Gynecomastia progresses gradually in four grades-
Grade 1 Gynecomastia: Only minor enlargement is present, and a localized lump can be felt beneath the nipple or around the areola.
Grade 2 Gynecomastia: Breast tissues expand to the chest width and cover the pectoral muscles. The enlargement may still not be prominent.
Grade 3 Gynecomastia: Moderate enlargement of breasts, which is clearly visible through clothes. The tissues also become firm.
Grade 4 Gynecomastia: This is the most severe grade of gynecomastia, in which the chest appears like breasts and causes physical and psychological issues.
Gynecomastia is classified into various types, including true and pseudo-gynecomastia. In true gynecomastia, only glandular breast tissue is present, while pseudo-gynecomastia consists of excess fat tissue in the chest, resembling female breasts. Typically, individuals with gynecomastia exhibit a combination of both glandular and fat tissues.
Gynecomastia Diagnosis
To diagnose gynecomastia and differentiate between true and pseudo-gynecomastia, physicians employ several methods:
Medical History: The doctor will inquire about symptoms, medical history, and any medications or substances that might contribute to the condition. Certain drugs, such as anabolic steroids, anti-androgens, or those containing estrogen, can contribute to gynecomastia.
Physical Exam: A physical examination is conducted to assess abnormal tissue growth, including examining the size, shape, and consistency of breast tissues, which differ from fat tissues. The pinch test, where the examiner evaluates breast tissue by pinching it, may help distinguish the condition, although it may not always provide conclusive results. Further testing may be recommended if needed.
Blood Test: A complete hormonal profile, via a blood test, can evaluate hormone levels, aiding in diagnosis.
Imaging Test: To assess the extent of growth and rule out breast cancer, imaging tests such as mammography, CT scans, MRI scans, or ultrasounds may be recommended.
Biopsy: If there are suspicions of cancerous breast tissue growth, a biopsy may be performed to confirm the diagnosis.
These tests assist plastic surgeons in determining the most appropriate approach for treating gynecomastia.
Gynecomastia Treatment Options
While gynecomastia often resolves naturally in children, teenagers, and adults and may not require treatment, surgical intervention becomes necessary in persistent cases where breast tissue growth remains even after hormonal balance is achieved. Surgical treatment aims to remove the excess tissue.
Lifestyle Modifications: Initially, lifestyle changes such as weight management, avoidance of specific medications or substances contributing to gynecomastia, and regular exercise may be recommended to manage the condition
Watchful Waiting: For gynecomastia resulting from age-related hormonal changes, doctors may suggest a period of observation to monitor whether the growth stops over time. Regular monitoring of the condition is conducted during this period.
Medications: Although specific medications for treating gynecomastia do not exist, certain drugs can address the underlying hormonal imbalances. For example, selective estrogen receptor modulators (SERMs) like tamoxifen or raloxifene may be prescribed to counteract the effects of estrogen on the male body.
Surgical Intervention: When gynecomastia persists and causes physical and psychological distress, surgical intervention may be recommended. Male breast reduction surgery, known as gynecomastia surgery, combines liposuction and gland excision techniques to effectively address gynecomastia.
The most suitable method for gynecomastia treatment is chosen by the doctor based on individual circumstances.
