GYNECOMASTIA describes the enlargement of glandular tissue in men both young and old, which may cause discomfort by making the nipples tender and sensitive. Gynecomastia occurs when hormonal changes stimulate breast development, resulting in enlarged male breasts. Weight gain can also contribute to chest fullness through excess fatty tissue, although this differs from true gynecomastia. Some men have both conditions, creating what they may describe as a feminine chest appearance.
If breast enlargement develops because of another health condition, treating the underlying issue may help reduce it. For persistent overdeveloped or enlarged breasts, male breast reduction surgery may be an option to remove excess breast tissue. A consultation helps determine whether monitoring, medical care, or surgical treatment is appropriate.
Understanding the Causes of Enlarged Breasts in Men
Although testosterone is commonly associated with men and estrogen with women, both sexes produce both hormones. Men generally produce more testosterone and smaller amounts of estrogen. Changes in this balance can cause men to develop gynecomastia, whether from reduced testosterone, increased estrogen production, or greater sensitivity to estrogen. Relative estrogen excess, natural hormonal shifts, certain medications, and some health conditions can cause gynecomastia and contribute to breast enlargement.
Puberty
Hormonal imbalance changes during puberty can cause pubertal gynecomastia, which often resolves without treatment as hormone levels stabilize. Some estimates suggest that more than half of adolescent boys experience some degree of temporary breast enlargement during puberty.
For those with persistent symptoms, male breast reduction may be considered after an evaluation of physical development, symptoms, and the duration of the condition. Surgery on male breast tissue is generally delayed until breast growth has stabilized.
Use of Certain Drugs
Medications such as spironolactone, ketoconazole, and cimetidine can contribute to gynecomastia. Using anabolic steroids can also disrupt hormone balance and cause breast enlargement. During a consultation, Dr. Quan reviews the patient’s medical history, medications, and supplement use to identify possible contributing factors.
Patients should consult their prescribing clinician before stopping or adjusting medication. Men taking antiandrogens for prostate cancer may also experience breast enlargement, although changing these medications may not be appropriate. When symptoms persist, an evaluation can help determine suitable options to treat gynecomastia.
Facts about Gynecomastia Surgery Treatment
Male breast reduction is a plastic surgery option that can provide lasting improvement for appropriately selected male patients. This surgical procedure may involve liposuction to address excess fat, direct excision for the surgical removal of glandular breast tissue, or a combination of both. It is commonly performed as an outpatient procedure.
The recommended surgical technique depends on breast size, skin elasticity, and the amount and type of excess tissue present. Patients with marked gynecomastia may also need removal of excess skin. In severe cases, additional incisions or nipple repositioning may be necessary to improve chest contours.
A board-certified plastic surgeon evaluates gynecomastia patients to determine whether cosmetic surgery is appropriate and explain the expected results, recovery, and risks. Although surgery removes existing tissue, future hormonal changes, certain medications, or weight gain can affect the outcome. For some patients, observation or treatment of the underlying cause may be recommended before surgery.
Male Breast Reduction Surgery in Baltimore, MD
If you’re a man who’s concerned about persistent breast enlargement in one or both breasts, the Aesthetic Center at Woodholme is here to help with both surgical options and professional advice for how to achieve a more masculine chest shape. Call us today at (410)-406-7378 or contact us online to schedule your confidential appointment with a board-certified plastic surgeon about your options for male breast reduction.
Dr. Ira D. Papel is certified in Head and Neck Surgery. Dr. Papel earned his B.A. from Johns Hopkins University and his M.D. from Boston University of Medicine. He completed a residency at the Johns Hopkins Hospital in Otolaryngology-Head and Neck Surgery and a fellowship at the University of California, San Francisco in Facial Plastic and Reconstructive Surgery. Dr. Papel is considered an international expert in rhinoplasty, revision rhinoplasty, and facial aesthetic surgery.
