What Causes an Overgrowth of the Breast Tissue is Men?

What are the options to get rid of the excess tissue?

Doctor Answers (12)

What Causes an Overgrowth of the Breast Tissue is Men?

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Most gynecomastia occur as a result of hormonal changes during puberty and can be temporary.  When it persists and is not desired, surgical intervention is the most effective treatment.  Other less common causes of gynecomastia may include liver disease, testicular tumors, certain medications, marijuana use, anabolic steroid use. 

John T. Nguyen, MD, FACS, FICS
Double Board Certified Plastic Surgeon


Houston Plastic Surgeon
5.0 out of 5 stars 24 reviews

What causes gynecomastia

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Some enlargement of male breast tissue commonly occurs during puberty, and the incidence of noticeable, transient, pubertal breast enlargement has been reported to be as high as 60%. For most males this hormone-related breast enlargement is temporary, but for some individuals the breast tissue proliferation will persist and even increase in size.

For the majority of men with gynecomastia, no clear causative factor can be identified. It is thought that some cases of gynecomastia may relate to an imbalance between circulating levels of estrogens, which stimulate breast tissue development, and androgens including testosterone which counteract estrogen effects. Because gynecomastia may rarely be associated with endocrine (hormone) disorders, testicular tumors, and the use of some medications/drugs, it is important that you discuss the condition with your primary care physician prior to surgical treatment.

Testosterone deficiency (TD) is actually quite common, and it is now well understood that testosterone levels tend to decrease significantly in most men at or around the age of 50 (sometimes called 'andropause' or 'male menopause'). I have had a number of patients begin testosterone replacement therapy (TRT), under the direction of their primary care physician, either prior to or following their consultation appointment for gynecomastia surgery. While TRT can improve energy level, mood and libido in patients with TD, it unfortunately does not appear to reverse or improve gynecomastia in most cases.

Male breast enlargement can occur as a result of significant weight gain, in the absence of actual breast tissue excess. This is sometimes referred to as "pseudogynecomastia", which implies that the breast has enlarged because of the accumulation of fatty tissue only. While it is true that male breast enlargement in some cases is primarily due to excess body mass / obesity, in many cases patients who appear to have "pseudogynecomastia" turn out to have a significant amount of fibrous breast tissue as well. This is not that surprising, given the fact that it has been shown that the condition of being overweight can upset the balance of estrogens and androgens in favor of estrogens (sometimes called a "pro-estrogenic state"), which is a set-up for the development of true gynecomastia.

Male breast enlargement associated with excess body mass / obesity may improve with weight loss. In many men, however, the feminized appearance of the breast will persist, due to underlying true gynecomastia, incomplete regression of breast area fat, persistent skin excess after weight loss, or some combination of the three.

Increasingly patients are being seen for gynecomastia that develops after using 'prohormone' and/or anabolic steroid supplements as part of a bodybuilding regimen or to improve athletic performance. While the goal is to increase muscle mass, strength and performance, some of these agents and supplements can be converted by the body into estrogen-like compounds. Additionally, supplemental androgens may suppress the normal production of natural androgens by the testes. These factors can tip the balance of androgens and estrogens in favor of the estrogens, which then stimulates the development of breast tissue and results in visible breast enlargement. This form of breast enlargement generally persists after supplement use is stopped, requiring surgical treatment.

Michael Law, MD
Raleigh-Durham Plastic Surgeon
4.5 out of 5 stars 42 reviews

Causes of Male Breast Enlargement, Gynecomastia

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It is frequent for adolescent boys to have some enlargement of normal breast tissue before they reach adult testosterone levels. 95% have it disappear. If it lasts over a year it will not go on its own. Men in old age also get breast enlargement as their testosterone levels fall. Certain medications can cause breast enlargement, such as spironolactone or anabolic steroids. Marijauana and alcohol excess can be a cause. Some chronic illnesses are associated with it. The vast majority of men have no dangerous cause for the growth. Work up is controversial because it is rare to find a cause in an otherwise jealthy man.

Mary Lee Peters, MD
Seattle Plastic Surgeon
5.0 out of 5 stars 94 reviews

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What causes male breast development

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Many surgeons have already answered this question quite well.  I would recommend a good medical workup if you had breast development years after puberty.  Rarely, testicular tumors can cause gynecomastia. Also be aware that smoking marijuana and taking medications like propecia can cause this.  Most cases are benign, arrive during puberty, and do not go away with time. Good luck.

Christian Prada, MD, FACS
Saint Louis Plastic Surgeon
5.0 out of 5 stars 89 reviews

Causes of Gynecomastia

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The causes of gynecomastia are several from hormone imbalance to certain drugs to puberty. Of course, excess weight gain can cause the breast to enlarge with everything else. But the most common cause by far is excess estrogen. Men have excess testosterone during puberty, a common time for gynecomastia to occur, and this is because testosterone is aromatized into estrogen, and this causes gynecomastia in some people. If the estrogen is high enough, most men will develop breast enlargement.

