Can Men Also Develop Breasts? Understanding and Treating Gynecomastia

A 14-year-old should be standing tall and full of confidence, but young Z instead kept his head down and his back hunched, afraid others would discover his hidden secret.

Three years earlier, when Z had just started middle school, he gradually noticed abnormal breast development. His chest was larger than that of other boys his age, especially noticeable in summer when wearing short sleeves. At first he thought it was just puberty and paid little attention. But as time went on, he realized something was wrong: his chest seemed to be growing even larger. This embarrassing "secret" gradually became a psychological burden, and he grew more and more self-conscious.

Accompanied by his family, Z went to the hospital. After a detailed examination, the doctor diagnosed him with gynecomastia (male breast development).

At this point, everyone likely has the same question: can men really develop breasts?

1. What Causes Gynecomastia?

Gynecomastia is caused by an imbalance in the ratio of estrogen to androgen in the body, due to either increased estrogen or decreased androgen, leading to abnormal development of male breast tissue. Clinically, based on cause, it is generally divided into four types: physiological, pathological, drug-induced, and idiopathic.

Physiological causes:

• Neonatal period: estrogen from the mother or placenta enters the fetal bloodstream, which may stimulate the infant's breast tissue and cause temporary development.
• Puberty: because of active sex-hormone secretion during puberty, the testes synthesize large amounts of estrogen before producing testosterone, leading to a temporary hormonal imbalance.
• Old age: as organ function declines in older men, testicular function decreases, causing an imbalance in the estrogen-to-androgen ratio.

Pathological causes:

• Endocrine disorders: conditions such as adrenal cortex tumors or testicular cancer may disrupt hormone levels and subsequently induce breast development.
• Obesity: obesity is a common issue in modern life. Obese men are prone to abnormalities in their estrogen-to-androgen ratio, leading to breast development and enlargement.

Drug effects: certain diseases (such as liver or kidney disease) and specific medications (such as some antidepressants or blood-pressure drugs) can affect hormone levels and potentially cause breast development.

Idiopathic causes: this category covers cases in which drug induction and underlying disease have been ruled out but no clear cause can be found. Current research suggests a possible link to environmental pollutants containing estrogen-like compounds.

2. How to Recognize Gynecomastia

Observe the appearance: for patients with an obvious clinical presentation, the typical feminized appearance of the breasts can directly confirm the presence of gynecomastia.

Assess by touch: the breast is composed mainly of glandular tissue (firm) and adipose tissue (soft). If the enlarged breast feels predominantly firm, it is mainly glandular tissue; if it feels mostly soft, it is likely mainly adipose tissue.

Undergo examinations: if self-examination is inconclusive, it is best to visit a proper hospital. A physician can perform a physical exam and order relevant tests such as sex-hormone tests, breast ultrasound, or MRI, all of which help with diagnosis and treatment planning.

Note: if you feel a one-sided, hard, painless breast lump, it is advisable to seek medical attention to rule out the possibility of male breast cancer.

3. If Diagnosed with Gynecomastia, How Is It Treated?

Treatment options for gynecomastia mainly include addressing the underlying cause, medication, and surgery.

Treat the underlying cause: when a cause can be identified, the first choice is to remove it, for example by treating a tumor or discontinuing the suspected medication.

Medication: when pathological causes have been ruled out, medications that inhibit estrogen can be used to help the abnormally developed breast tissue regress in its early stages.

Surgery: surgery is currently a relatively definitive and efficient way to treat gynecomastia; however, not all cases require it.

Advantages of Male Breast Correction Surgery

Many people who come to the hospital say they are deeply troubled by the unusual appearance of their chest. They often avoid tight clothing and hope surgery can offer a one-time solution, yet they also have many concerns, such as: "Will there be significant pain after surgery? How long is recovery?" and "Will the surgical scar be very large?"

Traditional surgery involves larger incisions. If a mass on the body surface needs to be removed, it may even cause some damage to surrounding healthy tissue, resulting in noticeable pain, slow recovery, and an obvious scar. To ease patient suffering and shorten recovery time, Dr. Wang Yongchuan has refined the traditional surgical technique.

After this refinement, for gynecomastia the doctor uses a minimal incision at the edge of the areola. He combines techniques such as liposuction for fat contouring, dissection and removal of the breast gland tissue, repair of the superficial fascial layer with fat flaps, and skin repositioning and retraction to restore the chest contour to the normal male standard. This method features a very small incision, is performed as day surgery (no hospitalization required), offers high overall comfort, and results in an inconspicuous scar.

In conclusion, gynecomastia is not a frightening condition. Through lifestyle improvements, medication, and surgical methods, it can be effectively addressed. If you feel troubled by it, please actively seek help to find a solution that suits you.