Gynecomastia and its Various Stages & Types

In today’s era, everyone pays a lot of attention to their physical appearance and well-being, irrespective of their gender. Both, men and women want to look their best and ace ahead in life with all the confidence. Anything that comes in the way of their goals and aspirations is no longer neglected but sorted out. A growing concern among boys and men is gynecomastia. Though a common breast related concern, it affects them both physically and mentally. Swollen or enlarged breasts in men could cause embarrassment and keep them away from having the social life they desire. Gynecomastia can be treated and cured, ensuring that it causes minimal discomfort to the person. Get to know about this breast concern, its stages and how to get it treated.

Gynecomastia is also known as ‘man boobs’ or ‘moobs’ or ‘male gyno’. Enlarged breast tissues are found in new born babies, boys in their teenage or adolescence and men. Most cases of gynecomastia appear as a result of growth spurts in the individual’s life and often subside on its own. However, in some cases this condition would last longer and cause immense physical and emotional discomfort. Gynecomastia is caused by the excess production of female hormone estrogen and a decrease in the production of testosterone, the male hormone. Generally, in men, the production of estrogen or the female hormone is suppressed by the high levels of testosterone that is produced. This causes men to not develop breasts and have a flat chest. Unfortunately, in some men especially during puberty and towards 50 years of age, there is an imbalance in the hormone which leads to gynecomastia.

Other Causes of Gynecomastia

There are various causes for male breast enlargement which is other than hormonal. Some of the other causes include:

• Liver or kidney diseases
• Hyperthyroidism
• Malnutrition
• Obesity
• Lifestyle
• Smoking
• Consumption of drugs such as marijuana
• Side effects from certain medications
• Food such as milk, cheese, eggs, flaxseed, sesame seeds, certain berries that are rich in estrogen can also increase the symptoms.

Symptoms of Gynecomastia

• Enlarged male breasts
• Large area of the breast that firm, especially the region surrounding the nipple or areola
• Painful and hypersensitive to touch
• Tender, causing discomfort
• Nipple discharge

Enlargement of breasts in males can be either gynecomastia or pseudo-gynecomastia. The symptoms of pseudo-gynecomastia are very different from gynecomastia. One important differentiator is that there is usually no pain, discomfort, swelling or nipple discharge in the case of pseudo-gynecomastia. The size of the breasts would be much smaller than in the case of gynecomastia. Pseudo-gynecomastia affects the person mainly because of the enlargement that mimics female breasts but other than that there is no cause of concern. Individuals seek treatment for pseudo-gynecomastia for aesthetic reasons than medical. The breast is resized and the overall appearance of the chest is improved with treatment.

Types of Gynecomastia

Unilateral gynecomastia

Though male breast enlargement usually happens in both the breasts, there can be cases where only one breast appears larger than the other. This is referred to as unilateral gynecomastia.

Bilateral gynecomastia 

This type pf gynecomastia is where both the breasts are equally affected and there is a presence of a mass of rubbery substance in both breast.

Stages of Gynecomastia

The grades of gynecomastia can be classified into four.

Grade 1: Minimal increase in breast tissues without any dropping or sagging of the breasts

Grade 11: Moderate increase in breast tissues without any sagging

Grade 111: Significant increase in breast tissues with sagging of the breast to a minimal extent

Grade 1v: Severe increase in breast tissues with considerable sagging which mimics human female breasts

The Treatment for Gynecomastia

Gynecomastia can be treated with surgical and non-surgical interventions. In most mild cases of gynecomastia, the condition would resolve on its own, especially in newborns and teenage boys. If the person experiences no pain and does not impact his social life, there is hardly anything to be worried about. If a person is in grade 3 or grade 4 of the condition, he must seek necessary medical help. Some of the most common treatment for gynecomastia are:

• Lifestyle changes such as inclusion of diet, exercise and meditation. It is also important to keep away from smoking, alcohol and stress in order to treat the condition
• Liposuction - Liposuction is performed on individuals with lesser glandular tissue and more of accumulation of adipose tissues. Fat is removed from the breasts by way of using a thin tube or cannula. An incision is made to insert the cannula which then extracts or pulls out all the fat in the region. This suction mechanism to remove fat gives it the name liposuction.
• Surgical Excision / Gynecomastia Surgery - In individuals who have excessive glandular tissue, surgical excision is the most optimal treatment option. Surgical excision of the excess breast tissue and fat is one of the common procedure performed that give longer lasting results. During this procedure, along with removal of excess breast tissues, the nipple is repositioned to improve the chest contour. This procedure is also referred to as male breast reduction surgery. Only a qualified cosmetologist or surgeon would be able to assess the patient’s breast condition and suggest the right treatment technique.

Before treating gynecomastia, it is very important to analyze and identify the root cause for the condition. If a person has developed gynecomastia due to liver or kidney diseases, or due to malnutrition or other medical issues, these issues must first be addressed or treated.

Gynecomastia before and after

Cost of Gynecomastia Treatments

The cost of gynecomastia treatment in India would be between INR 65k to 95k. Gynecomastia in Chennai would cost a minimum of INR 50k and upwards.

