What causes gynecomastia in adult men, when to get checked, and how it’s treated.
Gynecomastia is the enlargement of breast gland tissue in men, often caused by a hormone imbalance. Certain medications, anabolic steroids, alcohol, weight gain, and some health conditions can contribute. It’s different from pseudogynecomastia, which is excess fat. A medical evaluation can identify causes. When enlargement persists, surgery can remove the tissue for a flatter chest.
Many men feel self-conscious about enlarged breasts, often avoiding fitted shirts, the beach, or the gym locker room. It’s more common than many realize, and it’s frequently treatable.
Board-certified plastic surgeon Dr. Siamak Agha, who leads The One Plastic Surgery Center in Newport Beach, explains that understanding the cause is the first step. Here’s what adult men should know.
Key Takeaways
- Gynecomastia is enlargement of breast gland tissue, often related to hormone imbalance.
- Medications, steroids, alcohol, weight gain, and health conditions can contribute.
- Pseudogynecomastia is excess fat rather than gland tissue.
- Surgery can remove excess tissue when enlargement persists.
What Is Gynecomastia?
Gynecomastia occurs when there’s an imbalance between estrogen and testosterone in the body, leading to growth of breast gland tissue. It can affect one or both sides and may feel like a firm or rubbery disc under the nipple.
Gynecomastia vs. Pseudogynecomastia
- Gynecomastia: growth of glandular breast tissue
- Pseudogynecomastia: excess fat in the chest without significant glandular growth
Many men have a combination of both. The distinction matters because treatment differs. Fat may respond to weight loss or liposuction, while glandular tissue usually requires surgical removal.
Common Causes in Adult Men
Hormonal Changes
Testosterone levels naturally decline with age, which can shift the hormone balance.
Medications
Some medications are associated with gynecomastia, including certain drugs for heart conditions, prostate conditions, ulcers, and some psychiatric medications. Never stop a prescribed medication without talking to your doctor.
Anabolic Steroids and Supplements
Anabolic steroid use is a well-known cause. Some supplements may also contain hormone-affecting ingredients.
Alcohol and Substance Use
Heavy alcohol use and some recreational drugs may contribute.
Weight Gain
Excess body fat can increase estrogen levels.
Health Conditions
Liver disease, kidney disease, thyroid problems, and certain tumors can cause gynecomastia.
Enlarged male breasts are common, and understanding the cause is the first step toward the right treatment.
When to See a Doctor
See your doctor if you notice:
- A new lump or swelling
- Pain or tenderness
- Nipple discharge
- Enlargement on only one side
- Skin changes
While rare, male breast cancer can occur. A doctor can evaluate your symptoms and may order blood tests or imaging.
Treatment Options
Address Underlying Causes
Changing medications, stopping steroid use, reducing alcohol, or treating a health condition may help in some cases, especially if caught early.
Weight Loss
If the enlargement is mostly fat, weight loss may help.
Surgery
When gynecomastia persists, gynecomastia surgery can remove glandular tissue and excess fat. Techniques often combine liposuction with removal of gland tissue through a small incision, usually at the edge of the areola.
Recovery:
- Compression vest for several weeks
- Return to desk work often within about a week
- Chest workouts resumed after several weeks, as cleared
Choosing a Surgeon
Look for a board-certified plastic surgeon experienced in gynecomastia surgery with natural, masculine results. Ask how they address both fat and glandular tissue.
Effective gynecomastia treatment addresses both the gland tissue and the fat around it.
Quick Answers
Will gynecomastia go away on its own? In some cases, especially when caused by a medication or temporary hormone change, it may improve after the cause is addressed. Long-standing gynecomastia often doesn’t resolve without surgery.
Is gynecomastia surgery covered by insurance? Usually not, since it’s often considered cosmetic, but coverage varies. Some plans may cover it in specific circumstances.
Can exercise get rid of gynecomastia? Exercise can reduce chest fat and build muscle, which may help with pseudogynecomastia. It generally won’t remove true glandular tissue.
Will gynecomastia come back after surgery? Results are usually long-lasting once tissue is removed. However, weight gain, steroid use, or certain medications can cause new tissue growth.
The Bottom Line
Enlarged male breasts are common and can have many causes, from hormones to medications and health conditions. A medical evaluation helps identify the cause, and when enlargement persists, surgery can remove the excess tissue for a flatter, more confident chest.
This article is for educational purposes only and is not medical advice. Consult your doctor about any breast changes and before changing any medications.
About the expert: Dr. Siamak Agha is a board-certified plastic surgeon who leads The One Plastic Surgery Center in Newport Beach, California, and performs gynecomastia surgery and male body contouring.