What Causes Man Boobs? The Ultimate Guide to Gynaecomastia Treatment [2023]


Dr Bernard Beldholm

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What is gynecomastia?

Gynecomastia is an enlargement of the breast tissue in the male breast. Gynecomastia in men is a common concern. It’s even normal to see gynecomastia on skinny guys. “Moobs”, as they are sometimes called, are no laughing matter.

Gynecomastia gland

Large breasts and enlarged areolas in men may be caused by an imbalance of hormones known as estrogen and testosterone. Gynecomastia glandular tissue grows when these hormones send the wrong signals. Typically what happens is that testosterone levels drop while estrogen levels increase. While both men and women have both sex hormones, testosterone is more associated with manly features and estrogen is the more feminine hormone. Estrogen symptoms in males can cause breast swelling and tenderness that can lead to large man boobs.

What causes gynecomastia?

Breast gynecomastia usually has two causes.

Puberty and breast development hormones

Hormones and gland problems are common in teen boys. Around age 12, it is normal for sex hormones to increase rapidly. The body goes through all kinds of changes, from deepening voice to developing facial hair.

Fluctuating hormone levels can also cause temporary problems, like voice cracking and yes, even growing breasts. This can be embarrassing for a teen boy and make changing in the locker room a fearful event.

For most young males, the hormone levels eventually sort themselves out and breast swelling decreases with age. However, some men don’t outgrow it. Some young men get gynecomastia that follows them into adulthood. A hormonal imbalance in men may be the culprit.

Steroid use

Bodybuilders take note: Using steroids can disrupt the endocrine system and result in the development of male breasts.

Boys and men may take steroids to increase muscle mass rapidly. This can maximize workouts and even improve athletic performance. Steroids are dangerous, however. They mess up normal biological processes and endanger the lives of the men who use them.

Steroids affect male hormones in several ways. According to American Family Physician, “The injection of exogenous testosterone inhibits natural production of testosterone, which cannot recover rapidly enough between steroid-injecting cycles to prevent estrogen predominance”.2

Gynecomastia from steroids may be irreversible, according to the AAFP. Gynecomastia surgery is one way to remove excess breast tissue in males. Luckily, gynaecomastia reduction surgery is quick and has great results.

There are two types of gynecomastia

One type is called pseudo gynecomastia. That means that a male breast just has excess fatty tissue causing it to resemble a female breast more than a manly chest. Then there is real gynecomastia. This is the kind that is caused by a hormonal problem. It affects the gland responsible for breast growth.

Gynecomastia symptoms and diagnosis

Gynecomastia is usually self-diagnosable. Since most cases of gynecomastia are fairly straight forward, special tests are not needed. These are some of the most common signs.

Gynecomastia symptoms

Severe man boobs and mild gynecomastia symptoms share many symptoms:

  • Breast tenderness
  • Swollen breast glands
  • Large breasts
  • Male nipple pain
  • Hard lump under nipple
  • Chest asymmetry
  • Enlarged or puffy areola
  • Breast hormonal imbalance
  • Prominent breast shape that shows through clothing

Chest fat or gynecomastia

Many men wonder ‘Do I have gynecomastia or just fat?”. Increased male breast size doesn’t mean you have true gynecomastia. If you have gained weight recently, it is likely just chest fat. True gynecomastia is unlikely to go away with diet and exercise. Either way, male breast reduction surgery can help remove excess fat & gland.

Download our free guide: “Do I have Gynecomastia? Find out in 3 Easy Steps”

3 Steps to Identify if you have gynecomastia Handbook

Puffy nipples but not gynecomastia

Some men notice that their nipples protrude outwards. Puffy or wide areola can have other causes besides gynecomastia. While it is a common symptom, large nipples in men can also be caused by gaining a few pounds. Dieting and exercise can help reduce symptoms. However, if gynecomastia is the cause, other treatments may be needed.

Mammogram male gynecomastia

Mammograms are not necessary to diagnose gynecomastia. Due to the low incidence of breast cancer in males, the risk is so minimal that mammograms are usually not advised. Gynecomastia is far more often the cause of male breast lumps.(5)

Check out these mammogram images to see a comparison of a normal male breast vs. one with gynecomastia. Note that the skin is often thicker in the affected area as well.

Gynecomastia ultrasound

Ultrasounds are not routinely used to diagnose gynecomastia. Ultrasound images obtained from men with gynecomastia show that there is sometimes a fan or disc-shaped nodule surrounding normal fatty tissue under the nipple. Click here to view radiology images of gynecomastia. (4)

Is gynecomastia harmful?

