What is gynaecomastia?

Gynaecomastia is swelling of the breast tissue in boys and men, caused by an imbalance of the hormones oestrogen and testosterone. Gynaecomastia can affect one or both breasts, sometimes unevenly.

 Baby boys are often born with gynaecomastia, caused by high levels of their mother’s circulating oestrogen, but it settles in weeks.

The next peak is in teenagers (1in 4) when it is tender and firm and very embarrassing. Fortunately, it usually settles within a couple of years. A minority come to surgery where the tissue is excised via a semicircular incision around the areola (the pink skin around the nipple)

In adult life, there are a variety of causes from medical conditions such as testicular disease and cirrhosis, various medications and street drugs. Bodybuilders taking anabolic steroids are at great risk of developing gynaecomastia.

Middle-aged men (1 in 3), as they put on weight, develop a soft fatty version. This can be of feminine proportions.

These fatty breasts respond well to liposuction. The breast disc below the nipple tends to contain a higher proportion of glandular tissue and may need to be directly excised.

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