I have been diagnosed with gynecomastia. My breasts and nipples seem to change appearance frequently. Any suggestion? (photo)

I've been using Androgel since last August (2014) and as a side effect, I developed and was diagnosed with gynecomastia. I'm a 66 year old male, lost a testicle at age 18, and prior to taking Androgel had almost no testosterone levels (free value was 1.0 and total was 60). At times my breasts including nipples seem normal (see picture) but then there's often a change and my breast develops a more cone shape and the nipple area becomes puffy and engorged. It also aches at times. Any thoughts?

Doctor Answers 8

Reducing Breast Size in Men over 50

The treatment of men over the ages of 50 or 60, with #gynecomastia still follows basic surgical guidelines and principles. First, the patient must be in generally good health. There is no defined upper age limit for gynecomastia surgery. However, medical issues, such as hypertension, diabetes, etc. must be under control prior to surgery. In older men the main difference in the surgery compared with younger men has to do with their skin tone and nipple position. As we get older, we lose #elastin in our skin which leads to decreased tone. Therefore, in certain cases, the gynecomastia surgery in older men will also need to address the loosened skin and possibly #repositioning of the nipple and areola. This will allow for the most ideal contour and a patient who is happy with their results.

Orange County Plastic Surgeon
4.9 out of 5 stars 110 reviews

Treatment of Gynecomastia on Testosterone Replacement

There are two fundamentally different approaches to your gynecomastia. Let's talk about the non-surgical approach first. Testosterone is converted to estrogen by the aromatase enzyme which is present in many cells throughout your body. Your breast enlargement is due to excess estrogen in your body which can come from your androgel, conversion from other androgens, and from fat stores in your body. I would check your testosterone and estrogen levels in your serum to see if your testosterone is within range of your optimal level. If you have too much testosterone causing breast development, you can reduce your androgel use. If your estrogen level is too high, you can try to lose weight with lifestyle changes, or take a low dose of aromatase inhibitor such as anastrozole.

The second approache is surgical, if you find that you have enjoyed the changes in your mind and body from testosterone replacement, and do not want to reduce your testosterone replacement. You can remove the breast tissue in your chest through a periareolar incision.

Lu-Jean Feng, MD
Cleveland Plastic Surgeon
4.6 out of 5 stars 94 reviews


Hi, thanks for your picture and for your inquiry, it seems that your case it is a clear case of gynecomastia. You need surgical intervention so the glandular component and fat tissue could be removed. Please have an in person or virtual (Skype) consultation so you can discuss your concerns, options and expectations thoroughly, good luck in your PS Journey!
Dr. Jaime Campos-Leon

Jaime Campos Leon, MD
Mexico Plastic Surgeon
4.4 out of 5 stars 253 reviews

Sever gynecomastia

Your gynecomastia is  very large.Surgery can be done but it is best for you to choose the right surgeon who must be very experienced. Good luck

Mordcai Blau, MD
New York Plastic Surgeon
4.6 out of 5 stars 76 reviews


You have gynecomastia ,the correction entails surgical removal of the glandular component and fat.From the photo you provide your breast does not seem "normal" to my eye ,rather you have significant gynecomastia.

Jay M. Pensler, MD
Chicago Plastic Surgeon
4.6 out of 5 stars 14 reviews

I have been diagnosed with gynecomastia. My breasts and nipples seem to change appearance frequently. Any suggestion

Changes in the shape of the Nipple areola complex happens due to physical stimulation, temperature changes etc.,. Sometimes they can be associated with pain.
Correcting the gynaecomastia usually relieves these problems.
Consult a Plastic surgeon near you.

Karthik Ram, MRCS, DNB
India Plastic Surgeon
4.8 out of 5 stars 54 reviews

Gynecomastia surgery

Your gynecomastia is advanced.  Liposuction alone will be insufficient.  You will need surgical excision of the gland.  Choose someone with experience.

Tim Neavin, MD
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 46 reviews

Gynecomastia Reduction

You have a significant case of gynecomastia and your symptoms indicate that there are active breast tissue changes. Only gynecomastia reduction surgery can put to rest these ongoing changes which may likely continue to persist and increase with persistent hormonal stimulation.

Barry L. Eppley, MD, DMD
Indianapolis Plastic Surgeon
4.7 out of 5 stars 72 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.