Categorized as #physiologicol gynecomastia, up to 2/3 of boys going through puberty develop some form of gynecomastia. This form of gynecomastia is due to the surges in testosterone and estrogen which often lead to an imbalance of the testosterone:estrogen ratio. Puberty is a difficult time for most boys, with many changes occurring not just physically but also emotionally. Developing gynecomastia during this age can affect the self-image and confidence of a teenager. The peak incidence occurs around 14 years of age.In up to 75% of boys who develop pubertal gynecomastia, it will disappear without treatment within 2 years. In 90% of boys with pubertal gynecomastia, it will disappear without treatment within 3 years. So deciding who needs surgery is very important in this age group because a majority of these boys will not need any intervention.