14 year old boy with teen gynecomastia more pronounced on the right than left. The gynecomastia causes a ballooning of the nipple area and a feminine shape of the chest. The asymmetry is common. After surgical treatment, normal masculine chest is restored, scars easily hidden in the areolar tissue.

How Common is Teen Gynecomastia?

  • 4% of all teen boys will have some “male breasts” between age 10 and 19. pubertal gynecomastia
  • 13-14 are the peak years of male breasts or nipple ballooning, giving the chest a feminine look.
14 yr old boy with nipple puffiness or ballooning caused by stimulated breast tissue. One year later ( age 15) after surgical treatment of teen gynecomastia, masculine chest shape, gynecomastia scar hidden just below nipple.
  • 10% of boys age 17 will have persistent gynecomastia that will not go away without surgical treatment.
17 yr old boy with muscular chest and abnormal nipple projection due to persistent teen gynecomastia. Scars are easily hidden in the axilla or in the darker areolar skin. After one year, athletic masculine chest shape restored without visible scars.

If I have Teen gynecomastia, Does That Mean My Hormones are Abnormal?

No. