Experts explain the causes of and treatments for gynecomastia, or male breast enlargement.
By David Freeman
Elliot W. Jacobs, MD, knows a thing or two about enlarged breasts in men, and not just because he specializes in treating the condition.
“My own breasts became enlarged when I was a teenager,” says the New York plastic surgeon. “It was very embarrassing. Once, I went to my locker after gym class and saw that a classmate had hung a bra on it.”
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Millions of men and boys know what it’s like to have enlarged breasts (sometimes called man boobs or “moobs,” or, in doctor talk, gynecomastia). In many cases, it doesn’t have to be a permanent condition.
Why It Happens
Male breast enlargement can start in puberty as hormone levels are shifting. In those cases, it typically doesn’t last long, ending without treatment as hormone levels settle down.
Enlarged breasts can also start in adulthood. As men age, they tend to lose testosterone and gain weight. Lower testosterone can lead to enlargement of glands in the breasts. Extra weight adds fatty tissue under the breasts. That can leave a man with bigger glandular tissue and more fat in his breasts. Fat cells make small amounts of estrogen, which can further enlarge men’s breasts.
Though it can be embarrassing, male breast enlargement usually isn’t a health threat. But in some men, it can be a sign of low testosterone, an overactive thyroid, cirrhosis of the liver, a genetic problem, or some cancers. Certain medications can also cause gynecomastia. Common culprits include anabolic steroids, as well as the stomach acid drug cimetidine (Tagamet), the heart drug spironolactone (Aldactone), the prostate cancer drug bicalutamide (Casodex), and several other drugs.
In many cases, stopping the offending drug and switching to another helps reduce enlarged breasts.
Abusing alcohol and marijuana can also contribute to gynecomastia.
In many cases, the exact cause isn’t clear. It’s wise to make an appointment with a board-certified endocrinologist to make sure, even if your male breast enlargement hasn’t bothered you a lot.
How to Treat ‘Man Boobs’
The treatment depends on the cause.
If another health condition is causing your enlarged breasts, treating that underlying condition may help.
If the reason for enlarged breasts is being overweight, weight loss is often the first step, says Glenn Braunstein, MD. That’s good for your overall health, too. Braunstein is chairman of the department of medicine at Cedars-Sinai Medical Center in Los Angeles.
If you have a lot of weight to lose, it may not shrink your breasts back to normal size, due to the stretched-out skin. Plastic surgery is an option for that.
Surgical options for enlarged breasts are to get liposuction to remove fat and scalpel surgery to remove glandular tissue. A plastic surgeon does the surgery, which takes 60-90 minutes. It’s an outpatient procedure, meaning no overnight stay, and it often dramatically improves appearance.
Jacobs has never sought treatment for his own breast enlargement.
“Over the years, I sort of got used to it,” he says. But he has done breast-reduction surgery on more than 1,500 men, transforming lives in the process. “For the first time in years, these men are standing up straight and wearing tight shirts,” he says. “Literally and figuratively, a weight has been lifted off their chests.”
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