Hormones mark the difference between men’s and women’s breasts. If men were castrated and took female hormones their whole life, they would develop female breasts. It’s as simple as that. So gynecomastia in men is really caused by having too many female hormones (primarily estrogen) and not enough male hormones (primarily testosterone).

Often when boys go through puberty, due to changing hormones, they can develop gynecomastia. This type of gynecomastia often goes away on its own when the hormones stabilize after puberty. Many people misdiagnose themselves with gynecomastia because they have excess adipose tissue (fat) in their breasts. Obese males often have this excess adipose tissue in their chest. This condition is called pseudogynecomastia. Losing weight can get rid of most of this problem, although the chest might look a little sloppy because of the excess skin.

A trained physician can often diagnose gynecomastia just by the look and feel. Sometimes they need to use ultrasound and x-rays imaging to confirm their findings.

There are many factors that can cause the imbalance in male/female hormones that causes gynecomastia.

WHAT CAUSES GYNECOMASTIA?

Medications - There are many medications that can possibly cause gynecomastia. Some act directly on the breast tissue while others increase the production of prolactin. Some medicines, for example, the ones used to treat prostate cancer can also lead to gynecomastia. These are anti-androgen drugs. Some medicines increase estrogen, or allow estrogen to work more efficiently. Anti-psychotics and also certain blood pressure medications can cause gynecomastia. Remember that people’s body’s are different and respond to medications differently. If you personally don’t notice any gynecomastia from the medicine you are taking, regardless of whether or not it is “supposed” to cause gynecomastia, you probably don’t need to worry. If you do, talk to your doctor.

Idiopathic -This just means that it is a sort of random cause. There probably is a reason, but they don’t know. Since gynecomastia isn’t life threatening, it hasn’t received the research funding. Genetics can certainly play a huge role in the development of gynecomastia.

Abuse of anabolic steroids - This is a big one. One of the major drawbacks to taking anabolic steroids, is that many of them can aromitise into estrogen. A lot of times when a body builder is on a steroid cycle, there body is changing so much they don’t even notice they are starting to develop female like breast tissue under all that muscle. Then, after it’s too late, they notice. You don’t have to take anabolic steroids for a long time either to develop gynecomastia. Some people start to get it after just one cycle. Be very careful! Certain steroids cause it more than others. Also, some people take anti-estrogen medicine along with their steroid cycle to negate some of the female like breast development.

Diseases - Certain tumors, eg some testicular tumors, can lead to a rise in estrogen. Hyperthyroidism can also lead to increased estrogen levels. Cirrhosis of the liver can also lead to gynecomastia. Decreased testosterone production can also lead to gynecomastia. Klinefelter’s syndrome, for example, leads to lower testosterone output.

Puberty - The hormonal changes in puberty can lead to gynecomastia. This is often temporary and will go away after puberty.

Obesity - Obesity often leads to greater estrogen production. Losing weight will also lower your estrogen levels.

Some people say that marijuana can also cause this. The key is to pay attention to your own body. If you are starting to develop gynecomastia, go see your doctor immediately. If he brushes you aside, go see someone else. Not all doctors are experts in this. In fact, most are not.

IS GYNECOMASTIA HARMFUL?

I think that many men with gynecomastia would think otherwise. It’s possible that some people don’t care that much and can live with it. It’s certainly true that many men with gynecomastia are extremely embarrassed about this concern. They don’t want to be seen with their shirt off, the problem occupies a lot of their thinking time, they have less confidence because of it.

Those problems are more than just minor inconveniences. It’s unreasonable to think that men in today’s world can easily handle being ridiculed for their “man boobs”.

A little scar above the eye that you rarely think about is a cosmetic problem. Making excuses to not go swimming with your friends because you believe you will look stupid with your shirt off goes way beyond cosmetic. It is literally effecting the quality of your life.

CAN I REVERSE GYNECOMASTIA THROUGH DIET, EXERCISE, AND/OR MEDICINE?

