Written by J. Dayne Petersen
Gynecomastia ˌgī-nə-kō-ˈmas-tē-ə. It sounds like a dinosaur in my second grader’s school book. Unfortunately, it is a medical condition that can cause males, especially adolescent males, a great deal of embarrassment, and open them up to harassment. Gynecomastia is the abnormal development of breast tissue, or the development of female like breasts, in males.
Imagine being a 15 year old boy who has begun to develop female like breasts. Imagine having to change in the locker room at school for P.E. Imagine trying to wear three shirts when you go swimming to hide your body shape, or avoiding the pool altogether. Imagine what other boys would say to and about you.
It occurs most often in adolescent males going through puberty, and elderly males. The condition may resolve itself, but it may not. I see men in my practice who have dealt with the embarrassment of this condition for years.
Gynecomastia has several causes that can result in varying levels of increased breast glandular tissue. Gynecomastia can be related to hormone imbalances, tumors in hormone secreting glands, male breast cancer, testicular cancer, or side effects of medication or drugs. However, most causes of gynecomastia have no identifiable cause other than being related to the changes in hormones which accompany puberty.
Obesity in adolescents can also give rise to a related condition called pseudogynecomastia. Enlarged breasts in these boys and men are the result of excess fat deposition. An increase in adolescent obesity has correlated with an increase in incidence of gynecomastia. According to the CDC, adolescent obesity rates have tripled over the last 30 years. Fat tissue excretes estrogen. It would follow that males with high levels of fatty tissue would be at greater risk for conditions related to hormonal imbalance.
The good news is that most gynecomastia is not medically harmful and it is treatable. Treatment is always more difficult when the condition has a weight related factor. No one ever said that changing your lifestyle would be easy. But just as a tummy tuck patient will get the best result if the procedure is done when the patient is closest to his/her ideal weight, the gynecomastia patient will get the best results when weight issues are addressed first. For an already discouraged and self-conscious adolescent to hear that diet and exercise are a necessary prerequisite to treatment can be hard.
Gynecomastia is treated most commonly with liposuction, which permanently removes the bulk of the excess tissue from the chest area. It may also require a small incision around the nipple to remove excess glandular tissue. In the best cases the skin will retract and flatten on its own. Sometimes, however, suctioning the fat will leave sagging skin and the surgeon will need to remove that skin, leaving a scar similar to a woman’s breast lift. Those scares will fade over time. The emotional scars of being teased or being acutely self-conscious may take just as long to fade.
See a doctor and get evaluated. A board certified plastic surgeon is a good place to start. Don’t suffer on the sidelines.