Everything You Need To Know: Gynecomastia Guide

Gynecomastia Guide explains that Gynecomastia is the swelling of the breast tissue in males, typically explained by a hormonal imbalance between the amount of estrogen and testosterone that is being produced by the body. Gynecomastia can attack each breast, or both, resulting in an uneven proportion of fatty tissue. This condition can affect males in all stages and progress at any age due to normal, natural changes in hormone levels, although other causes do exist.

Gynecomastia surgery before and after photos

Gynecomastia Guide

Gynecomastia may not be a life-threatening predicament, so is treated as predominantly a superficial condition. However, it is still an extreme ailment to cope with as it interferes with other areas of daily life. Men and boys with gynecomastia sometimes experience intense pain in their breasts, similar to the soreness that a woman would endure during her menstrual cycle. The physical and aesthetic attributes alongside the tender reactions as the two main symptoms lead to severe insecurity and embarrassment in males.

It is possible for Gynecomastia to go away on its own if hormones stabilize. Most cases require medication or a surgical procedure.


Signs and symptoms of gynecomastia include:

  • Swollen breast gland tissue
  • Breast tenderness

When it’s time to see a physician or specialist:

  • Swelling
  • Pain
  • Tenderness
  • Nipple discharge in one or both breasts

Types of Gynecomastia

Stages of Gynecomastia

Type 1

Type 1 Gynecomastia is commonly referred to as a “puffy nipple”. The breast is composed of glandular tissue that is firm and dense. Many Type 1 gynecomastia patients have a lean body mass, have little fat, and are of young age. Surgically removing the glandular breast tissue is the preferred choice for leading experts and is mildly invasive.

Type 2

Type 2 Gynecomastia is the most prevalent of all the types. Most males develop an excess breast volume that consumes the lower chest and is often the size of a tennis ball increasing over time to potentially the size of a large softball. Liposuction is the preferred and most effective treatment however; some patients have a combination of both fatty and glandular tissue. For these particular cases, a combination of liposuction and surgical removal is the preferred choice of surgery.

Type 3

Type 3 Gynecomastia has a chest angle of 45-60 degrees and starts to sag when the angle is within this range. Treatment for Type 3 gynecomastia depends on age and skin quality of the chest. Surgical removal of breast tissue is the standard technique to certify that all of the necessary breast tissue has been removed.

Type 4

Type 4 Gynecomastia has a chest angle of 60-90 degrees. At this point, there is already a noticeable component of chest sag present and skin removal is absolutely unavoidable in order to correct the visibility of breast sag. Surgical removal of breast tissue is the ideal and optimal procedure to ensure all of the breast tissue is extracted. Liposuction is no longer an effective option for eliminating Type 4 gynecomastia.

Type 5

Type 5 Gynecomastia exhibits an obvious sagging breast tissue, which falls below the chest fold. The bottom of the areola is now visible and located above the chest fold. Type 5 gynecomastia requires an anchor lift to properly tighten the chest. Males with Type 5 have extra excess skin that needs to be treated accordingly. Both liposuction and surgical removal of breast tissue at the same time for this type of gynecomastia are necessary.

Type 6

Type 6 Gynecomastia has extreme breast tissue sag and falls below the chest fold. It can be seen extending under the armpits and towards the back. If an individual is heavy and overweight, liposuction may be used to flatten the breast and decrease the fatty deposits. Surgical removal of the glandular breast tissue is typically required at this level.

Type 7

Type 7 Gynecomastia has the top of the areola sagging below the level of the chest fold. There may be noticeable volume in the breast which will often extend towards the back. Surgical removal of the breast tissue is imperative for Type 7 gynecomastia to deliver the complete extermination of all unwanted breast tissue for male patients.

Causes of Gynecomastia

Natural Hormonal Changes

Testosterone and estrogen control the development and preservation of sexual traits in both men and women. Testosterone regulates male characteristics, like muscle mass and body hair production. Estrogen is the key supplier of female virtues, including the growth of breasts. Estrogen is often associated as being exclusive to the female, but men do produce it in small quantities as well. The imbalance of these two hormones for whatever reason is the main cause of gynecomastia and usually hits during one of three preeminent stages of growth.

  • Infants. Most people are unaware that more than half of male infants are born with enlarged breasts due to the high exposure of their mother’s estrogen. The swelling goes down on average two or three weeks after birth.
  • Puberty. It seems almost customary and most probable for a young man to develop gynecomastia at this time due to the overwhelming changes occurring to his body. If swelling or other symptoms continue to progress after or longer than six months to a year, it would be wise to be evaluated by a physician.
  • Senior Men. This condition may become prevalent once again between the peak ages of 50 and 80. One out of four men can be affected and the symptoms are so modest they may not even realize it.


  • Anti-androgens are prescribed to treat prostate enlargement, prostate cancer, and other diseases/disorders.
  • Anabolic steroids and androgens.
  • AIDS medications. Gynecomastia can develop in HIV-positive men who are receiving a treatment regimen called highly active antiretroviral therapy (HAART).
  • Anti-anxiety medications, such as diazepam (Valium).
  • Tricyclic antidepressants.
  • Over-the-counter antibiotics.
  • Ulcer medications
  • Cancer treatment (chemotherapy).
  • Heart medications

Recreational Drug Usage and Alcohol Consumption

  • Large quantity of alcohol
  • Amphetamines
  • Marijuana
  • Heroin
  • Methadone

Health Conditions

  • Hypogonadism
  • Aging
  • Obesity
  • Tumors
  • Hyperthyroidism
  • Kidney Function
  • Liver Failure and Cirrhosis
  • Malnutrition and Starvation

Herbal Products

In rare instances, natural plant oils, like lavender or tea tree, commonly added to shampoos, soaps, and lotions have been linked to gynecomastia. The correlation between those products directly reflects weak estrogenic activity.

