medications that may cause gynecomastia, ask your physician if alternative therapies are available.
The complications of gynecomastia
You may experience mental health consequences if you suffer from gynecomastia. This could result in feelings of embarrassment, anxiety, or depression. To manage these feelings, you can take several steps.
Discuss your feelings regarding gynecomastia with your doctor. Any mental health problems you may develop can be managed by a mental health professional.
According to statistics collected by the National Institutes of Health (NIH), between 50% and 60% of adolescent males experience gynecomastia. Gynecomastia often manifests in young individuals due to more male estrogen levels than is normally produced by the body during puberty. Around the time a man enters his 20s, the chest contour tends to naturally flatten out, but this may not always be the case.
Men with gynecomastia
Gynecomastia is even more prevalent among adult men. The same NIH study found that approximately 65% of men aged 27 to 92 years had some degree of gynecomastia. While the symptoms of gynecomastia in adolescents and adults may be similar, the causes of the condition are very different. Additionally to hormonal imbalances that occur over time, certain health conditions can also contribute to male breast enlargements, such as thyroid disorders and cancers of the pituitary gland. Consumption of alcohol and recreational drugs, such as marijuana, can also lead to gynecomastia.
What causes gynecomastia in puberty?
Gynecomastia is an increase in the size of the breast (guy-nuh-kah-MAS-tuh) as a result of the imbalance of the levels of the hormone estrogen and testosterone. Gynecomastia may affect one or both breasts, sometimes unevenly.
Gynecomastia before and After Puffy Nipples Eliminated
Gynecomastia, often referred to derisively as ‘man-boobs’, is endemic in the United States. While gynecomastia can be associated with excess body mass and obesity, many males I see for gynecomastia reduction surgery are not overweight, but simply have experienced the spontaneous proliferation of fibrous breast tissue on one or both sides of their chest, for reasons that medical science currently cannot fully explain. This causes many young men to ask, Why Do I Have Gynecomastia? For young men and teens with gynecomastia, the problem can create a vicious cycle of self-consciousness and social withdrawal. With breast area enlargement, a boy gradually becomes insecure about his appearance without a shirt on or even in workout clothing. They begin to avoid social situations in which their chest appearance is obvious (the gym, the pool, pickup games), and sometimes come to avoid sporting activity of any kind. This can potentially damage their psychosocial development and has a profoundly negative effect on their sense of well-being and quality of life. It certainly is possible that some gynecomastia may improve without surgical intervention after a few years, particularly in very young teens. However, if my own sons had gynecomastia that persisted beyond two years, particularly if they are fifteen or over, I would certainly support their decision to go forward with Surgical Treatment for Gynecomastia
Gynecomastia will not go away with diet or exercise, although I have seen young men injure themselves due to excessive workouts, and others put their health at risk by minimizing calories. Glandular tissue cannot be dieted away. if you are a parent with a son who is concerned about gynecomastia, assure him that it is not his fault and support him in any way you can.
Gynecomastia, often referred to derisively as ‘man-boobs’, is endemic in the United States. While gynecomastia can be associated with excess body mass and obesity, many males I see for gynecomastia reduction surgery are not overweight, but simply have experienced the spontaneous proliferation of fibrous breast tissue on one or both sides of their chest, for reasons that medical science currently cannot fully explain. Some males have fullness of the overall breast area, while others have exclusively enlarged glands or puffy nipples.
For young men and teens with gynecomastia, the problem can create a vicious cycle of self-consciousness and social withdrawal. With breast area enlargement, a boy gradually becomes insecure about his appearance without a shirt on or even in workout clothing. They begin to avoid social situations in which their chest appearance is obvious (the gym, the pool, pickup games), and sometimes come to avoid sporting activity of any kind. This can potentially damage their psychosocial development and has a profoundly negative effect on their sense of well-being and quality of life. Many young men will wonder, Why Do I Have Gynecomastia?
It certainly is possible that some gynecomastia may improve without surgical intervention after a few years, particularly in very young teens. However, if my own sons had gynecomastia that persisted beyond two years, particularly if they are fifteen or over, I would certainly support their decision to go forward with this surgery.
Gynecomastia correction surgery is the only surgery I perform on teens. I hear stories of young men who wear as many as four shirts during the heat of summer to camouflage fullness in their chest that makes them feel self-conscious. One parent shared with me that her son was selecting colleges based on the school colors. He only wanted to attend a college where the school colors included black, navy or dark green.
I have seen young men work out too hard and injure themselves, hoping that building muscle will be a distraction from gynecomastia. Others reduce calories so much that they risk a health problem. There is no diet, workout program or pill to eliminate gynecomastia. if gynecomastia persists for a year or more, it may be time to consider Surgical Treatment for Gynecomastia Some parents want the best for their sons’ but they do not realize that gynecomastia is not fat and that the only proven way to eliminate gynecomastia is with surgical correction.
