Joseph A. Mele MD
Plastic Surgery

 

Types of Gynecomastia

Gynecomastia can be classified by type. Usual gynecomastia has two components: glandular tissue and fatty tissue. The glandular tissue is firm, rubber-like, and frequently tender. It is most commonly confined to the area behind the areola and nipple, but can encompass the entire breast in severe cases. The fatty tissue can also occur anywhere in the breast, but is most commonly concentrated in the lower breast. Fatty tissue is soft, so just like fat elsewhere in the body, it can often be removed with liposuction alone. The firm glandular tissue usually requires direct surgical removal.

Gynecomastia can be classified by location, size, cell type or age. Although not a medical term, moobs, the contraction of man boobs, has become a common term for gynecomastia. If you remember what gynecomastia means, moobs is technically more accurate. Here are some common medical terms for gynecomastia, and there are many more:

Gynecomastia classified by location or size

  1. Unilateral Gynecomastia - Gynecomastia only affecting one breast.
  2. Bilateral Gynecomastia - Gynecomastia of both breasts.
  3. Asymmetric Gynecomastia - Gynecomastia that affects both breasts, but is larger on one side. This is the most common morphology.
  4. Puffy Nipples - A common form of gynecomastia confined to the area beneath the areola, causing the nipple and areola to protrude. The more accurate term would be puffy areolae.
  5. Severe Gynecomastia - As the volume of the breasts increases, so does the skin. In cases of severe gynecomastia, the skin becomes lax and looses the ability to retract. Severe gynecomastia is more common in older men, and after massive weight gain and loss. Treatment usually includes removal of the excess breast tissue and may require additional incisions, resulting in scars, for the removal of the redundant skin.

Gynecomastia classified by cell type

  1. Gynecomastia is normally a combination of both glandular tissue and adipose (fat). The glandular breast tissue tends to be firm to hard and tender to touch. Adipose is soft and not usually tender. Sometimes one cell type predominates leading to purely glandular gynecomastia or pseudogynecomastia. Both types are smoothed during Gynecomastia Reduction Surgery
  2. Purely Glandular - Purely glandular gynecomastia is seen in men with a low percent body fat. It is most often seen in body builders and other athletes. This type of gynecomastia is made up almost exclusively of firm glandular tissue. It can be the result of anabolic steroids, which are metabolized into estrogens. Since the tissue is firm and rubber-like, liposuction is not effective and is not usually necessary. A small periareolar incision is usually all that is required to treat this type of gynecomastia. Weight loss is not an effective treatment for purely glandular gynecomastia.
  3. Pseudogynecomastia - At the other end of the spectrum is pseudogynecomastia. Psuedogynecomastia is almost exclusively adipose. It gives the same appearance as gynecomastia; however, pseudogynecomastia is more amenable to diet and exercise and weight loss. The indications for the treatment of pseudogynecomastia are the same as the indication for liposuction elsewhere in the body. When diet and exercise are not effective, and the breast fullness remains disproportionate to the surrounding areas, liposuction can selectively remove the fat from the chest. Sometimes a nodule of glandular tissue maybe hidden in the fat tissue beneath the areolar. If present, the glandular tissue may require a small periareolar incision for removal.

Gynecomastia classified by age

  1. Neonatal - Present at birth. Usually resolves without treatment.
  2. Adolescent - Occurs at puberty and affects more than half of all men ages 9 to 18. For half of these teens, adolescent gynecomastia will resolve in a few years. One third may have some degree of gynecomastia for the rest of their lives. Severe enlargement during adolescence may require surgical intervention.
  3. Adult - The most common form of gynecomastia occurs in adulthood.

Male Breast Reduction (Gynecomastia) Videos

Gynecomastia Reduction Consultations

The best way to explore your Gynecomastia Reduction options is with an private, in-office consultation. During your appointment, Dr. Mele will review what needs to be done to get the best results. Your options, costs and recovery will be discussed in detail, so that you can feel confident in your decisions. To schedule a consultation appointment in our San Francisco Bay Area Plastic Surgery office call (925) 943-6353, or use our contact form.