How do I know if I have Gynecomastia and When should I consider surgery?
San Jose, California – This is one of the most commonly ask
questions that I hear in my gynecomastia surgery practice. These answers are general guidelines and do not replace a consultation with your gynecomastia
plastic surgeon.
Do I Have Gynecomastia?
The most common type of gynecomastia is termed adolescent gynecomastia. This occurs at
puberty when start to grow hair. The
development of male breast at this age will usually resolve within about two
years. If adolescent gynecomastia persists as a swollen area around the
nipple, then it will most likely remain. The male breast size can be small to
extremely large. Sometime, the area is tender or even
painful. This remains permanent in about
15% of boys. The adolescent gynecomastia
issue becomes difficult if the young boy is heavy with a large amount of fat
accumulation around the chest and body.
Sometimes, it can be a combination of fat and breast gland and other
situations fat only. Time will tell as
one grows and the body composition changes.
Steroid induced gynecomastia is very
common. This situation is easy to
determine. If the chest is normal and
then after taking steroid, hormones, or in some cases muscle building protein
powder, one may notice a change in the chest size. The overall muscle component will increase
and the breast gland may or may not enlarge.
The area around the nipple-areola may become tender and sore. This usually something is happening like
breast growth. Sometimes, it is masked
by the bulk of the chest muscle and, may, overall look great. However, this can change when the steroids
are discontinued or the workouts change.
When the muscle bulk goes down the breast gland does not and steroid induced gynecomastia can become
obvious at this time. Estrogen blockers
may or may not prevent breast gland development. It is quite interesting that some men will
not develop steroid induced gynecomastia and some will. One never knows, but one thing is for sure
and that is it will not go away on it’s own.
Psuedogynecomastia is do fat deposits due
to being overweight. This can be lost or
improved with weight loss. For example,
if a young man did not have gynecomastia in his youth, no steroid use, but
developed an enlarge chest with weight gain over time, and then this is likely
pseudogynecomastia.
When Should I Consider Gynecomastia Surgery?
This is a very
difficult question and one that I am asked often. Gynecomastia is a very personal issue. Some boys and men live with the male breast
enlargement are very comfortably with body and accept the difference from other
men without any significant psychological issues. We see them often on every beach or swimming
pool having a great time. Some people
just cover in clothing and conceal their chest and deal with it in this way.
The other side of the coin is the person who is quite
embarrassed, carries a lot of shame, conceals his chest in clothing, and is psychologically
devastated. An interesting point it the
size or severity of the gynecomastia has no bearing to the severity of the
psychological issues.
I tell patients, when you feel it is significantly affecting your daily
life, it is worth consideration. I explain to patients that it is a individual
decision and that it will come to you sooner or later. Trust yourself and you decision.
