In majority of men, the cause is genetic and idiopathic (no known cause).  Typically, the breast tissue grows around puberty and remains large.

It is important to rule out reversible causes such as certain medication, anabolic steroid use, excessive alcohol intake, and medical conditions causing hormonal imbalance.

Probably the most common medication causing gynecomastia is Cimetidine, which is an antacid.

Increased estrogen levels leading to enlarged breast can be due to testicular tumors or hyperthyroidism.  Any liver disease may cause decreased clearance of estrogen, leading to gynecomastia.

Certainly, if any doubt exists, breast cancer should be ruled out by mammography or ultrasound.  Male breast cancer is rare, but it does occur.

Assuming all reversible or treatable causes have been ruled out, what options does a patient have for gynecomastia?  The most common procedure is liposuction, which involves suctioning of the fatty breast tissue.  Liposuction alone is adequate for most patients.  However, in a patient who has excess skin or non-fatty breast tissue, actual removal of breast tissue (subcutaneous mastectomy) with or without a breast lift may be necessary.

Gynecomastia surgery is a rewarding procedure both for the patient and the surgeon.  Many patients who were embarrassed to wear a bathing suit are now proud to show off their new breasts (or lack of!)

I have attached a before and after photo to illustrate the effectiveness of this procedure.

Michael A. Jazayeri, M.D. is a board certified plastic surgeon with over 10 years of experience. To schedule a complimentary consultation, please call 714-834-0101.