The recovery time for a gynecomastia surgery is usually 2 to 3 weeks. Individuals who have a desk job can get back to work with proper precautions from the third or fourth day after the surgery. During the recovery period, it is very important to take proper rest, nutritious food and create a stress free environment to aid better healing.

Like in all surgical procedures, there are risks involved with the treatment of gynecomastia. All invasive procedures come with the risk of complications such as excessive bleeding, scarring, infection, gangrene and others. It is very important for the patient to disclose past medical history and existing health problems with the doctor to avoid any complications.

Gynecomastia in itself is not a concerning or harmful health condition. However, if a person experiences discomfort on physical or emotional levels, they must consult a doctor and seek treatment. Early diagnosis and intervention can help decrease the symptoms and keep the condition under control. A doctor would be able to decide on the treatment and solve all concerns caused by gynecomastia. It is important for patients, especially young boys to understand that it is absolutely fine to experience growing boobs and seek medical support.

Frequently Asked Questions:

1. How many types of Gynecomastia are there?

Gynecomastia can be of three types.

• Florid gynecomastia where large, irregular and fluid filled breast tissues can be seen and appears at the early stages of the condition
• Fibrosis gynecomastia will have more ducts and an increased number of stromal or stroma fibrosis
• Intermediate gynecomastia – This type will have the features of both florid and fibrous type and will resemble the female breasts.

2. What are the stages of Gynecomastia?

There are four stages of gynecomastia. Stage 1 is characterized by only a mild growth of the breast tissues. Stage 2 will have moderate breast tissues. Both these stages will have no sagging of the breasts. Stage 3 will have significant breast tissue growth with sagging of the breasts. Stage 4 will have severe breast tissue growth with significant sagging that will look like a female breast.

3. Is there a pill for Gynecomastia?

Yes, pills can be used to treat gynecomastia depending on the whether the condition is mild or not. Medicines such as tamoxifen which blocks estrogen production in the body can be taken under the guidance of the doctor. Aromatese inhibitors are another type of medication used for reducing the symptoms of gynecomastia such as breast pain, tenderness and growth of breast tissues.

4. Does Gyno keep growing?

Gynecomastia can keep growing depending on the causes for the condition. If gynecomastia has occurred at the age of puberty due to the body’s natural hormonal changes, it would subside on its own within a year. However, if a person is suffering from a hormonal imbalance or has liver or kidney disease, there is a high chance that the gynecomastia will keep increasing. In such cases medical help is the best option.

5. How can I reduce my Gynecomastia naturally?

A healthy and balanced diet and changes to sedentary lifestyle can go a long way in treating gynecomastia naturally. Regular exercise, nutritious food and staying away from smoking, alcohol and unnecessary drugs can help keep the hormone levels of the body balanced. This in return will ensure that the patient has reduced symptoms of gynecomastia.

6. Does Gyno get worse?

Yes, gynecomastia can get worse with the breast tissues growing if not treated. If gynecomastia is ignored in the beginning stages, the condition would only progress further. This would impact the social and emotional wellbeing of the patient with the condition worsening. It is important to consult a doctor to understand and treat gynecomastia.

7. Will Gyno lump go away naturally?

If the cause for gynecomastia is puberty, it would go away naturally once the hormonal changes return to normal. Individuals could also try lifestyle changes to improve their chances of treating the condition naturally. If the condition does not seem to reduce on its own and is caused by hormonal factors or due to underlying health condition, it must be addressed appropriately.

8. What happens if Gynecomastia doesn’t go away?

Gynecomastia does get worse with time and aging. Sagging breasts are a common concern in women as they age and men with gynecomastia could experience the same if they leave it untreated. Excess weight gain and aging can make the condition appear worse.

9. How do you notice Gynecomastia?

Gynecomastia can be identified by an increase in breast tissues, enlarged nipples, pain and tenderness of the breasts. In some cases, there can also be nipple discharge. Gynecomastia could affect both breasts or just one.

10. Is it possible to get rid of Gynecomastia without surgery?

If your gynecomastia is in the early stages with only a mild growth of breast tissue, it would often subside on its own without medical intervention. Healthy lifestyle changes and nutritious food can help keep the condition under control. Medications such as tamoxifen, aromatese inhibitors work well in treating the condition without surgery.

11. What is the best treatment for Gynecomastia?

The best treatment for gynecomastia vary based on the individual’s health condition. For grade 3 and 4 gynecomastia, surgery is the best option. Excess breast tissue is removed and nipple grafting is done giving the patient’s longer lasting results.

12. Is Gynecomastia a serious problem?

Gynecomastia is not a serious or life threatening health concern. If an individual does not have any discomfort and if the gynecomastia is not very severe, the person can continue life as normal. Male breast enlargement needs attention when it is affecting the person’s life and causing physical or emotional discomfort. Most people do not even realize they have gynecomastia and continue with life as usual.

13. What causes a lump in a man’s breast?

Men can have a lump in their breast and the causes are not exactly known. Most often a lump is formed when a cell divides rapidly and starts accumulating to form a tumor. It is important to get the breast diagnosed for any abnormal tumors that need attention.  Surgery is often needed to remove the lump from the breasts. Doctors would also suggest a series of test to rule out any serious health issues.