Once your mammary glands have grown from exposure to estrogen, that’s it. The lack of estrogen won’t cause the breasts to shrink. With that said though, a lot of what seems to be gynecomastia, ie. high levels of adipose tissue in the breast, can be reversed through diet and exercise. If you lose fat you will lose it everywhere.

Also, some bodybuilders swear by taking anti-estrogen medication along with their steroid cycles. Some of this medicine is the same as what is taken for women with breast cancer. Some medicines decrease the steroids from aromatising into estrogen. Some medications fill up the estrogen receptor sites in the cells, thus not allowing the estrogen to take effect. There are many of these drugs. Clomid and Nolvadex are two examples.

Some people say that these medications can only be used to prevent gynecomastia. Some people say that they have had some good results in reversing it. The truth probably lies somewhere in the middle. It won’t work for severe gynecomastia so don’t even bother. If you have just developed a tiny bit of breast development, it is really just pseudogynecomastia. It might work a little. Some say that once you stop taking these medications it may return. You certainly won’t want to be taking breast cancer medicine for your whole life.

LIPOSUCTION AND SURGERY OPTIONS FOR GYNECOMASTIA

If you have gynecomastia and are otherwise a healthy, non-alcoholic, non drug using male, then gynocomastia liposuction surgery could be a good option for you. You’ll have to have a consultation with the surgeon and discuss your medical history, why you want the surgery and so on. If after the consultation, both you and the surgeon feel like this is the right step, then you can go ahead with the surgery.

Based on your specific case, the surgeon may decide to use liposuction and/or excision surgical methods. Often both techniques are used. Liposuction is used to suck out the fatty adipose tissue around the nipple. There are several liposuction techniques and the surgeon will use the appropriate ones. Excision is used to physically remove the enlarged glandular tissue. This is a same day surgery and usually takes a couple hours. You won’t need to stay in the hospital over night unless there are complications.

With any surgery there are risks. They use a general anesthetic so it’s possible to have an adverse reaction to that. It’s rare but it can happen. There could also be damage to deep tissue nerves, or blood vessels. Blood clots could form. etc. Then there are mostly cosmetic risks. There could be scarring, there could be discoloration of your nipples, etc. As far as surgeries go, its not an extremely risky one, but it is important to remember that there are risks. Make sure to pick a good surgeon. Since you are doing it for mainly cosmetic reasons, you want the surgery to be done extremely well. Some surgeons are better than others just as some tattoo artists are better than others. It’s extremely important to pick a good surgeon and the choice is up to you.

CHOOSING A GOOD SURGEON.

What to look for:

Most people say to look for educational background and years of experience. I think that those are important things to ask about but not the be all and end all. What you really want is a competent surgeon. Anyone would rather have a talented surgeon with 2 years experience over an old guy with shaky hands (not that all old surgeons do, in fact many are terrific). Ask them to show you several before and after pictures of the work they’ve done. See if you can read any reports from satisfied costumers. Ask if they’ve had any unsatisfied customers and what the problems were. Talk to them, talk to the their staff. Look at their education and experience. Look at where they work and how long they’ve been there. Get an overall feel of the person and their work before you decide. You certainly want a surgeon you can trust and feel comfortable with.

Get a second opinion. This isn’t the same thing as buying a new toaster. This is a major decision. Talk to at least 2 surgeons and go with the one you think is the best. This is not the time to start pinching pennies. This surgery is supposed to make you look better. Make sure it does. If you really want to save money, don’t get the surgery at all. With that said though, the most expensive surgeon with the prettiest brochures isn’t necessarily the best.

The price of gynecomastia liposuction surgery can vary quite a bit, depending on where you get it done, who the surgeon is, what your specific procedure will entail, etc.

In the USA, expect to pay between $2500 and $8000. The USA is expensive compared with most of the rest of the world, but it has some of the world’s best surgeons.

If you are thinking of getting the surgery done, go and get a couple different quotes from surgeons in your area. The consultation should be free anyway. Remember that if you can afford it, don’t make money too much of an option here. This isn’t the time to be pinching pennies. Good luck!