Gynecomastia: Causes, Symptoms, and Treatments

Gynecomastia is a condition of breast enlargement in boys and men. It is found in 40-50 percent of the male population in the world. Though gynecomastia can be found in men of all ages, it is more common during the newborn period, puberty, and old age. Dr. Mahesh Nair, M.Ch (Plastic), FDAFPRS, Belgium, and Founder of Nip and Tuck Aesthetics, says, “Gynaecomastia is a condition, not a disorder or disease. It does not debilitate someone or affects the day-to-day functions. However, it may lead to social withdrawal, making men less comfortable and less confident with their own bodies. It has the potential to affect one’s morale and self-image.”

There are four grades of gynecomastia. If the breast enlargement is small without excess skin, it is considered as grade one. While breast enlargement is moderate with mild excess skin in the grade two, it is moderate enlargement with more excess skin in the third. A person is considered to have fourth grade of gynecomastia if there is significant gland enlargement with lot of excess skin. 

Causes

Obesity is the most common cause of gynecomastia. Obesity leads to the accumulation of lots of fat in the chest. If a person is obese, definitely his grade of gynecomastia will be high.

Hormonal imbalance is another common cause of the condition. Gynecomastia caused by hormonal imbalance occurs in puberty. In teens, the male hormone, testosterone, start raising and the female hormone, estrogen, keeps falling. The imbalance leads to stimulation of breast tissue and the non-functional breast tissue gets formed and remain as gynecomastia. It may get reversed by the age of 20-21 when puberty gets over. But sometimes it would stay.  

Old age also causes gynecomastia. When men grow older, the levels of male hormone go down but the body continues to produce female hormones. It causes accumulation of fat in the breast and results in gynecomastia.

Medications like cardiac drugs, anti-depressants and anti-psychotic drugs also lead to gynecomastia. Alcohol abuse is another cause of breast enlargement. Kidney failure, liver diseases, some rare genetic syndrome, Klinefelter syndrome, and testicular tubes also cause gynecomastia.  

Symptoms

Normally male areola is roughly around 2cm in diameter. But in men with gynecomastia, it would be 4-5cm in diameter and the nipple and areola would look very puffed up and lack wrinkles. The chest will look like A or B cup size breast and there will be fat in the armpit.

Treatment

All four grades of gynecomastia have the same modality of treatment. “It is treatable with only surgery and no medication can reverse it. Plastic surgery, now offers a quick, permanent solution in the form of a key hole surgery incorporating latest technology, thereby letting one return to his chores almost from the very next day,” says Dr. Mahesh Nair.