Overview

Gynaecomastia, also colloquially known as ‘man boobs’, is a common condition that causes male breast tissue to overdevelop and swell, sometimes giving an appearance similar to female breasts. The condition may affect one or both sides, although it often develops unevenly. 

What Are ‘Man Boobs’?

The term ‘man boobs’ is used to refer to excessive growth of breast tissue in men. For some men, it is possible that they will only experience slight changes, for example slight puffiness around the nipple. However, other men may experience significant changes in the way their chest appears and they can develop breasts that are particularly prominent.  

Although ‘man boobs’ are not a medical emergency, they can cause pain and discomfort in some men. If this is the case, then male breast tenderness and pain should be fully investigated to establish if there are any underlying issues. Generally, however, the biggest impact of excess male breast tissue is a psychological one. 

What Causes Men to Develop Gynaecomastia?

Many men are left wondering what causes Gynaecomastia as they seek an effective way to deal with this condition. Although men of any age can be affected, it is generally seen in teenagers or those who are aged 50 or over.  

A common misconception is that excess male breast tissue is caused by being overweight. While weight is often an issue, and one that can be rectified with exercise and diet, there are other causes that need to be addressed with surgery. 

Hormone imbalance 

Both men and women have the hormones testosterone and oestrogen in their bodies. It is oestrogen that is responsible for the development of breast tissue. Usually, a man’s testosterone levels will be high enough to stop breasts developing, however, when the level of oestrogen is too high, it can take over resulting in the growth of excess breast tissue.

In cases where hormones are responsible, men, just like women, have no control over how much their breasts will develop. 

Weight

Being significantly overweight or obese, can also affect hormone levels. Being obese sees more oestrogen being produced causing breast tissue to grow. There is also likely to be excess fat in the chest area which adds to the appearance of breasts. Being overweight can often be attributed to a lack of exercise and a diet high in sugar and fat.

Puberty 

As teenage boys are going through puberty, their hormone levels can vary dramatically. If there is a drop in testosterone at any point this can see the breast tissue increase.

Older age 

As men get older, they tend to produce less testosterone. This generally starts to happen from the age of 50. By this age, it is also more common for men to be overweight, which may contribute to the problem.

Medical conditions 

Excess male breast tissue can also be caused by certain health conditions, including thyroid disorders, liver disease, kidney disease, lung cancer, infections or tumours in the testicles, or the presence of tumours on the pituitary gland or adrenal glands. These conditions can all influence hormonal imbalances which may result in excess breast tissue growth in men. 

Genetics 

Klinefelter syndrome, a genetic disorder where boys are born with an extra X chromosome, also causes Gynaecomastia. However, it is worth noting that this is a rare condition that affects just one in every 660 men. 

Why Do Men Seek Treatment for ‘Man Boobs’?

‘Man boobs’ can have a material impact on an individual’s life and it is very common for men to seek treatment as a result.  

Quite often the prompt to seek treatment is physical discomfort, as commonly ‘man boobs’ can be tender and cause considerable pain.  

Perhaps more common a reason to seek treatment is the psychological effect ‘man boobs’ can have on a person’s emotional wellbeing. Many men report a loss of self-confidence, and some will avoid certain activities such as exercise or swimming to avoid being seen and judged in public. Long term this can cause significant emotional distress. 

How Can Man Boobs Be Treated?

Knowing the causes of gynaecomastia will determine how it should be treated.

In cases of teenagers with fluctuating hormone levels, this is often something that will correct itself and the appearance of breasts may only be temporary.  

There are other occasions, even when the development of male breast tissue has been linked to puberty, that the appearance of breasts does not reduce and requires treatment.

Where the cause of male breasts is excess fat, caused by being overweight exercise and other changes in lifestyle may help. However, there are times when exercise is not enough due to the changes in hormones triggered by weight gain.

When you are unable to reduce the appearance of male breasts through lifestyle changes alone a consultation with a specialist will allow you to discuss surgical options that are available to you.  

• Liposuction is the main form of treatment for excess breast tissue caused predominantly by fat in men. This involves a cannula being inserted into the chest to break up the excess fat, before it is extracted. This results in a firmer, flatter chest. Depending on your concerns and the extent of the surgery, different types of Liposuction may be used to enhance the final result and potentially reduce recovery time.
• However, Liposuction alone is not always an appropriate treatment for patients with mostly glandular as opposed to fatty breast tissue as the condition can recur. For patients who have excess glandular tissue the breast disc may need to be removed, in combination with Liposuction – this is known as Webster’s surgery. This procedure involves a small incision being made around the areola to remove the glandular tissue.
• Male Breast Reduction, or Gynaecomastia surgery, typically takes around one to two hours to complete and is usually performed under general anaesthetic. 

Should I See a Doctor if I Have Male Breast Pain?

As is the case with woman, male breast pain also needs to be investigated. It is possible that pain could be caused by something as simple as a muscle strain from exercise however it could also be a sign of something more serious. As men are born with breast tissue just like women, it means that they are also at risk of developing breast cancer. Although breast cancer is far rarer in men than it is in women there are still around 350 cases each year in the UK.

Causes of male breast pain could also be down to a cyst or the existence of Gynecomastia itself. Breast tenderness in men should not be ignored as with many conditions, the sooner that it is diagnosed the better the chances of treatment working, and a full recovery being made.  

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