Gynecomastia in Adolescents

Congenital or Hereditary Gynecomastia is usually evident by the ages of 10 to 12 in boys. Thirty percent to sixty percent of young boys suffer from large male breasts and as many as thirty percent may live with enlarged male breasts for the rest of their lives. Gynecomastia in teenagers may also occur as a result of obesity, and less often for hormonal reasons, such as Klinefelter Syndrome and testicular tumors. In many cases, though, no specific cause of the gynecomastia can be found.

In true gynecomastia, the breast enlargement is due to glandular breast tissue (mammary tissue), and in pseudogynecomastia, excess adipose tissue is the cause of the enlarged chest. It is marked by the diffuse fatty tissue infiltration of the breast & axillary (armpit) areas. In pseudogynecomastia cases, diet and exercise may be advised before considering surgical procedures.  In many adolescent gynecomastia cases, both the glandular and fat tissues are present.  In these cases, the adolescent develops larger-than-normal deposits of glandular and adipose tissue, and these tissues may be permanent.

Having large male breasts may be a significant psychological and social problem for adolescents and, in fact, may leave a negative impact that carries on into adulthood.  Protruding breasts in young males often leads to teasing from peers, and often the adolescent will use avoidance in dealing with the condition.  Behavior often includes hiding the chest in public, such as swimming or taking their shirt off, withdrawing from others.

During adolescence, nearly two-thirds of all gynecomastia cases are bilateral but often each breast can be affected to different degrees. Adolescent gynecomastia often regresses spontaneously within six months of onset, 75 percent within two years, and nearly 80 to 90 percent resolve within three years. By the age of 16 to 17, this condition decreases in about 2/3 of young adult males. Dr. Blau's observation is that in severe adolescent cases, there may be residual glandular tissue, and in many other cases involving tubular or saggy breasts, gynecomastia may still remain behind the nipple-areola complex well into adulthood and is mostly permanent.

Gynecomastia treatment mainly consists of male breast reduction surgery. In Dr. Blau's opinion, there is an obvious indication that male breast surgery should be performed in selective cases.   After 25 years and a significant number of adolescent patients, Dr. Blau has developed a keen sense of when adolescent requires early surgical intervention.  When confronting adolescent patients, conservative measures should be attempted prior to the consideration of surgical intervention. As with all cosmetic surgery, results will be rewarding if expectations are realistic. All surgical procedures carry some risk which your doctor will discuss with you.

The following adolescent male breast reduction before-and-after photos will give you a sense of the results Dr. Blau has achieved in teenager gynecomastia surgery. However, each patient is unique and previous results are not a guarantee for individual outcomes.

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