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By Busayo Malafa, MD

Plastic surgeon, UPMC Plastic and Reconstructive Surgery

Men may not talk about their enlarged breasts, but it is a surprisingly common problem. It’s estimated that 40% to 50% of men experience it at some point in their lives. The condition is formally known as gynecomastia.

While there is usually no health risk associated with gynecomastia, it can be embarrassing and prevent men and teens from doing the things they enjoy.

However, men with this condition should know they don’t have to live with it. Treatment options are available.

What Is Gynecomastia?

Gynecomastia is a benign or noncancerous enlargement of one or both male breasts. A normal male breast has a small amount of glandular tissue. This tissue can become enlarged for various reasons, including hormonal imbalance, medications, or systemic diseases.

Gynecomastia typically appears in three periods of a man’s life.

  • In infancy, 60% to 90% of male babies may have enlarged breasts. This usually goes away in the first month of life.
  • In adolescence, 50% to 70% of young men may be affected due to a hormonal imbalance in which they have more estrogen than testosterone due to a lag in testosterone production. It often peaks at age 14.
  • Among older men, as their natural testosterone reduces with aging.

Old and young men with gynecomastia can feel embarrassment about their breasts. They may avoid some clothing or skip activities they would normally enjoy, like swimming. Gynecomastia also can damage self-esteem and contribute to depression, anxiety, and body dissatisfaction.

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What Causes Gynecomastia?

An imbalance in estrogen and testosterone hormones often causes gynecomastia. A reaction to a medicine also can cause it. In rare cases, it may be a symptom of liver disease, testicular cancer, lung cancer, a thyroid problem, or kidney disease. Studies have also found that some herbal supplements and marijuana use can contribute to it.

Being overweight and having extra body fat also can cause enlarged breasts. That’s called pseudo-gynecomastia because it appears the same, but the underlying cause of it is different.

For about 25% of cases, however, no cause is found.

How Is Gynecomastia Treated?

When you go for treatment, doctors will review your medical history and the medicines you’re currently taking. They will make sure there isn’t an underlying problem by doing a blood test to evaluate your liver enzymes and kidney function. They’ll also check your hormones for testosterone and estrogen levels.

The treatment depends on the cause. If a medicine is causing the problem, an alternative may be tried. If the cause is hormonal, you will be referred to an endocrinologist. You also may be prescribed medicine that reduces the body’s estrogen level.

In teenagers, doctors often wait a year to 18 months to see if gynecomastia will go away. If it does not resolve, then surgery or medication is recommended depending on the severity.

In adult men, surgery is an option if there are no underlying conditions and they have had gynecomastia for more than a year.

For small enlargements, liposuction is the best surgical intervention. In this simple procedure, the doctor makes an incision at the border of the chest and sucks out fat and breast tissue. Larger breasts with excess skin may require a mastectomy — or removal of excess skin — in addition to the liposuction.

Surgery for mild and moderate cases typically uses minimally invasive techniques on an outpatient basis, meaning a hospital stay is not required. These techniques generally result in less blood loss, less scarring, and a shorter recovery time. More severe cases may require incisions on the chest, but they also will be outpatient services.

Time off work is only a few days for the minimally invasive procedure but can be up to four weeks if the gynecomastia is severe and larger incisions are needed. You will need to avoid strenuous activity for two to three weeks after surgery. You also will need to wear a compressive vest to reduce swelling and prevent the accumulation of fluid. This vest fits discretely underneath clothing.

If You Have Gynecomastia: Understand Your Options

While there are very few underlying health risks with gynecomastia, it can be life-altering and reduce your quality of life. If you are uncomfortable with your breasts, you can do something about it.

Talk to your family doctor or see a plastic surgeon. We can guide you through your treatment options so that you can live your life to the fullest, looking your best.

To learn more or to find a plastic surgeon near you, go to findadoc.upmc.com.

Busayo Malafa, MD, is a plastic surgeon with UPMC Plastic and Reconstructive Surgery. She received her medical degree from the Indiana University School of Medicine and completed her residency in general surgery at WellSpan York Hospital, followed by her residency in Plastic and Reconstructive Surgery at the Medical University of South Carolina. She is board-certified in surgery by the American Board of Surgery.

About Plastic Surgery

Plastic surgery is an option for both cosmetic and reconstructive needs, and the UPMC Department of Plastic Surgery can help with both. Whatever improvement you seek, we can create an individualized treatment plan to help you achieve your desired results. Through our research and clinical trials, we have used cutting-edge techniques in our treatments for more than 70 years. We also have one of the largest academic plastic surgery departments in the United States and operate one of the region’s top centers for restorative medicine.

Plastic surgery is an option for both cosmetic and reconstructive needs. The UPMC Department of Plastic Surgery can help with both. We will work with you to create an individualized treatment plan to help you achieve your desired results. Through our research and clinical trials, we have used cutting-edge techniques in our treatments for more than 70 years. We also have one of the largest academic plastic surgery departments in the United States and operate one of the region’s top centers for restorative medicine. Our goal is to improve your quality of life. Find a provider near you.