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.