Gynecomastia

By: Beth Phillips, RPAC

Gynecomastia (guy-nuh-koh-MAS-tee-uh), also known as “man boobs” or “moobs” is a condition where a male’s breast tissue enlarges to a size that we would normally expect in a female.

I know this is a magazine for the Women of Upstate NY, but sometimes our guys need a little help!

In our plastic surgery practice, the treatment of gynecomastia is one of the most common issues that get men through our doors. I have often had my female patients inquire for their male counterparts about causes and potential treatments.

All men have breast tissue, and like females, the glandular tissue responds to variations in hormone levels. Any imbalance in testosterone and estrogen levels can potentially affect the breasts. While some of the hormone fluctuations are a normal part of the life cycle, there may at times be other causes that are treatable or avoidable. Newborns, boys going through puberty, and older men all have normal hormonal changes and gynecomastia at these times is not usually medically concerning.

Gynecomastia causes the breasts to swell and often become tender or painful. There is a condition known as pseudo-gynecomastia. This is male breast enlargement due to increased chest fat as opposed to true gynecomastia which is an increase in actual breast tissue. Pseudo-gynecomastia does not usually cause as much physical discomfort.

Other causes include medications, several health conditions, street drugs, alcohol and herbal products.

There are numerous medications that report gynecomastia as a potential side effect. This should be considered early in the diagnostic process when evaluating the disorder. Antidepressants, anti-androgens (often used to treat prostate conditions), anti-anxiety medications, heart and ulcer medications are among the most common. Anabolic steroids are well known to be a potential cause of increased male breast size.

Significant changes in a man’s breast size that is not within the normal window of hormonal change should not be ignored. It may be a side effect of a more serious medical condition. Tumors in the testes, pituitary gland or adrenal gland can often cause gynecomastia. Hyperthyroidism, kidney failure, liver failure, and cirrhosis are commonly linked with gynecomastia. Malnutrition causes’ testosterone levels to drop, but estrogen levels remain constant causing a hormonal imbalance.

Street drugs, primarily marijuana, heroin and amphetamines are known to contribute to the formation of gynecomastia. Since marijuana has been legalized in several states for medicinal and recreational use, I expect we will see an increased incidence of gynecomastia in years to come. To quote a saying I once read, “Doobies make boobies,” something I frequently remind my patients.

Alcohol consumption has been linked to increased breast size in men, primarily because the liver is responsible for eliminating excess estrogen from the blood. If the liver is damaged or “busy” due to alcohol use, the elimination is less. A controversial topic is that hoppy beers can cause a weak estrogenic effect. Hops contain high levels of phytoestrogen that can bind to estrogen receptors in the body.

Herbal products that have been associated with gynecomastia include lavender, tea tree oil and dong quai. Sometimes gynecomastia is just an inherited condition.

Most men that have gynecomastia without a known cause should have a workup with their medical doctor. This usually consists of some blood work, a basic exam including breast, thyroid and testicular examination and a mammogram. (Yes, guys can get them too!)

Depending on the cause, symptoms, and extent of the gynecomastia, some insurance companies will cover surgical correction. Even if it is not covered, most plastic surgeons will provide the correction as a cosmetic procedure.

Surgery for gynecomastia can range from liposuction of excess fatty tissue, to excision of excess breast tissue alone or can be more dramatic with removal of breast tissue. Skin and resizing of the nipple and areola.

As with any potential procedure, having a consultation with an experienced provider to be evaluated and explore your options should be an early step.

There is no need to suffer from the physical discomfort or potential emotional stress of enlarged male breasts.

For more information contact CNY Cosmetic & Reconstructive Surgery at 315-663-0112