Gynecomastia side effects are rarely anything to worry about. It is not harmful to your health. It is more of an aesthetic problem. Aside from being annoying, there is no need to fear that it will harm you or lead to cancer.

Is gynecomastia dangerous?

The short answer is no. Regardless of whether it’s real gynecomastia or pseudo-gynecomastia, it’s not dangerous. One possible side effect is that gynecomastia tends to enlarge the breast and cause tenderness and occasional secretions, but again it is not harmful.

Gynecomastia vs. cancer

Some men might worry about gynecomastia cancer concerns. Let’s put those fears to rest. Gynecomastia is not a sign of cancer. However, there are some hormonal disorders like testicular cancer or pituitary cancer that can secrete hormones that make the breasts bigger. However, in those instances, gynecomastia is the symptom rather than the cause.

There are a few rare conditions in men that can cause breast lumps in men and enlarged breasts. If you notice these symptoms, it is worth getting a checkup with your GP. Again, gynecomastia can sometimes be a sign of hormonal problems, but it does not lead to cancer.

Breast cancer can occur in men, but it is extremely rare. It tends to form away from the nipple in different area of the breast altogether, rather than palpable lumps below the nipple like gynecomastia. The two are totally separate conditions.

Learn about the latest gynecomastia treatments

If you have enlarged male breasts, you probably want to know how to get rid of gynecomastia for good. The good news is that you don’t have to wear t-shirts to the beach for the rest of your life. There is something you can do to treat gynecomastia.

Gynecomastia medication

There is very little research to show that gyno treatment pills and male breast reduction pills will help matters. There have been studies on gynaecomastia medicines that tried to shrink down the gland, but results were limited. Instead, surgery is often the preferred course of treatment to date.

Exercises for gynecomastia

Pseudo gynecomastia can often be treated with diet and exercise since it is normally caused by excess fatty tissue due to weight gain. In these cases, liposuction can help remove the fat. Real gynecomastia, the kind caused by a gland problem, cannot be fixed by exercise alone and requires surgery. Some men choose not to treat gynecomastia and live with man boobs, while others seek treatment. Since it is a cosmetic issue, the choice is yours.

Gynecomastia surgery

Pseudogynecomastia surgery

Fatty tissue can be treated with VASER liposuction. Doctor Bernard will remove the fat from your chest using the latest treatment. High-definition treatment is also available. High definition just means that there is much more aggressive liposuction in the treatment area. This is usually done for men without too much fat since the skin must shrink down once the fat is removed. That can be more difficult when too much fat is removed, which is why high-definition liposuction isn’t necessarily appropriate for men with too much adipose tissue.

Treatment for real gynecomastia

If you have true gynecomastia, then surgical removal of the gland is necessary to correct the problem. The fatty tissue can also be refined with liposuction to create a normal male chest. The results of surgery are long-lasting and treatment has a high patient satisfaction rating among men who are treated.

Who is a good candidate for surgery? 

If you have man boobs and it is not some other issue (i.e. cancer), you can get surgery to give your chest a normal appearance. You can read more about whether you should try gynecomastia surgery in this link. If gynecomastia bothers you, a consultation with Dr. Bernard Beldholm can help you decide if surgical removal is right for you.

Recovery after gynecomastia surgery

Recovery time depends on the extent of the operation and also whether high-def VASER is used. Recovering from Gynecomastia liposuction-only treatment usually takes a few weeks. There are no drains. Most men can get back to work and driving in a few days and return to the gym in about four weeks.

High-def liposuction has a bit more bruising and swelling. Usually one week off work and driving is needed for this.

If the gland is removed and you have liposuction, drains are needed for four days, and you’ll need one week off work and driving.

How fast will you see results?

After surgery, the chest area will be swollen at first. This happens because any surgery is a trauma. Your body’s normal response to any trauma is swelling.

The swollen tissue will go down over time. Swelling often peaks at the two-week mark, then subsides over the next few months. The male breasts continue to heal and settle into their final shape. Final results are visible around 3-6 months after surgery.

Will the gland come back once removed?

There is a small chance that the gynaecomastia will come back. Research literature demonstrates around a 10% chance of this happening.

Gynecomastia surgery before and after photos

A picture is worth a thousand words. It always helps to see before and after photos when you are considering cosmetic surgery. View real patient ‘before and after’ photos from men who have had gynecomastia surgery with Doctor Bernard to get an idea of what your final results might look like.

Scars after gyno surgery

All surgery leaves scars. Gynecomastia scars are very minimal. Usually there is a small scar beneath the nipple. It will not be obvious that you had gynecomastia treatment.

