Q: How do I know if I have gynecomastia?
A: Gynecomastia is often physically visible and may be difficult to hide in some men. The most common symptom is enlargement of the breast area, wherein you have breast tissue that’s greater than 0.5 centimeter (cm) in diameter.1
If you have any sort of breast swelling, it’s a good idea to have a doctor physically check if it’s gynecomastia or another health condition. Your physician will carefully evaluate your breast tissue, abdomen and genitals, and have you undergo blood tests and, possibly, mammograms.

Q: How do I get rid of gynecomastia naturally?
A: If you want a short-term temporary approach to getting rid of gynecomastia, wearing compression shirts may be a good approach. These are relatively inexpensive and come without side effects, so many men often opt for them. However, if you want to reverse gynecomastia naturally, there are several strategies you can consider, such as:
•Doing exercises and focusing on burning fat instead of building muscle.
•Moderating your diet to eliminate foods that cause estrogen production while consuming those that help promote testosterone production.
•Avoiding medications that may cause gynecomastia as a side effect.
•Avoiding plastics, herbicides and pesticides that may contain chemicals that may interfere with your hormone production.
In addition, you can also take supplements that may support your body’s production of testosterone. These include saw palmetto, ashwagandha and astaxanthin (taken with saw palmetto).

Q: How long does gynecomastia among pubescent males last?
A: Because of their changing hormones, males who are going through puberty often experience gynecomastia. It develops between ages 10 and 12 years, and most often occurs among boys between ages 13 and 14 years.
In 20 percent of individuals, the condition can persist even after they turn 17 years old. However, pubescent gynecomastia can usually resolve within six months to two years without the need for any treatment.3

Q: Does gynecomastia go away?
A: There are ways to minimize the appearance of gynecomastia, and it often starts with managing your hormone levels, particularly boosting your testosterone production. Getting enough exercise, maintaining a healthy diet and avoiding gynecomastia triggers may potentially diminish the appearance of feminized breasts.
Some men also opt for surgery, aka male breast reduction, as a last-ditch attempt to eliminate gynecomastia. However, take note that this is an invasive procedure that may lead to certain side effects and complications. Discuss your options with your physician and be aware of the potential risks involved.

Q: Does gynecomastia hurt?
A: The main symptom of gynecomastia is having a lump of fatty tissue underneath the nipple. It may prompt breast sensitivity and tenderness as well, and may cause the areola or the dark skin around the nipple to grow in diameter. However, it does not cause any severe pain.
Should you experience intense pain, as well as other alarming symptoms, have your physician take a look immediately. Other warning signs to be wary of include persistent swelling, tenderness and nipple discharge. If any of these occur, you may need more stringent diagnostic tools to rule out other illnesses.

Grade or Type Severity Description
1 Very mild The male breast appears to have a localized button of tissue around the areola.
2 Mild to high There is moderate breast enlargement that goes beyond the areola boundaries, wherein the edges are noticeably indistinct from the chest.
3 High and visible Aside from moderate breast enlargement that goes beyond the areola boundaries and have edges that are indistinct from the chest, skin redundancy is also noticeable present.
4 Severe and visibly feminine The breast enlargement is highly noticeable, and comes with skin redundancy and breast feminization.

Grades of Gynecomastia
The American Society of Plastic Surgeons classifies gynecomastia under four grades, with 1 being the mildest and 4 being the most severe.1 This table shows a more detailed description of each one:
Gynecomastia May Be Classified According to Symmetry
Another common way that gynecomastia may be classified is according to its symmetrical aspect — or, to put it in simpler terms, whether it appears in just one breast or in both. This is why gynecomastia may be identified as either bilateral or unilateral gynecomastia. Basically, men with bilateral gynecomastia have noticeable enlargement in both breasts,2 while unilateral gynecomastia means that only one of the breasts has noticeable growth — the other appears normal in terms of size and shape.

