Everything You Should Know About Enlarged Male Breasts or Gynecomastia

What is Gynecomastia?

Gynecomastia is a health condition in which the breasts of males puff up. This condition is primarily caused due to hormonal imbalance. Gynecomastia, also known as man boobs, not only create social uneasiness for males but also puts one in a state of mental discomfort. There are different options one can choose to treat Gynecomastia, but the most effective one is surgery.

Though gynecomastia is not a life-threatening disease, it can be discomfort and may cause social anxiety and stress. It can even lead to depression sometimes. If you are also one of those people who have been coping with this condition in silence, you should know that male breast reduction surgery is a safe and sound technique that permanently removes breast tissues.

How Does Gynaecomastia Form?

Gynaecomastia, also known as moobs or man boobs, forms primarily due to hormonal imbalance. The breast glandular tissues are a part of both male and female anatomy. In females, the hormone estrogen controls the growth of the breast tissues and other female characteristics. In males, the testosterone hormone is the one that can control physical characteristics. These hormones are present in both males and females. And gynecomastia forms when the levels of testosterone hormone decrease and estrogen hormone levels increase due to some reason.

Due to the high estrogen levels, the glandular tissues start to grow gradually and stop growing after some time. The large size of breasts becomes a matter of social and personal distress for males. Many men feel uncomfortable even going out and wearing clothes they like. Eventually, they have to seek treatment from experts. If you suspect that breast tissues are developing abnormally, you should talk to a plastic surgeon to discuss the best line of treatment.

Types of Gynecomastia

• Pseudogynecomastia (mostly fat tissues)
• True Gynecomastia (mostly glandular tissues)

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Causes & Symptoms of Gynecomastia

Causes

Symptoms

Diagnosis and Evaluations Done For Gynecomastia

Self Diagnosis

You can self-diagnose gynaecomastia by recognizing the symptoms. If you take the normal size and shape of your chest into consideration, it is clearly possible to identify what type of changes are occurring in the chest region. 

The glandular tissues that develop in gynecomastia are different from chest fat. A hard lump starts to form under the nipples, which is firmer than fat tissues. When your breast glandular tissues are enlarged, you can feel the flower-shaped growth under the skin. Glandular tissues are the part of the breast tissues that produce milk. Due to this, males often experience discharge from the nipples, which indicates that they have gynecomastia. 

In chest fat, you won’t feel the firmness or mass under the nipples. Moreover, the chest fat won’t have any shape, and it will look like the skin has sagged. 

Diagnosis by Doctor

You will have to visit a plastic/cosmetic surgeon to find out whether you have gynecomastia or not. The doctor will perform a physical examination to accurately diagnose whether you have gynecomastia or chest fat, also known as pseudogynecomastia. 

The physical examination is done while the patient is lying on his back. It includes:

• Examination of the breasts in which the doctor will examine the breast’s shape, size, and firmness. 
• The doctor will pinch-test the side of the breasts around the nipple or areola. 
• If a disk-shaped mound of tissues can be felt around the nipples, it indicates true gynecomastia. 
• The doctor will also check the armpits or breasts to see if there are any enlarged lymph nodes present. 

Besides the physical examination, the doctor will also recommend a few tests that will allow the doctor to gather more information about your overall health and narrow down the most appropriate treatment option. 

Recommended Tests

• Blood Test– A blood sample is taken for the test to analyze the levels of different hormones in the body. 
• Urine Test- It also helps to determine the levels of hormones in the body. 
• Imaging Test- The tests like ultrasound, X-ray, CT scan, MRI scans, etc., are suggested to create clear images of the enlarged breasts. These tests help the doctor to see the composition of the tissues. 
• Mammogram- This test is done for cancer screening, i.e., to detect the early signs of breast cancer. It looks for microcalcification or hard masses in the breasts. 
• Biopsy- It involves the extraction of a small amount of tissue from the breasts to examine it for the disease. It is not necessarily done for cancer screening but to check whether the abnormalities in the tissues are due to cancerous growth or some other reason. 

Grades of Gynecomastia

Grade I

This grade has only a minor level of enlargement in the breasts. A localized button of tissue starts to grow around the areola. The chest will only be slightly swollen, and it won’t be noticeable when you are wearing clothes. 

Grade 2

At this grade, the male breast tissues expand to the width of the chest. The pectoral muscles are almost completely covered with the breast tissues, but the edges are still less prominent. 

Grade 3

It is a moderate stage of breast development at which the breast tissues become completely visible through clothes. The excess skin continues to grow and become more prominent. The breasts also have more firmness at this stage. 

Grade 4

At this grade, the development of breasts is almost complete. It is the most severe stage as there is a large amount of excess skin, and causes problems in the regular life of the individual. 

The males may start experiencing back pain and sit in a slouching position to ensure that the excess breast fat isn’t clearly visible. If left untreated for a long time, gynecomastia may also cause spinal deformity in males. 

How to Prevent Gynecomastia Progression?

In most cases, it is almost impossible to prevent the development of male breasts. There are numerous factors that make these tissues grow. That’s why it is difficult to avoid them all. Still, there are some things that you can do to lower your chances of having gynecomastia. These things include:

• Avoid using illicit and recreational drugs, such as anabolic steroids, androgens, heroin, marijuana, amphetamines, etc.
• Do not drink alcohol. And if you do drink alcohol, drink in moderation.
• Get your medicines reviewed by the doctor to find out if some medications may increase your chances of developing breast tissues.

Common Myths & Facts Related to Gynecomastia

Myth 1: Gynecomastia occurs due to being overweight. 

Gynecomastia occurs because of a hormonal imbalance between male (testosterone) and female (estrogen) hormones.

Myth 2: Steroids increase testosterone levels, thereby treating gynecomastia. 

Overuse of steroids can increase the risk of testes shrinkage, which results in decreased production of testosterone. Therefore, the risk of hormonal imbalance increases. 

Myth 3: Doing more chest exercises will reduce the size of male breasts. 

Doing chest exercises will build your chest muscles that will push the breast tissues farther from the chest, making them look tuberous. 

Myth 4: Genetics plays a major role in the development of gynecomastia. 

Gynecomastia is rarely caused due to genetics. A rare genetic condition called Klinefelter Syndrome may result in gynecomastia, but it affects one male out of 550.

Myth 5: Gynecomastia is a sign of breast cancer. 

Having gynecomastia, neither means that you have breast cancer nor increases your risk of developing breast cancer. 

When to Consult a Gynecomastia Doctor?

It is common for men to misunderstand gynecomastia as chest fat or pseudo-gynecomastia. They usually become concerned about the condition when it exhibits symptoms like tenderness, pain in the breast region, additional swelling in the area, etc.

You should note that there is no right time to see a doctor regarding gynecomastia. You can decide to visit a doctor if you feel uncomfortable due to the large size of your breasts or don’t like their appearance.

The best person to consult for gynecomastia is a plastic surgeon. But you may also need help from an endocrinologist as the condition is directly caused due to hormonal imbalance.

Questions to Ask Your Doctor

Gynecomastia Treatment Cost & Insurance Coverage

In India, gynecomastia treatment cost ranges from Rs. 35,000 to Rs. 1,00,000. This is only an estimated cost range that varies for each patient depending on various factors, such as

• Doctor’s consultation and operating fee
• The grade of gynecomastia (severity)
• The technique used for gynecomastia treatment
• Diagnostic tests
• Hospitalization expense
• Pre and post-surgery medications
• Post-surgery care and follow-up consultations

Insurance coverage