Diagnosed with prepubertal gynecomastia as a teenager. Do I need surgery for my breasts? (photo)

Hello, and thank you for your question regarding what to do with pre-pubertal gynecomastia, which is diagnosed in a teenager, and whether you need surgery for your breasts. Thank you for your history and your pictures. There can be many reasons for gynecomastia. There are four primary causes of gynecomastia: physiologic, medication-related, medical conditions, and idiopathic. Physiological causes are common in newborns, teenagers undergoing puberty, and older males 70% of adolescent boys developed temporary breast enlargement due to fluctuating hormones. Medications like finasteride, calcium channel blockers, alcohol, marijuana, and anabolic steroids can all increase male breast tissue. Medical conditions can also increase gynecomastia. Medical conditions include hypogonadism, testicular tumors, cirrhosis, hyperthyroidism, and obesity.
I assume your physician has thoroughly evaluated you. If all of those causes are normal or have been corrected, then your gynecomastia treatment would be considered aesthetic or cosmetic. Therefore, that means you do “need” gynecomastia surgery to improve your health. In your case, undergoing gynecomastia surgery would be elective and would be performed to make your chest look better. In terms of treatment, it depends on the results of the physical examination. If you have hard masses underneath the nipple areola complex, you will need an incision and removal of the glandular tissue. If the rest of the chest is soft, then this is usually treated with either excision or VASER, combined with Micro-Air Power-Assisted liposuction (a.k.a. PAL) and Renuvion radiofrequency (or RF). For glandular tissue removal, an incision is placed just underneath the areola. Treatment is usually done under general anesthesia and requires about 2 to 4 hours of anesthesia. Allow for a 5- to 7-day recovery period. In general, the majority of gynecomastia surgeries involve both glandular tissue removal (“gynecomastia mastectomy”) and liposuction. Overwhelmingly, patients are satisfied with their treatment. Your previous providers are correct; aside from addressing the other medical conditions mentioned above, the only way to effectively treat your gynecomastia is through surgery. Good luck. I hope I’ve answered your question regarding the fact that you’ve been diagnosed with pre-pubertal gynecomastia as a teenager, and whether you need surgery for your breasts.
Sincerely, Dr. Katzen, MD, MBA. (Plastic Surgeon, President of the American Society of Bariatric Plastic Surgeons, certified by the American Board of Plastic Surgery, Fellow of the International Society of Aesthetic Plastic Surgery, American College of Surgery, International College of Surgery, and American Board of Metabolic and Bariatric Surgery, and member of the American Society of Plastic Surgery, American Academy of Cosmetic Surgery, RealSelf Hall of Fame, and RealSelf Doctor Advisory Board for Medical Review and Consumer Panel.)

Gynecomastia during puberty can have a very negative psychological impact but often times it resolves on its own. Gynecomastia during adulthood rarely resolves and in the absence of any medical causes such as hormonal abnormalities, some tumors or certain medications, is considered to be a cosmetic issue.
Based on your pictures I would strongly recommend a thorough liposuction with excision of the gland to give you a flat contoured chest.

Thank you for your query. I would recommend a full evaluation and work up of gynecomastia, especially since it is growing rapidly. You can decide about surgery after that. Please find an experienced board certified Plastic surgeon who can examine you and help you with all your concerns. All the best!

Prepubertal gynecomastia will sometime improve with time. As many years have since passed, it is unlikely you will have much change without surgery.

Based on these photos you are excellent candidate for gynecomastia reduction. Surgery involves liposuction of the breast and, if present, rexcision of hard glandular tissue located underneath the nipple. Surgery is done in twilight anesthesia in our practice and recovery is short. Good luck.

Prepubertal gynecomastia can sometimes resolve on its own as the body continues to develop, especially if it occurred during puberty. However, if the condition persists into adulthood and is causing discomfort, emotional distress, or self-consciousness, surgery could be a consideration.
Gynecomastia surgery, known as male breast reduction, is a common procedure to address excess breast tissue in men. It typically involves liposuction, excision, or a combination of both to remove the tissue and contour the chest.
It’s always a good idea to consult with a board-certified plastic surgeon who can evaluate your condition and provide personalized advice on whether surgery is necessary for you.