What's the earliest age to correct gynecomastia?

Question

My 13 year old son has gynecomastia and he has become very self-conscious about it. He has always been very active in sports and I worry that it will hinder his activities. As his friends have started to make comments about it. He no longer takes his shirt off in public. Is it possible let to have surgery before highschool? If not what is the earliest he can have surgery?

Ozge Ergun, MD · Answer

Thanks for the question. Boys or girls below the age of 18 should abstain from having plastic surgery. I wish you all the best.

Jose M. Soler-Baillo, MD, MS · Answer

Thank you for your question.  I recommend that he waits a couple of years until he has gone through puberty.  There is a possibility that the gynecomastia will resolve itself during this time.  If not, you should take him to be seen by a board-certified plastic surgeon to determine what would be both best and realistic for him.All the best,Dr. ResultsMiami, FL

Jed H. Horowitz, MD, FACS · Answer

Gynecomastia is a common occurrence in boys going through puberty.There are different types of #gynecomastia. Categorized as #physiologic 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.#Normal Gynecomastia is usually apparent in males between the ages of 12 to 15 years old. It is also common for older men 65 years old or more who experience a drop in their testosterone levels. #Normal Gynecomastia takes approximately one to two years to naturally regress on its own.Meanwhile, #Adolescent Gynecomastia is hereditary and usually appears in 30% to 60% of boys between the ages of nine to fourteen. Many cases of adolescent gynecomastia resolve on its own as the boy grows into adulthood. Some with #Adolescent may choose to undergo surgery to correct the situation, this usually happens at the age of 18 or above. In severe cases in young boys, the physician and child development specialists will need to speak to the parents regarding the severity of the gynecomastia and if surgery is an option before the age of 18.While there is no “youngest
age” to undergo gynecomastia surgery, I make sure my teenage
patients have had gynecomastia for at least two years and have no other identifiable
causes for their gynecomastia.

Larry S. Nichter, MD, MS, FACS · Answer

Ideally, gynecomastia surgery is delayed until full development, around age 18 after adolescent hormonal influenced breast development ceases. Sometimes it will resolve to a degree afterwards. Also if your child is overweight, often the breasts will diminish with weight loss once in the normal range. However I have operated on several adolescent males to develop gynecomastia for those stigmatized and  traumatized by the size of his breasts in severe cases with good results. Yes it is possible they will grow again and another procedure may be required for best results, Discuss the risk vs benefits with your board certified plastic surgeon that has experience in this age group.

Mathew A. Plant, MD, FRCSC · Answer

Essentially any time after the completion of puberty is reasonable. Gynecomastia often goes away on its own by 15-16 years once the hormone surges of puberty end, but if there is actually breast gland then it may need removal. I'd suggest getting a referral from his paediatrician to a local plastic surgeon to be examined. This is all covered by OHIP until he turns 18 so there is no harm or cost associated with getting a consultation. Best of luck!

Scott W. Vann, MD, FACS · Answer

I have done many teenagers with gynecomastia, Youngest so far is 15, but if all were approperate and your son was willing with supportive parents, I would probably do someone his age. Look for a plastic surgeon who does a lot of these procedures.   Good luck.

Miguel Delgado, MD · Answer

Most of the time the adolescent chest will return to normal on its own within a few
 months to a maximum of two years, after that time it is most likely 
permanent and only can be corrected by surgery. Age is not as important as the psychological damage that can happen to young men suffering with gynecomastia.   I have done surgery for many young men at age 13 and younger, there is a possibility that the breast tissue may continue to develop until the young man has past puberty, but not usually. Be sure to see a Board Certified Plastic surgeon that specializes in male breast reduction. Good luck!

Atul Kesarwani, MD, FRCSC · Answer

There are many factors to consider when considering any body contouring procedures in someone who is not yet an adult.  In addition to all the regular surgical concerns, one must consider:       The extent of the deformity and how much it bothers the patient       The physical and emotional maturity of the patient       Whether the deformity will resolve or improve with time       Whether the surgical intervention will affect ongoing growth or the final outcome       The support of family and parents.With gynecomastia, specifically, one must consider how physically mature a 13 year old your son is, and how much his condition is affecting what he wants to do with regards to sports and social interactions.  It is very difficult for parents to see a child suffering.  A consultation with a plastic surgeon who is experienced with gynecomastia surgery in adults and in teenagers is a reasonable step to gather information.

Karthik Ram, MRCS, DNB · Answer

Dear Lissam ,Thanks for raising this question. It is always debated one. In my practise , I do surgeries, when they started to notice and psychologically getting affected by the issue . Age does not matter . It is my practise . I tell the parents that there is possibility of recurrence ,if we operate very early (before 18 years). But it has to be addressed early to avoid the deep rooted psychological insults.

Jacob Bloom, MD · Answer

Thanks for your question.  As adolescent boys go through puberty gynecomastia can be a very normal part of their maturation but an embarrassing one.  Many times this goes away naturally with time.  Prior to surgery an evaluation by a board certified plastic surgeon and his pediatrician should be completed.  This will help determine time course and other medical factors such as hormone secreting tumors and medications that can lead to breast formation in males.  As long as these are all normal and the breast tissue has been present for > 1 year plans for surgery can be started.  Thanks for your question.

What's the earliest age to correct gynecomastia?

Answers (10)

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