Hello, I believe I have really bad Gynecomastia and would like to understand the severity of the situation and solutions if poss

I just require clarity. I go to the gym quite frequently in aims to lose weight and reduce my body fat as well as build mass, I workout constantly. I'd like to know the best solutions behind my problem, is this simply a case of me needing to continue to lose fat or is this gynecomastia? I'm currently 205 and trying to get down to around 170-180lbs before I even consider going under the knife though. Thank you

Doctor Answers 16

Hello, I believe I have really bad Gynecomastia and would like to understand the severity of the situation and solutions if poss

Thank you for your question and for sharing your photographs.  Though nothing replaces an in-person examination it does appear that you are suffering with a higher grade of gynecomastia, with excess glandular tissue and skin.  I do not think that any additional weight loss or working out will correct this.  I would recommend reaching your goal weight, but only surgery will ultimately correct the tissue excess. Be sure to see an ASPS board certified plastic surgeon in consultation.

Atlanta Plastic Surgeon
5.0 out of 5 stars 38 reviews

About Gynecomastia and the Treatment Options

According to official statistics, 36% of adult young men and 57% of older #adult men in the United States have this medical condition in one of the four grades.
About 200,000 to 3 million cases of #gynecomastia are being reported every single year. So if you have #breast #enlargement and you feel you're an exception, please understand that 1 in 3 young adult #men and 1 in 2 older adult men are just like you and have breast enlargement.

Several common factors can cause gynecomastia including excessive levels of #estrogen, natural #hormone changes, use of recreational drugs or alcohol, medications and their associated side effects, and, various health conditions. Also, there are different types of #gynecomastia.

There are three types of surgical #treatment #options available that treat gynecomastia. Your board-certified plastic surgeon will recommend the type best suited for you. The most important decision to be made before performing any surgical procedure is determining whether you are an ideal #candidate.

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 94 reviews

Hello, I believe I have really bad Gynecomastia and would like to understand the severity of the situation and solutions if poss

Surgery to remove skin and tissue is likely to achieve your best result.

Kenneth Hughes, MD

Beverly Hills, CA



Thank you for your question and photos. You do appear to have Gynecomastia and solutions could involve glandular tissue excision and well as repositioning areolas/lift.

Gynecomastia affects all shapes and sizes of men- even those who are slim and in great shape. Further weight loss or exercise will not resolve this. I recommend that you book an in-person consultation with a board certified Plastic Surgeon who has plenty of experience in this procedure and find out what your options for treatment are.

All the best

Hello, I believe I have really bad Gynecomastia and would like to understand the severity of the situation and solutions if poss

Hi there
you have a grade 4 gynaecomastia ,with both skin and tissue excess
correction can either be staged or a single procedure aimed at removing the breast tissues and skin depending on the plastic surgeon you chose.
your exercise might not help you more
best of luck


It appears from your pictures that you have true gynecomastia, asymmetric, and with relatively severe droop or ptosis. This represents glandular tissue and probably will change very little with exercise or weight changes. It is not usually a serious medical condition, but if you are concerned about the appearance I would recommend that you seek consultation with a board certified plastic surgeon, as surgery will be necessary to masculine the appearance of your chest.

Jeffrey D. Wagner, MD
Indianapolis Plastic Surgeon
4.9 out of 5 stars 16 reviews

Gynecomastia and treatment Expained

Yes, You have significant gynecomastia. This can be caused by genetics, use of hormones including those used to build muscles, and certain tumors that produce estrogens, and most often without a specific reason. You can have your primary care doctor rule out these causes. Healthy male patients with excess breast tissue or unwanted breast development who have no underlying breast disease.Men who desire improved physical and aesthetic appearance should have realistic expectations based on their condition and the procedure performed.
Intended ResultPermanent reduction of unwanted volume and improvement in the contour and appearance of the male chest.
Procedure descriptionThere are varying degrees of gynecomastia ranging from puffy nipple to severe breast enlargement and/or breast sag. The severity of the gynecomastia will determine which treatment option is necessary. In most cases, men suffer from standard gynecomastia, which can be surgically treated as an in-office procedure under local anesthesia. For more severe cases, it may be recommended that you have your procedure under general anesthesia at an outpatient surgery center. Your consultation will determine which option is best suited for treating your gynecomastia.


If you plan on losing more weight, this may help reduce the volume, but you have significant skin hanging as well and likely need a skin excision as well.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 24 reviews

Male breast gynecomastia excess skin and fat of male breast liposuction male breast reduction

Hi Serge,
Thank you for your questions and your pictures regarding male breast tissue or gynecomastia. I commend you on your working out and losing another 25 to 35 pounds. Further weight loss may burn off some of your breast fat. However, unfortunately, I do not think that you will lose a significant amount of your male breast fat. This male breast fat is notoriously stubborn and resistant to weight loss.
From your pictures and history you do have gynecomastia. As you know, gynecomastia is excess male breast tissue.  In your particular case, you have excess male breast tissue, excess male breast skin, and Grade 3 ptosis of the nipple. Grade 3 ptosis means that the nipple is at the inferior most portion of the breast.
If your breast do not significantly change after your 25 to 35 pound weight loss, you will probably require surgery. During your male breast surgery, excess male breast tissue, male breast fat, and male breast skin need to be removed.  In addition, during your male breast surgery, your nipple needs to be raised and centered.
In your particular case, an incision needs to be made underneath your breast. This is in the inframammary fold; the inframammary fold is where the breast meets the chest wall. Through this inframammary fold incision excess male breast tissue and excess male breast skin can be directly removed. In addition, in order to reposition the nipple, an incision needs to be made around the areola. A vertical incision does not need to be made.
Male breast reduction surgery for gynecomastia takes about three to four hours.  Gynecomastia reduction surgery is done under general anesthesia. Typically, gynecomastia surgery is performed as an outpatient, meaning that you go home the same day you came in for surgery. Recovery takes approximately 7 to 10 days.
It is very important that you were your compression garment for at least 6 to 8 weeks after your gynecomastia surgery. To optimize your gynecomastia reductionresults and flatten your scars as much as possible, I strongly encourage silicone cream and silicone tape.  These should be applied for at least six months.
Good luck! Thanks again very much for your question regarding male breast reduction and gynecomastia. If you have any questions regarding gynecomastia or male breast reduction surgery, please do not hesitate to contact my office. Sincerely, Dr. Katzen

Extreme Gynecomastia

Hey Serge - You definitely have a more severe situation than the average "gynecomastia", but the good news is that aggressive skin and tissue excision techniques exist that can balance and masculinize your chest quite well (while keeping your nipple attached), provided you are willing to accept "anchor-shaped" scars.  Best to be at your relatively optimal/goal weight however, and you'd have to avoid the gym for at least a month thereafter. Hope this helps and best of luck in your quest . . .

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.