Going through puberty - Normal Weight, Chest and yet I have Puffy Nipples, Is it still Gynaecomastia? (photo)

Question

Dear Doctor, I believe that I might have gynaecomastia. It is only my nipples which sometimes seem a little puffy yet my chest (breast) is perfectly fine. Since I am currently at the age of 16, is surgery recommended if my case is gynaecomastia? In addition, if it should go away after a while, how long before it does so? Thanks, Any help is greatly appreciated!

Jed H. Horowitz, MD, FACS · Answer

The male breast is composed of glandular tissue and fatty tissue. An excess in either type of tissue can cause the chest to take on the look of gynecomastia. Gynecomastia can affect men of all different body types. There are different types of #gynecomastia.

Particularly, 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.

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.

Tom J. Pousti, MD · Answer

Good advice would necessitate in person evaluation but if you are dealing with pubertal gynecomastia it often resolves within 1 to 3 years after onset. Adult onset gynecomastia however does not necessarily do so. If persistent, it is often best treated with  partial excision of the prominent glandular tissue  as well as liposuction surgery of the peripheral chest area.  If the prominence of the chest wall is caused by adipose tissue, then liposuction surgery may suffice.  I hope this, and the attached link, helps. Best wishes.

Steven L. Robinson, MD · Answer

Thank you for your question. From your description, it sounds like you do indeed have a mild case of gynecomastia. However, due to your age, there is a good possibility it will get better over time. I would be patient and wait until you are 18. If it has not gone away by then, it probably will not. You couold then talk to a Plastic Surgeon. Best wishes

Mordcai Blau, MD · Answer

If it is not a major issue you can wait .How should I choose a surgeon?Choose carefully. The decision is yours. Advice to assist in making your selection.Only a board certified plastic surgeon1. Experience matters. Choosing a surgeon increases the likelihood that they have seen a case similar to yours in the past. Selecting a surgeon whose practice is focused on gynecomastia exclusively is also an indicator of experience.2. Results matter. The more before-and-after pictures, the better. Pay attention whether the surgeon is confident enough to show multiple angles of the same patient.3.Only gynecomastia Reviews matter. 4. Expertise matters. Is your surgeon recognized by the profession as an authority in the field? Have they authored books or medical journal articles regarding your surgery?Be realistic about your expectations. Also, revision surgery tends to be significantly more difficult than initial surgery.

Julio Clavijo-Alvarez, MD, MPH, FACS · Answer

Thank you for your question.
It is difficult to determine if you have or not gynecomastia, without a picture
or physical exam.
Based on your description, It doesn't seem to be the case. Usually patients
with gynecomastia complain of: 
1. Tenderness and sensitivity to the nipples.
2. Hardness to the nipples
3. Breast increased size.

Most of the times the symptoms that you complain of, should go away once your
body stabilizes the hormonal storm that you are going through.

I would recommend you to go to your pediatrician to make sure everything is
within the normal side.

Best luck.

Sherwood Baxt, MD (retired) · Answer

I don't think anyone can answer your questions with precision but the key issue here is given your age and history, definitely wait. Surgery is definitely an option but not at this time. Might get considerably less noticeable over the next few years

Going through puberty - Normal Weight, Chest and yet I have Puffy Nipples, Is it still Gynaecomastia? (photo)

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