Understanding Gynecomastia

Gynecomastia is a condition characterized by the development of enlarged breast tissue in males, typically caused by hormonal changes. Hormones, our body’s chemical messengers, can fluctuate due to age, medications, or health conditions, often leading to noticeable changes. Studies estimate that between 30-70% of men will experience gynecomastia at some point in their lives.

According to available research, only a small percentage of the population experiences long-lasting, permanent gynecomastia, with estimates suggesting around 10% of men who develop gynecomastia will have a persistent form of the condition; meaning that while a significant portion of men may experience gynecomastia at some point in their lives, most cases resolve on their own, leaving only a small percentage with permanent breast tissue enlargement.

Pubertal Gynecomastia

Gynecomastia is especially common during puberty, when hormone levels fluctuate rapidly, causing breast tissue to swell in adolescent boys.

While this condition can be distressing, it is important to know that in most cases, pubertal gynecomastia can go away on its own. As the body balances its hormones, the excess tissue often diminishes without the need for surgical intervention.

In adolescent boys, gynecomastia is typically a temporary condition. The vast majority of cases resolve naturally over time, usually within a few years as hormone levels stabilize. By the time a young man reaches his early 20s, symptoms of gynecomastia often disappear on their own. During this time, monitoring the condition with a trusted healthcare provider is crucial to ensure that the issue does not persist into adulthood.

If you’re unsure about whether gynecomastia will go away or if surgery is necessary, I can help. As a board-certified plastic surgeon with years of experience treating gynecomastia, I will provide clear, honest guidance during your personal consultation.

Adult Onset Gynecomastia Causes

Many herbs, oral supplements, and medications can cause or exacerbate the growth of breast tissue in men to varying degrees.

Supplements:

• Herbs with phytoestrogenic properties, such as red clover, alfalfa, licorice, saw palmetto, ginseng, and black cohosh, can mimic estrogen’s effects on the body. 
• Protein powder: Some suggest that casein and whey protein powder may contain estrogen and cause gynecomastia. However, others say that the estrogen levels in protein powder are too low to have a physiological effect on the human body. 
• Prohormones, such as DHEA are gym supplements that act similarly to steroids and can cause gynecomastia. 
• Lavender oil or tea tree oil lotions or topical treatments can lead to both an increase in estrogens and a decrease in testosterone levels.

Medications that can cause or increase gynecomastia include: 

• Anabolic steroids, such as testosterone cypionate
• Antifungals, such as ketoconazole and metronidazole
• Heartburn and ulcer drugs, such as cimetidine, ranitidine, and omeprazole 
• Growth hormone 
• Methotrexate and alkylating agents used for chemotherapy 
• Prostate cancer medications like bicalutamide (Casodex) and flutamide 

Before starting a new supplement, you should always let your doctor know what medications you are taking.

When Is Gynecomastia Surgery Necessary?

For some men, gynecomastia symptoms do not resolve on their own, especially in cases where hormonal imbalances continue into adulthood or a supplement or medication are causal. Hormonal fluctuations caused by factors like medication, weight gain, or certain health conditions may lead to persistent gynecomastia. If gynecomastia has been present for a year or more, it most likely will not go away on its own, even with maximal medical treatment.  In these situations, surgery may be the most effective solution to restore a more masculine chest contour and alleviate physical and emotional discomfort.

In some cases, working with your healthcare provider to address hormonal imbalances can help reduce gynecomastia symptoms. However, it’s important to note that no topical creams, pills, or non-surgical options have been proven to effectively treat gynecomastia long-term. Surgery remains the most reliable way to remove excess breast tissue and improve your chest appearance.

As a specialist in male body contouring, Dr. Brown recommends waiting until you’re at least 18 years old before considering surgery. By this time, your body has likely completed its development, and it will be easier to determine if surgery is the right option. For men in their mid-20s or older who are still experiencing gynecomastia symptoms, surgery can offer a permanent solution. 

What to Expect from Your Gynecomastia Consultation

If you’re considering gynecomastia surgery, Dr. Brown will meet with you in person during a consultation to discuss your needs and determine the best approach. Together, we will go over important details, including:

• The cause of your gynecomastia symptoms and how long it has been present.
• Surgical techniques, such as liposuction, and where small incisions will be made.
• What you can expect during recovery.
• Review of activity and exercise schedule after your procedure

Additionally, Dr. Brown will review your medical history to ensure that surgery is safe for you. Once we gather all the necessary information, we will schedule your male breast reduction procedure.

Schedule Your Consultation Today

If you’ve been struggling with gynecomastia and are unsure if it will go away on its own, it’s time to take control of your health and confidence. At our La Jolla and Del Mar/Carmel Valley offices, Dr. Brown provides comprehensive care to men seeking solutions for gynecomastia. During your consultation, your goals, medical history, and the next steps in your treatment plan will be discussed.

Call (619) 461-1500 today to schedule an appointment and take the first step toward restoring your confidence and comfort.