Body builders who are on anabolic steroids often get gynecomastia because of the conversion of the excess testosterone into estrogen. Now most have learned to take Arimidex or a similar medication, which is a medication that prevents the formation of estrogen from testosterone.

Lab tests shuld be ordered by yhour physician to determine the total and free testosterone, DHT (dihydrotestosterone) and estrogen. This will indicate hormone levels that are valuable in determining the cause.

The options or reduce the breast tissue is surgery. This usually requires an incision at the lower border of the areolar where there is a color change. Scars can be inconspicuous. Unfortunately, too often too much tissue is removed leaving a depression where the excess tissue was removed. The procedure requires some liposuction in some individuals to feather the edges of the tissue removed. Gynecomastia surgery can be done with either local anesthesia in some people or general anesthesia.

Gynecomastia is very embarrassing for some men and the surgery is quite appreciated.

E. Ronald Finger, MD. FACS

Savannah, GA  Plastic Surgeon

E. Ronald Finger, MD
Savannah Plastic Surgeon
5.0 out of 5 stars 36 reviews

Gynecomastia for over grown breast tissue...

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Gynecomastia is enlargement of male breast tissue.  It may be caused by an imbalance of hormones, but sometimes it just happens on its own.  Most of the time it is not a serious problem, but if one is not comfortable with it, there are a few ways to treat gynecomastia.  Liposuction is an excellent option because it is used to remove unwanted deposits of fat and breast tissue from the body.  If liposuction is not enough, your surgeon may need to excise the excess breast tissue, which requires a small incision to cut away the excess glandular tissue, fat and skin from the breast.  Make sure you see a board certified plastic surgeon to go over your options

 

Shain A. Cuber, MD
Edison Plastic Surgeon
5.0 out of 5 stars 35 reviews

Causes of gynecomastia

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The most common causes in my practice are obesity, old age, puberty and back luck.   There are some medications and diseases that can cause gynecomastia, but the above causes are much, much more common.   I have yet to see a medical work up for gynecomastia come back with a clear explanation. 

The best candidates for surgery are men who are HWP with good skin tone.  I have done gynecomastia surgery on teenagers who have had so much embarrassment that it was worth doing the surgery even though the gynecomastia may have resolved to some extent as the patient got older.

   

Lisa L. Sowder, MD
Seattle Plastic Surgeon
5.0 out of 5 stars 48 reviews

Cause of gynecomastia

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The exact cause is unknown but it has something to do with the effect of female hormones on the male breast. Either the breast tissue is ultra-sensitive to the hormones or the hormone receptors do not let go of the hormones, which allow their effect to work stronger. There are a few actual "conditions" as well as side effects from medicines that can also produce gynecomastia.

Ronald Schuster, MD
Baltimore Plastic Surgeon
4.5 out of 5 stars 30 reviews

Gynecomastia-What Causes It?

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There are numerous causes for gynecomastia-(male breast development).  Certain medications, alcohol, hormone imbalance, certain types of tumors, marijuana, being overweight, genetics, and steroids have all been associated with its occurrence. The most common cause though is" idiopathic" meaning that we-the doctors-just do not know why it occurs.  The majority of males with the onset of puberty experience some breast development.  This is due to the very high hormone levels which can trigger some breast growth.  After puberty settles down, then for most men, the breast development resolves but not in all men.  In some men, just as in women,  the breast tissue is mostly fatty and in others, it is more glandular.  How you treat each requires different techniques.  Please consult with a board certified plastic surgeon before proceeding and as Dr. Pousti noted in his reply, there are lots of "Treatments" out there that really are not proven; so use caution and do your research.  Good Luck!

Herluf G. Lund, Jr, MD
Saint Louis Plastic Surgeon
4.0 out of 5 stars 18 reviews

What Causes Gynecomastia?

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The excess breast tissue in men known as gynecomastia can be caused by various factors such as; hormonal imbalance, steroid use, certain medications, genetics, and marijuana use. Some studies show soy as a possible cause. In many cases, the cause is just not known. Liposuction will only remove fat as the breast tissue is too dense to get through the cannula. Surgical excision is the only way to remove breast tissue, and in the hands of a well trained Board Certified Plastic Surgeon that specializes in gynecomastia you can expect to get a great result. Seek an evaluation by a well trained surgeon who will be able to help you determine the possible cause of your gynecomastia. In some cases you may be referred to an endocrinologist for further evaluation. Good luck.

Miguel Delgado, Jr., MD
San Francisco Plastic Surgeon
4.5 out of 5 stars 35 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.