Pseudo-gynecomastia is the enlargement of male breasts caused by an excess amount of tissue in the fatty region below the nipple. This can be due to excessive weight gain and is commonly found in younger obese males.
True gynecomastia is the enlargement of male breasts caused by an excess amount of tissue in the glandular breast region. Excess tissue development is uncommon in this region.
Causes of gynecomastia include:
This condition can occur in one or both breasts as small benign lumps beneath the nipple. Gynecomastia is not uncommon and usually goes away after a period of months, during which the lumps may be tender. This condition persists in about five percent of males. An abnormal increase in male breast mass, such as gynecomastia, has been correlated to body mass index (BMI), a calculation used to measure the healthiness of one’s height to weight.
* This is before and after of minimally invasive lipo of neck and jawline done under local anesthesia. Results are significant with minimal downtime.
Tamoxifen and raloxifene are two common drugs can be used to treat men with enlarged breasts. Liposuction can also be performed in order to reduce the excess male breast tissue for those more drastic cases.
Pseudogynecomastia persists similar symptoms but is a fat deposit without glandular proliferation and is increasing at the same rate as the incidence of obesity in American men.
Liposuction is a common procedure to eliminate the fat deposits left behind for those suffering from gynecomastia. During the procedure, small incisions are made over the breast area. Small tubes called cannulas are inserted into the incisions and fat is extracted through the tubes attached to a pump. The gentle fat extraction leaves behind minimal scarring and a few weeks of recovery time.
Liposculpture relies on the technology of tumescent fluid that numbs and liquefies the fat, allowing easier removal through tiny incisions. The tumescent method of lipoplasty is the most effective form of liposuction because a fluid containing anesthetic and capillary minimizer which limits blood loss is injected into the fatty tissue and then removed. Results are more even using this technique and require less recovery time. You can return to work after two to three days and because local anesthesia is optional, risks associated with anesthesia are eliminated.
The male breast is composed of fat (adipose) and connective (fibrous glandular) above the pectoral muscle group. Male breast tissue is usually located immediately under the nipple and is firmer than the surrounding fatty tissue. The growth of abnormally large breasts in males is called gynecomastia and is the excess growth of breast tissue, not excess fat tissue. During puberty, boys can start to develop male breasts. This normal development is caused by hormones that lead to other changes in puberty and occurs in 65 percent of all normally healthy boys and usually resolves without intervention late into puberty.
Male breast development is often not a medical concern and is generally treatable. Low testosterone or other hormone imbalance may be the cause, along with medication, illness or increase in body fat; which is known to convert male hormones to estrogen.
Liposuction is performed with a typically smaller tube inserted into small incisions in the breast. Unwanted tissue is then removed through a suction pump carried through the small tubes. Local anesthesia is used throughout the procedure to keep the patient at ease, and after surgery is complete, stitches will be placed along incision lines. Compression devices should be applied 18 to 24 hours post-surgery in order to avoid bleeding and bruising.
Laser liposuction is a procedure found to be very successful among men that have relatively normal weight, but isolated pockets of fat, such as the breast. Because lasers emit heat, the skin contracts, giving a tightening effect as well. Laser liposuction used in conjunction with surgical liposuction can yield the best results depending on the patient’s goals. Laser liposuction used alone is generally used for body contouring, achieving a normal breast shape, instead of used as a weight loss solution.
Gynecomastia is a medical condition that occurs in males when there is an imbalance of the hormones estrogen and testosterone. It can cause an increase in the amount of breast gland tissue in one or typically both breasts, leading to breast enlargement. It may also have genetic causes in many patients. The appearance of gynecomastia can vary, but it typically presents as a rubbery or firm mass that is located directly behind the nipple as well as generally enlarged breasts which can be composed of fat as well as breast tissue. The enlarged male breasts may or may not be tender to the touch and can be felt by gently pressing on the breast tissue. Gynecomastia typically affects both breasts, and the breasts may grow unevenly. In some cases, the nipple-areolar complex may appear more projected than the rest of the chest. Gynecomastia in most patients is composed of both fatty tissues as well as glandular breast tissue. In more severe cases, the breast tissue may take on a rounder, more proportionate shape, resembling that of a woman’s breast.
Gynecomastia is a relatively common condition that affects boys and men. According to medical research, gynecomastia is the most common male breast disorder and can occur at different times, including birth, puberty, and in older men. Researchers have estimated that the prevalence among men ages 50 to 80 is between 24% and 75%. During male puberty, gynecomastia is also a common occurrence affecting up to two-thirds of pubescent boys, but this hormone-induced condition usually resolves on its own within three to six months.
