Gynecomastia: Enlarged Breasts in Men

Shame. Humiliation. Insecurity. These are some of the emotions experienced by men with enlarged breasts, or gynecomastia.

About half of all men today have excess localized fat and/or excess glandular tissue in one or both breasts. Gynecomastia accounts for more than 65 percent of all male breast disorders, according to the American Society of Plastic Surgeons (ASPS).

Causes of Enlarged Breasts in Men

In most cases, the cause is unknown. Sometimes it is an imbalance of the sex hormones estrogen and testosterone. But heredity conditions, diseases including certain endocrine disorders, tumors, and chronic diseases or certain drugs such as anti-depressants, blood-pressure medicines, marijuana, and steroids may also cause the condition.

Some men or boys have fat on their chests that makes it look as though they have breasts. This is not gynecomastia, but is called pseudogynecomastia and may go away with diet or exercise. Some men or boys will need treatment for this, as these fat pockets can be resistant to the effects of diet and exercise. In contrast, true gynecomastia will not usually improve with diet and exercise.

While not a serious medical problem, enlarged breasts can cause pain. They can also cause embarrassment — especially among young boys who may be teased as a result of their male breasts. It is especially common in teen boys. Up to 65 percent of 14-year-old boys have enlarged breasts, according to the American Academy of Family Physicians. This is largely due to the fluctuations in sex hormones that occur during puberty. The excess breast tissue disappears without treatment in two years in 75 percent of these boys, and within three years in 90 percent of them.

Repeated use of products containing lavender oil or tea tree oil may spur breast growth in prepubertal boys, according to a study in The New England Journal of Medicine. The effects fade when boys stop using the products.

More than half of male infants are born with enlarged breasts due to the effects of their mother's estrogen. This typically disappears within two to three weeks after birth.

In older men, gynecomastia often results from decreasing levels of the male sex hormone testosterone, which occurs with advancing age. In addition, men experience an increase in body fat with age and a resultant rise in the ratio of estrogen to the male sex hormones (androgens).

Gynecomastia Treatment

Surgery, liposuction or a combination of the two may be used to treat enlarged breasts. The reasons for surgery are two-fold in men: The first goal is to reconstruct the contour of the chest. The second goal is to determine if a suspicious lesion in the chest is cancerous. Enlargement typically occurs on both sides of the chest. If it is one-sided, firm and hard, see a doctor immediately to rule out male breast cancer.

The first step for treatment is a consultation with a fully-trained plastic surgeon. This evaluation will determine if you are a good candidate for male breast reduction.

You may be a candidate if you are healthy, are of relatively normal weight, have realistic expectations, are bothered by the feeling that your breasts are too large and (this is important) your breast development has stabilized. In general, the best candidates for surgery have firm, elastic skin that will reshape to the body's new contours.

Teens may benefit from surgery if their gynecomastia has been present for more than two years or if the problem is severe. In some teens, secondary procedures may be needed down the road if breast development continues.

Male breast reduction may be discouraged if you are obese, or if you are overweight and have not first attempted to lose the fat around the breast area with an exercise or weight loss program. If you use drugs that may cause the condition, you are not a good candidate. Your doctor would first advise you to stop using these drugs or to switch to other medications that do not cause it. Never stop taking a prescription medication without talking to your doctor first.

In addition to taking a thorough medical history, your surgeon will also assess whether you have any allergies or have had any prior surgeries in the chest region. He or she will also perform a physical exam to measure the extent of excess fat and glandular tissue in the chest area. Your surgeon will also likely conduct diagnostic testing to determine the underlying cause of your enlarged breasts. This will include tests of your endocrine function. The endocrine glands secrete the hormones that have been linked to enlarged breasts.

Your surgeon will likely take some "before" photos during this consultation process and will also discuss your expectations from the surgery.

Please visit us at www.bhpsg.com for further information and call us to set up a consultation today!