What Causes Gynecomastia?

 Plastic surgery has long been seen as a choice women make, and while men certainly undergo plastic surgery procedures as well, widespread public acceptance of male-focused procedures is much more recent. One of the fastest-growing areas for male patients is gynecomastia surgery. Portland’s Waldorf Center team explains that a 2023 report on plastic surgery statistics noted an 88 percent jump in the number of times this surgery was performed compared to the prior year. 

Interest in gynecomastia surgery is obviously on the rise. But what exactly is the procedure—and what is it seeking to address?

A Closer Look at Gynecomastia

Gynecomastia is a condition that causes breast tissue or the appearance of breasts to develop on a male’s chest. Often the result of hormone fluctuations and elevated estrogen levels, the condition is more common in newborns, boys going through puberty, and old men whose testosterone levels are dropping. It can also result from certain medications, supplements, and medical conditions.

For newborns, the estrogen that causes gynecomastia comes from the mother. This may result in the development of breast buds, but as the baby grows and his individual hormone levels begin to “settle,” the problem tends to resolve on its own within about six months.

For pre-teens, newly fluctuating hormones as puberty begins can cause the development of breast buds that may last for a couple of years. For teens, the condition most often occurs in early or middle puberty and can last a few months to a couple of years. In all of these cases, the breast tissue should be expected to go away on its own.

Adult men who experience gynecomastia have a range of potential triggers to consider. The use of various drugs and substances—including marijuana, methamphetamines, and even alcohol—can lead to the development of breast tissue on the chest. Various cancers can also cause gynecomastia (liver, lung, pituitary, testicular), as can cirrhosis of the liver or a hyperactive thyroid.

Among the many medications that can cause the development of breast tissue are steroids, certain chemotherapies, pills to treat anxiety or depression, epilepsy drugs, and more. For most patients, the chest contours flatten after the medication is no longer taken.

Some men develop the look of breasts simply due to excessive weight gain. There may not be breast tissue on the chest, but the large amount of localized fat cells create volume that gives the area a more traditionally feminine look. Weight loss efforts may help to shrink the mounds, but there is no guarantee that a calorie-deficit diet or a strict exercise routine will impact the chest in the desired way.

What Can Treat Gynecomastia?

The specific treatment recommended for addressing gynecomastia depends on the nature of the condition. As noted above, males who have developed breast buds will often see them go away in a matter of months.

A chest with significant fatty tissue may benefit from liposuction, which is the surgical removal of fat cells. It is important to keep in mind, however, that removing volume from an area of the body can leave behind stretched-out skin that gives the area a lax and sagging look—or, in men, the appearance of breasts. Patients who want to address this excess skin can get a lift or a tuck to achieve better-defined contours.

Gynecomastia surgery tends to focus on the specific removal of glandular tissue, though the procedure may also involve suctioning out fat. The entire goal is to sculpt a more traditionally masculine chest, which is flatter. The procedure may also include moving the nipples and their surrounding areola so that they sit more in a more masculine position, as well as reducing the areola size so that the darker-pigmented circle of skin is not so prominent.

Learn more about gynecomastia and male breast reduction surgery by reaching out online to contact The Waldorf Center for Plastic Surgery, or call 503-882-0124.