Gynecomastia in males is caused by an imbalance between the hormones estrogen and testosterone. It can also be due to genetic causes as well as being overweight. Normally, men produce small amounts of estrogen, the hormone that controls breast growth. However, if a man’s body produces too much estrogen or has low testosterone levels, it can increase breast gland tissue. Other causes of gynecomastia may include medication side effects, such as certain antidepressants, antibiotics, chemotherapy, prostate cancer medicines, ulcer or cardiovascular medicines, as well as certain medical conditions such as liver or lung cancer, cirrhosis of the liver, overactive thyroid, or hormone problems such as cancer of the pituitary gland, adrenal glands, or testicles. Alcohol, marijuana, methamphetamine, and heroin use can also cause gynecomastia. In some cases, gynecomastia can be a side effect of renal failure or malnutrition.
The signs and symptoms of gynecomastia can include swelling, pain, tenderness, and nipple discharge in one or both breasts. In most cases, there are no other signs except having large breasts. To diagnose gynecomastia, your doctor may perform a physical exam to feel for soft lumps in the breast tissue, particularly behind the nipple. Additionally, your doctor may recommend blood tests to check for hormonal imbalances or a mammogram to determine the cause of the gynecomastia.
If you suspect that you may have gynecomastia, It is best to seek a consultation with your doctor, such as a board-certified dermatologist or endocrinologist, or primary care doctor, for an accurate diagnosis and personalized treatment plan. It’s important to address the underlying cause of gynecomastia, as well as any emotional or psychological distress that may be associated with this condition. Your board-certified dermatologist or plastic surgeon can also advise you as to treatment options such as liposuction, Kybella injections, or surgical removal of the breast tissue.
The duration of this condition can vary depending on several factors such as the age at which it occurs, the cause of the condition, and the severity of the enlargement.
In most cases, gynecomastia caused by hormone changes during puberty will go away on its own within six months to two years. However, if a medication or medical condition is causing gynecomastia, the duration may vary. For example, if the cause is a medication, stopping the medication may resolve the issue.
When gynecomastia is caused by genetic factors or fat, the condition does not go away. The treatment modalities include liposuction, Kybella injections, as well as surgical excision of the breast tissue. If gynecomastia is because of medical hormone issues, the underlying cause needs to be addressed medically. Some men may benefit from medication or hormone therapy, while others may also require surgery to remove the excess breast tissue through liposuction or excision. Kybella injections which dissolve fat may also be useful in patients who want to avoid surgery. The choice of treatment will depend on the underlying cause and the severity of the condition.
Gynecomastia can occur as a side effect of testosterone therapy, but there are steps you can take to reduce your risk of developing this condition.
One of the primary causes of gynecomastia is an imbalance in the ratio of estrogen to testosterone in the body. Therefore, it is important to maintain proper testosterone levels while on testosterone therapy. This can be achieved through regular monitoring of testosterone levels and adjusting the dosage as necessary.
In addition to monitoring testosterone levels, it is important to avoid using drugs that can contribute to gynecomastia, such as anabolic steroids, amphetamines, heroin, and marijuana. Alcohol should also be avoided or consumed in moderation, as excessive alcohol intake can contribute to an imbalance in hormone levels.
Medications such as raloxifene and tamoxifen have been approved by the FDA for the treatment of breast cancer in women, but have also been used off-label to treat gynecomastia in men. These medications work by blocking estrogen receptors and can be effective in reducing breast tissue growth in men.
A healthy diet and regular exercise can also help maintain proper hormone levels and reduce the risk of gynecomastia. Certain foods with estrogenic properties should be avoided or consumed in moderation, as they can contribute to an imbalance in hormone levels.
One way to reduce gynecomastia is through medication. Tamoxifen and aromatase inhibitors such as anastrozole are medications that have been approved by the FDA and may be helpful for some men with gynecomastia. However, these medications have not been specifically approved for use in people with gynecomastia.
In addition to medication, lifestyle changes can also help reduce gynecomastia. Aerobic exercise can help you lose weight and reduce breast size. It is also important to avoid illegal drug use and to switch medications or seek treatment for substance use disorders if needed to reduce your risk of developing gynecomastia.
In most cases, surgical options are the best way to address gynecomastia. The best surgical procedure which leaves almost no visible scars is liposuction. Dr. Rokhsar performs his liposuction for gynecomastia under local anesthesia making it the safest way of doing liposuction. The entry points of the cannulas are also strategically hidden in the axillary folds and inframammary crease. This is a quick outpatient surgery taking less than three hours all done under local anesthesia with quick recovery. Kybella injections which destroy fat by putting holes in membranes of the fat cells are an effective option for those who want to avoid undergoing a surgical procedure such as liposuction. More than one injection session spaced 2 months apart may be needed for the treatment of gynecomastia with Kybella injections. Lastly, surgical excision of the glands can be a treatment modality. Dr. Rokhsar is an expert in the treatment of gynecomastia through liposuction.
The cost of gynecomastia surgery can vary depending on factors such as the surgeon’s experience, the facility’s location, the type of procedure performed, and other related expenses. The price can also vary depending on the severity of the condition, the patient’s goals, and the type of procedure recommended by the surgeon.
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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.
Dr. Rokhsar was chosen by
magazine as a top dermatologist in its Best Doctors 2017, 2018, 2019, 2020, 2021, 2022 and 2023 issues.
