Can an Injury to the Pec Area Trigger Gynecomastia?

I was hurt in 2008 at work lifting some heavy stone. I tore my rotator and labrum and had surgery in 2009. I also had a pop in my right pec that went from the nipple to almost under my arm. The area was 2 to 3 times the size of my left pec and black and blue for a few weeks. The swelling went down after about 6 months, but is still bigger than the left. My doctor sent me to a cosmetic surgeon that was unsure and said i may have damaged the pec minor, but also it looked like gynecomastia.

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Injury to pec area does not cause gynecomastia!

Your description is quite accurate for a partial muscle tear causing an intramuscular hematoma (which is what caused the bruising and swelling). This should have been diagnosed and evacuated at the time of the injury, but letting this collection of blood reabsorb over 6 months' time has left persistent scar tissue in the right pec area.

Shame on your "cosmetic surgeon" consultant for failing to diagnose this, though 6 months after injury this may well have looked less like an old collection of blood and more like a fibrous mass of scar tissue that closely mimicked the consistency of gynecomastia tissue. Damage to the pec minor would have been less likely than damage to the pec major, but whichever muscle was injured is immaterial to the diagnosis.

At this point you require excision of the scar mass to equalize the chest/breast area. This can be done through a short periareolar incision, but beware--liposuction (including ultrasonic and laser-assisted) will be a spectacular failure and will NOT make any real improvement!  This scar tissue is very firm and fibrous--not at all like fatty tissue--and totally inappropriate for liposuction. Proper surgical treatment of this will require subcutaneous excision of the excess bulk, preserving a small disc of normal tissue beneath the nipple areola complex to prevent unnatural adherence to the underlying muscle, and placement of a drain for about a week. Make sure you see an American Board of Plastic Surgery-certified plastic surgeon, not a "cosmetic surgeon" who may have little true general surgical or plastic surgical training or experience!


Minneapolis Plastic Surgeon
5.0 out of 5 stars 178 reviews

Can an Injury to the Pec Area Trigger Gynecomastia?

Hi T71,


Thanks for the post. The injury you sustained should not have any bearing on whether you have gynecomastia or not. Gynecomastia is due to an excess in breast tissue that gives the chest a more feminine appearance. Musculoskeletal injuries in and of themselves will not stimulate an increase in breast tissue formation.  It could be that you had a muscle injury and gynecomastia as well. You should be evaluated by a plastic surgeon experienced in gynecomastia surgery.

Sincerely,

Dr. Dadvand

Babak Dadvand, MD
Los Angeles Plastic Surgeon
5.0 out of 5 stars 14 reviews

Ruptured Pec muscle

Sounds like a ruptured Pec muscle. A CT scan or MRI should confirm this diagnosis. But this is not gynecomastia. If the pec tore at its connection to the arm, it should be fixed earlier rather than later.

Gynecomastia from trauma

It sounds as though you may have ruptured part of your chest muscles.  They then balled up can are causing your gynecomastia.  The treatment may involve slightly larger scars, but the excess muscle may be amenable to excision in order to improve the appearance of your chest.

Pectoralis injury deformity. Cause doesn't matter, cure is the same.

Even when a muscle tears and causes a deformity (the most obvious one is biceps tear), unless it is immediately repaired, it can't be repaired.  What you can do is work on the soft tissue to disguise it.  Liposuction or excision of some breast tissue can be part of the cure.  Fat transfer or custom made implants for indentations.  

Ritu Chopra, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 17 reviews

Gynecomastia

I doubt if the injury led to gynecomastia.Simply put,gynecomastia is excess breast tissue in men and nothing more.It also can be fatty tissue./so I don't believe the injury led to this.

Robert Brueck, MD
Fort Myers Plastic Surgeon
5.0 out of 5 stars 34 reviews

Can an Injury to the Pec Area Trigger Gynecomastia?

It sounds like you developed a hematoma from your injury that has now partially resolved, but you probably have scar tissue associated with the hematoma.  You may have some excess breast tissue or fat on your breast as well, but  this would not have developed from the injury.

Amy T. Bandy, DO, FACS
Newport Beach Plastic Surgeon
5.0 out of 5 stars 92 reviews

Chest injury

I tousns like you may have tore your pectoralis major in your accident but without an exam I could not say. It would not cause gynecomastia.

Steven Wallach, MD
Manhattan Plastic Surgeon
4.5 out of 5 stars 18 reviews

Gynecomastia Not Likely Due To Trauma

In medicine you can never say never nor always, but it is very unlikely that you would develop gynecomastia due to an injury to your pectoral muscles.  Your deformity may well be due to your previous injury, but if there is also gynecomastia present, it is probably coincidental and not caused by that previous injury.

John Whitt, MD (retired)
Louisville Plastic Surgeon
5.0 out of 5 stars 2 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.