Everyone scars differently, and scar healing cannot always be predicted. The smartest thing you can do is choose a qualified surgeon who is experienced in gynecomastia gland removal surgery.

Gynecomastia scar care

Scar care after surgery is essential. Once the incision is healed, you can begin scar treatment. Keeping the skin hydrated is important for scar healing. There are also topical gels containing silicone or centella asiatica (also known as gotu kola) for scars. LED light therapy and Laser Genesis are great for speeding healing and fading scars.

What do the scars look like?

There will be a small scar near the nipple. It is normal for scars to start dark red or brown at first. They can sometimes appear to get worse around 6 to 8 weeks. That is because circulation increases at the site of the incision where the skin is attempting to heal itself.

Don’t worry, though. The scars will eventually fade to medium pink or brown in the first 3 to 4 months. By the 6th month, they are often a soft pink or brown color. They will only get better looking from there. Eventually, there will be a tiny scar that blends in with the skin around it. Mature scars usually lack pigment, so it can be slightly off-color compared to the normal skin around it.

It can take 1 to 2 years for the scars to mature, at which point they normally lose pigment and blend in with your skin. A faint line will remain, but again it is a small scar that is really not noticeable. If the scars are healing slower than you’d like, there are cosmetic treatments like Laser Genesis that may help.

Please note that these timeframes are just estimates. Healing does not occur on a fixed timeline. Everybody is different.

Gynecomastia FAQ’s

Download our free ebook: “Gynaecomastia Surgery – Must know facts”

Gynaecomastia Surgery Handbook

Gynecomastia is not something men like to talk about. Because of this, many men who suffer from “man boobs” have concerns. These are some of the most common questions asked by Dr. Beldholm’s patients over the years.

Can I have gynecomastia in one male breast?

Some men wonder ‘Can hormones cause one breast to swell?’ Yes, it is possible to develop gynecomastia in only one breast. While possible, this is not very common. Research shows that only about five percent of affected men have unilateral (or one-sided) gynecomastia.1 Treatment options are the same, except only the affected breast may need to be treated.

How common is gynecomastia?

It is estimated that up to 70 percent of males develop gynecomastia at some point in their life. This most often occurs in puberty when breast tissue in boys tends to grow. Frequently, the breast tissue reduces in size over time. It may persist into adulthood, however. Even if it goes away, gynecomastia sometimes comes back. It normally peaks in adult men between age 50 to 69, affecting nearly 1 in 4 patients in this age group. Steroid users are also at a high risk for gynecomastia, which may be permanent.

How to hide gynecomastia with shirt off?

Gynecomastia is a problem because it can be hard to hide. You may think it is as easy as throwing on a shirt, but men who have it can tell you that this is not always the case.

The contours of the chest often show through clothing. That means you’d have to wear shirts made from thicker material, which can be expensive and uncomfortable on hot days. You can also wear an undershirt, but again layering is not always comfortable. It gives you more laundry to do and can make you sweat. Plus, adding layers just adds bulk to already-big male breasts.

Gynecomastia surgery can help if you are tired of hiding man boobs under clothes.

Does gynecomastia go away in adults?

Many boys develop gynecomastia during puberty. It is common for teens to worry about how to get rid of puffy nipples during puberty Thankfully, it goes away for some young men without doing anything. That is not always the case, though. Sometimes gynecomastia carries on into adulthood. Many patients have had man boobs for decades.


  1. Blau, Mordecai, et al. “Anatomy of the Gynecomastia Tissue and Its Clinical Significance.” Plastic and Reconstructive Surgery. Global Open, Wolters Kluwer Health, 30 Aug. 2016, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5010345/.
  2. Dickson, Gretchen. “Gynecomastia.” American Family Physician, 1 Apr. 2012, https://www.aafp.org/afp/2012/0401/p716.html.
  3. “Enlarged Breasts in Men (Gynecomastia).” Mayo Clinic, Mayo Foundation for Medical Education and Research, 2 Oct. 2019, https://www.mayoclinic.org/diseases-conditions/gynecomastia/symptoms-causes/syc-20351793.
  4. Jones, Jeremy. “Gynecomastia: Radiology Reference Article.” Radiopaedia Blog RSS, https://radiopaedia.org/articles/gynaecomastia?lang=us.
  5. Popli, Manju Bala, et al. “Pictorial Essay: Mammography of the Male Breast.” The Indian Journal of Radiology & Imaging, Medknow Publications, 2009, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2797738/.
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