What is gynecomastia? How do I know if I have it?
What do I need to look for to tell if what's going on with me is that I have, unfortunately, 'man boobs' or if I have that condition called gynecomastia? That's all I want to know to start. What are the distinguishing factors to tell one from the other - with certainty - and when you can distinguish one from the other, what are the options for treating both?
Hi there! Good question.
Gynecomastia is the technical medical term for "man boobs," irrespective of the cause. It basically means "female breasts" and can be the result of hormonal changes, medications, tumors and other biologic causes and/or fat excess in the breast area. For most men, gynecomastia has both fatty and fibrous tissue contributing to the breast enlargement. The fibrous stuff is right under the nipple and the fat is most of the rest of the breast. Normal male tissue has very little fat in the breast unless the patient is overweight, although some men may have it as a result of genetics (for instance, it kind of runs in my own family, even when the men are not particularly overweight).
Managing patients for gynecomastia usually includes a basic medical workup to rule out treatable conditions that might be correctible by other means. For example, if you take anabolic steroids, discontinuing them under a doctor's supervision may help reverse the condition. If you have a rare tumor in your pituitary gland secreting a hormone called prolactin (the hormone that makes females produce milk), you could have that treated surgically. There are other causes that can typically be ruled out with a hormonal and routine lab test, and sometimes a mammogram will be ordered to rule out the very rare likelihood of male breast cancer.
Assuming a negative workup, the treatment often consists of a combination of liposuction, often aided by ultrasound to break up the denser male fibrofatty breast tissue, and direct removal (like a lumpectomy) of the very dense glandular tissue right under the breast.
The surgery takes between 1 and 3 hours depending on the extent of fat, the size of the areolas (much of the surgery is done through very small incisions at the border of the nipple), etc.
Lots of great board-certified plastic surgeons including our office here in California with extensive experience in this condition.
-- Dr. Sayed
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Gynecomastia is, by definition, any increased tissue on a male chest. If you flex and tighten your chest muscle and pinch the overlying tissue with the other hand, you will have your proof. The question then becomes whether you can live with it or not. If not, then your only option would be male breast reduction surgery. Look for a plastic surgeon who is also a gynecomastia expert for the best possible result. You can get much more information from my website, which is specifically devoted to gynecomastia. www.gynecomastianewyork.com
Elliot W. Jacobs, MD, FACS
New York City
Dr. Elliot Jacobs has 3 Gynecomastia reduction before & afters: