COVID-19 UPDATE: As of May 11, 2020, we have re-opened our office to regular in-person appointments. We are operating at a lower-than-normal capacity in order to respect social distancing advisories and best protect the health of our patients. We are still offering telemedicine as an option. For more information please call us at (314) 996-8800.


What causes gynecomastia?

Gynecomastia is the development of excessive breast tissue in a male. There are several conditions associated with gynecomastia that can include medications, hormonal imbalances and genetic disorders. Estrogen can cause an increase in male breast tissue whereas androgens limit male breast development. Estrogen is typically linked to female sexual characteristics while androgens are linked to male sexual characteristics. Both men and women possess estrogen and androgen hormones, but these hormones exist in different concentrations between sexes and the tissues of the body may be more or less sensitive to these hormones depending on whether you are male or female. Gynecosmastia can therefore be caused by conditions in which the male breast tissue is more receptive to estrogen than androgens. These causes can be broken down into conditions that cause excessive estrogen production, increased susceptibility to normal levels of estrogen, or conditions in which there is decreased androgen production.

Dr. Terry Myckatyn, MD and Dr. Marissa Tenenbaum, MD

Dr. Terry Myckatyn and
Dr. Marissa Tenenbaum:

Trusted. Experienced. Committed.

In most cases, either no clear cause is ever found for gynecomastia and this is referred to as idiopathic or it is simply due to excessive fatty tissue of the breast. Depending on the level of extra fat and skin, this can be corrected with liposuction alone or a combination of liposuction and excision of skin and tissue.

The causes of gynecomastia are summarized in this table:

Broad Classification     Specific Cause 
Certain medicines Estrogens
  Androgens and anti-androgens
  Some chemotherapy (alkylating drugs)
  Calcium channel blockers (verapamil)
  ACE inhibitors (captopril)
  Dopamine blockers (metoclopromide)
  Central nervous system drugs (TCAs)
  Several others
Street drugs Marijuana
Medical diseases  Liver disease (cirrhosis)
  Kidney failure
  Thyroid disease (thyrotoxicosis)
Gland failure Adrenal gland failure (adrenal hypoplasia)
Cancer Bronchogenic carcinoma (form of lung cancer)
  HCG-secreting tumors of the testicles
  Steroid-producing tumors of testicles/adrenal gland
Congenital disorders Klinefelter’s syndrome
  Androgen-insensitivity syndromes
Miscellaneous Several miscellaneous causes also exist

To learn about which gynecomastia procedure is appropriate for you, see illustration:

Factors to consider when treating gynecomastia

To learn how ultrasonic liposuction is used to treat gynecomastia, how to treat gynecomastia that includes both fibrous tissue and a disk of tissue under the areola, or how to treat gynecomastia with a large amount of male breast tissue or skin excess, such as after significant weight loss, see illustration:

Details of male breast reduction

If you have questions or would like to book a consultation with one of the surgeons at West County Plastic Surgery, please call (314) 996-8800.

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