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When most people hear about procedures to remove excess breast fat, tissue and skin, they associate it with women. But the condition known as gynecomastia is the enlargement of male breast tissue. In response to too much estrogen (a female hormone) or too little testosterone (a male hormone), the glandular tissue of the breasts swells and forms a breast bud (enlarged breast). Gynecomastia can occur in babies, teen boys, and older men.
Gynecomastia commonly occurs in boys during puberty because of the balancing act their hormones play, with up to 69% of adolescents affected by the condition at some point in their lifetime. Gynecomastia can even persist into adulthood. Surgery to correct this condition is usually recommended for these patients.
Although treatment guidelines for gynecomastia are widely practiced, the psychological impact of gynecomastia on adolescent boys has remained largely unknown. But now a new study reveals the difference between boys with gynecomastia, and healthy, unaffected boys of the same age and gender. Researchers looked at each group’s physical, social and emotional well-being. The adolescents with gynecomastia were found to have significantly lower measures of mental health, self-esteem and social functioning and also had higher rates of eating-disorder thoughts and behaviors than their peers.
The severity of the gynecomastia or the patient’s body mass index (BMI) did not affect the degree of impact. Merely having the breast disorder was enough to show these physical, emotional and social deficits. Even the mildest gynecomastia can negatively affect the psychosocial well-being of a young man. The physical health of males with gynecomastia was considerably worse than that of the healthy boys, but was attributed to the higher rate of obesity rather than the disorder.
These findings suggest that gynecomastia is more than just a cosmetic issue. Male breast reduction procedures are up 15 percent and it may be because adolescents with the condition suffer psychologically as a result of their breast condition. Prior studies have found higher rates of depression, anxiety and embarrassment in boys with larger chests. Parents and patients should be aware of the psychosocial issues associated with gynecomastia, and consider early evaluation for adolescents suffering from this condition, regardless of severity. Early surgical treatment may also be necessary to improve these adverse emotional and social effects. It’s not just a cosmetic issue but also an anxiety that could get in the way of everyday activities.
Dr. Cameron Rokhsar
Dr. Cameron Rokhsar, MD, FAAD, FAACS, is the founder and medical director of the New York Cosmetic, Skin, & Laser Surgery Center. Dr. Rokhsar is a graduate of Harvard College and NYU School of Medicine. Dr. Rokhsar is double board certified in dermatology and micrographic dermatologic surgery, being one of the few select dermatologists in the country who is also fellowship trained in laser surgery. A researcher and innovator, Dr. Rokhsar is the creator of the non-surgical nose job and has been instrumental in the research and development of laser systems such as the Fraxel, CO2, Mirady, Vbeam, Themitight, and Ulthera devices. An Associate Professor of Dermatology at Mount Sinai Hospital in NYC, Dr. Rokhsar actively teaches the cosmetic dermatology clinic to the resident at Mount Sinai. An expert injector of fillers, and a trainer for many companies, patients fly in from around the world to see Dr. Rokhsar in his Garden City and Manhattan offices in New York.