Gynecomastia – causes and treatment options


Gynecomastia is an enlargement of the mammary gland in men, with increased breast tissue being formed. This enlargement can occur bilaterally, but also unilaterally. Often the affected patients have a feeling of tension in the breast area and hypersensitive nipples.

In most cases, gynecomastia is benign, but especially if it occurs unilaterally and the patients have reached an older age, breast cancer may also be responsible.

Blood work can be ordered from a general practitioner or else from a specialist, such as an endocrinologist or internist, by means of a laboratory test. Your blood will be tested for hormones, liver and thyroid levels. An ultrasound and mammography may also be performed.

Pathogenesis in gynecomastia usually unknown.

The origin of a disease, also called pathogenesis, is unknown in half of all patients. A distinction is made between physiological and non-physiological gynecomastia.

For example, 90% of all newborns develop gynecomastia, but even in puberty there is still a 50-70% chance of suffering from gynecomastia. Here it is hormones or but also overweight that can lead to gynecomastia. Often there is an imbalance between testosterone, the male sex hormone, and estrogen., the female sex hormone. The increased estrogen level can cause increased formation of glandular tissue.

If breast gland enlargement occurs due to a pathological change, it is considered non-physiological. This may be due to medication, for example, or hormonal imbalances. Approximately half of all men have to deal with gynecomastia at some point in their lives.

The enlargement of the mammary gland can be divided into different degrees:

  • Grade 1 – small inconspicuous male breast.
  • Grade 2 – breast resembles a young girl’s breast
  • Grade 3 – the breast is very pronounced with an underbust crease

How we can help you

Gynecomastiacan be treated conservatively or surgically. Conservative treatment involves relieving symptoms and rebalancing hormones. If you get conservative treatment, you may be able to prevent or slow down further breast enlargement, but you won’t be able to shrink the change. If you decide to have surgical treatment, that’s where we come in.

Do you suffer from pseudogynecomastia? This is the enlargement of the breast without the formation of glandular tissue. In this form, Dr. Bernard can help you with liposuction. In this procedure, a small incision is made at the edge of the pectoral muscle, a fluid is infiltrated, and the fatty tissue to be suctioned becomes larger. After that, the fatty tissue can be suctioned out.

If your gynecomastia is severe, Dr. Bernard can help you with liposuction in addition to breast reduction.

If you suffer from true gynecomastia, this can also be effectively operated on. Dr. Bernard can perform liposuction and male mammary gland removal, also called andromastectomy, in these circumstances. In this procedure, excess glandular tissue is removed through an incision in the nipple area. This surgery can also reduce the size of the nipple, which usually looks larger in gynecomastia. Drains are then additionally placed in the tissue to ensure the drainage of tissue fluid.

If you suffer from Deutinger’s grade 3 gynecomastia, breast reduction may also be indicated. In that case, the glandular tissue is removed and then a breast lift is performed.

What to keep in mind after the surgical treatment

The treatments take place under general anesthesia. If only liposuction is planned for you, it can usually be performed on an outpatient basis, which means you can go home a few hours after the procedure.

In general, we can say that hematomas (bruises), post-operative bleeding and wound healing problems may occur, but these are rare.

In the initial phase after surgery, wear a compression vest to prevent or relieve swelling, water and bruising.

You should also avoid sports and take it easy for at least 6 weeks.