Testing for Gynecomastia

Gynecomastia can be diagnosed after a brief evaluation by your physician. An assessment of your family history as well as medical history will assist the physician in providing the proper treatment options available and the main source that contributed to the development of this condition. Precautionary advice or prescriptions can be requested and made available for those seeking the information. Blood tests and mammograms may also be administered to confirm or negate initial suspicions of gynecomastia. Further testing could be necessary if results come back conclusive or inconclusive for other resolves. The additional tests may include Computerized tomography (CT) scans, Magnetic resonance imaging (MRI) scans, Testicular ultrasounds, and Tissue biopsies. This will help to determine if gynecomastia is being misdiagnosed, or if there is a chance to uncover other, deeper, more severe problems, such as infection or the presence of breast cancer.

Treatments and Medications

Gynecomastia may go away if left untreated once hormones begin to stabilize and balance out. Although exercising and dietary plans are always beneficial for an overall healthy lifestyle, they are not the solutions to correct gynecomastia.

If gynecomastia is caused by an underlying condition, such as hypogonadism, malnutrition or cirrhosis, that condition may need an immediate and effective treatment plan. If an individual is currently using medications or recreational substances that can cause gynecomastia, your physician will recommend suspended use or substituting for another treatment option.

In the adolescent phase, those who experience the effects of gynecomastia with no evident cause, are recommended by physicians to undergo continual evaluations every 3 to 6 months to monitor improvement on its own. Full recovery without treatment expands an average time of two years. If no progress or counterbalance of hormones is achieved after that amount of time, the next steps moving forward are to be made toward a treatment plan, otherwise significant pain, tenderness, and embarrassment will increase.

Gynecomastia Shirts?

Compression shirt for men with Gynecomastia

The latest technique offers a quick fix but not a long-term solution. It has been created and designed to sustain self-confidence among the individuals experiencing this condition. The Gynecomastia Shirt acts as a compression vest to hide the physical alternations to your breast tissue and muscle. The main advantage is its instantaneous support and reinforcement of the appearance of males concerned with the overall aesthetics that this condition exposes. They are comfortable and non-restricting to daily activity. The Gynecomastia shirt is part of a “treatment” in the very broad sense of the word, as this offers a temporary benefit, and does not alleviate any real symptoms of the condition.


Many of the same medications or similar techniques that are used to treat other conditions such as breast cancer often produce optimal results in easing and healing the pain and physical attributes amongst gynecomastia patients. Medications may currently be approved by the Food and Drug Administration, but they have not yet been approved specifically for this use. Individuals, under no circumstance, should begin taking any medications unless under surveillance and sanction from their medical professional.

Surgical Procedures Available to Gynecomastia Patients

After initial treatment or observation, surgery is the next efficient and logical step. Surgical procedures are often the only guaranteed way to resolve gynecomastia. It is the most personalized and custom treatment technique because there is little to zero guesswork involved as to what the outcome will be. Surgery will provide you with the fastest results, quick recovery times, and specialty care from trained medical professionals.

The two major procedures available to accomplish the task at hand are liposuction and a mastectomy. More often than not, Gynecomastia may require a combination of procedures in order to achieve exceptionally favorable results. A mastectomy will be able to dispose of the breast gland tissue, while liposuction will compensate by removing excess breast fat. Surgery is often completed endoscopically, meaning only small incisions are used. The less invasive type of surgery demands much less recovery time.

The actual surgical time is on average about two hours and requires local or general anesthesia. You will be requested to wear a special compression garment for a period of time during recovery to help support the newly augmented contours of your chest. Downtime is minimal (roughly one week) and the outcome is permanent, unless future access weight gain causes excess fat in the breast area.


Routinely there will be some swelling, bruising, and temporary diminished feeling in the chest and the nipples. All of these symptoms will subside gradually within a few weeks. Discomfort, which begins several hours after completion of surgery, has been described as “an intense chest muscle burn” and mostly disappears within 2–3 days. Painkillers are prescribed as well as an antibiotic to prevent infection.

Scarring is minimal. It is always recommended to review your surgeon’s Before and after photos so there are clear, realistic, and appropriate expectations.

Strenuous exercise, activity, and sports should be avoided for approximately four weeks after the surgery. Completion of healing time for full recovery may take anywhere from three to six months as if varies for each individual. Other lasting benefits from the surgery may include:

  • A change in posture
  • A change in attitude
  • Newly restored or found self–confidence
  • Enhanced cosmetic appearance


There are a few factors you can control that may reduce the risk of gynecomastia but certain tactics should be implemented if you are someone sensitive to this condition. Remember Gynecomastia is an equal opportunist and can affect anyone.

  • “Say No!” Do not participate in the recreational use of illegal drugs. Examples include steroids and androgens, amphetamines, heroin, and marijuana.
  • Avoid alcohol. Do not drink frequently or extremely large quantities of alcohol. You may drink in moderation at your own risk as alcohol can affect each individual differently and the severity of the condition.
  • Review your medications.  Always consult your physician prior to taking medication. Even if the medication is prescribed or over the counter, having knowledge of the potential side effects is crucial to preventing gynecomastia. If there are any foreseen symptoms or effects of your medication, a medical physician can provide you with other choices or treatments



Dr-Douglas-SteinbrechDouglas S. Steinbrech, M.D., F.A.C.S. is a plastic and reconstructive surgeon that specializes in male aesthetics. Dr. Steinbrech is certified by the American Society of Plastic and Reconstructive Surgeons and a diplomate of the American Board of Plastic Surgery. Learn More seals


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