Gynecomastia Versus Pseudogynecomastia
There may be instances when a man immediately assumes that the appearance of “man boobs” means he has gynecomastia, but here’s the truth: Just because you have breast growth does not automatically mean that you have this condition. Rather, it could be what’s called pseudogynecomastia.
So, what’s the difference between the two? Basically, it all boils down to what’s causing the chest enlargement. If you have true gynecomastia, it means that the swelling is caused by excess breast tissue. However, if it’s pseudogynecomastia, the culprit is fat, and not tissue. Men who are obese or overweight are prone to pseudogynecomastia.
For a physician to properly identify a patient’s condition, this simple diagnostic procedure is performed: The patient will be asked to lie down with his hands behind his head. The physician will palpate the sides of your chest, to see if there is a firm or rubbery area around the nipple. If this is present, it indicates gynecomastia, but if there’s none, it’s pseudogynecomastia.

Am I a candidate for male breast reduction?
The most important question you should ask yourself is: does the condition bother you both psychologically and physically?  Should the answer be positive, you should consider surgery and start to gather information that will help you make an intelligent decision while consulting with a Board Certified Plastic Surgeon who is experienced in this type of surgery, obtaining information from web sites and referrals.

 Am I too young to have gynecomastia surgery?
In general, we recommend you wait until the age of 18 years. There are some circumstances where a person should consider it earlier. For this you will have to consult a Plastic Surgeon.

 How do I choose the right Plastic Surgeon?
As a rule, he/she should be a Board Certified Plastic Surgeon. Most importantly, the surgeon should have experience with this specific procedure. In today’s world, the Internet is an invaluable tool that can help you to make your decision by reading specific content and viewing photo galleries.

Communication with your surgeon’s office staff and the physician are of paramount importance. Once you decide to have the surgery, you should interview a few surgeons and  expect to receive complete and satisfactory answers to all of your questions. Good rapport with the office staff and surgeon prior to surgery is essential for a successful end result.

 What results can I expect?
You should discuss this with your surgeon prior to surgery, and make sure you fully understand everything that is involved while keeping your expectations realistic.  Your experienced surgeon can help you with this.

 How many procedures of this nature has the surgeon performed? In a month, in a year, in his career?
If he has significant experience, it should be substantiated with good quality pre and post-operative photos as well as references.

 What are the surgical risks?
See the section on Surgical Risks.

 What kind of scar should I expect?
Usually periareolar (about 1 inch scar in the lower part of the areola) that is generally inconspicuous. Sometimes, tiny scars remain in the armpit or chest after liposuction. Some people need more extensive procedures, and this should be discussed with your surgeon in detail prior to surgery.

 Will I have pain that will require medication?
Usually pain is minimal, but since we want to make sure you will be comfortable, we do provide you with a prescription for pain medication.

 How much time should I take off from work or school?
This depends on the type of work you do and the extent of the surgical procedure. Usually it’s between 3 and 10 days, but healing time varies for each individual and should be discussed with your surgeon.

 What types of anesthesia do you offer?
Local anesthesia is determined based on the type of surgical procedure and the patient’s tolerance. Sedation is not a general anesthesia, but the patient is asleep. This is the preferred method in my office because it is safe when done by an experienced  Board Certified Anesthesiologist. General anesthesia is rarely needed in my office.

 Is the operating room certified?
My office is certified by The Joint Commission on Accreditation of Healthcare Organizations. This commission certifies 80% of the major hospitals in the United States of America. This certification provides you with extra assurance on the highest quality standards of a surgical suite.

 How should I prepare for the surgery?
Prior to surgery you should get detailed instructions from your surgeon’s office.  Pre-operative testing is mandatory. You should stop medications such as blood thinner, aspirin, Advil,  Vitamin E and herbal remedies such as St. John’s Wort and Ginkgo Biloba. Do not eat or drink eight (8) hours prior to surgery. Arrive on the day of surgery in comfortable clothing that is not tight or confining. Have a responsible person accompany you to and from the doctor’s office.

 What type of dressing will I have?
My personal preference is an elastic (ACE bandage) or surgical vest. Sometimes gauze dressing is all that is necessary.

 Will I have a drain?
Usually not, but in cases of excessive bleeding, a drain will be necessary. This will be removed in a few days post-operative.

 Should I change my own dressing?
This depends on the amount of bleeding or discharge, and should be discussed with your surgeon. It is always wise to have sterile gauze and surgical tape at home.

 Will my health insurance cover this procedure?
In most cases, they do not cover this procedure.

 What can cause gynecomastia?
Gynecomastia can be caused by drugs, steroids or  marijuana as well as other factors.  These should be discontinued prior to surgery to minimize recurrence.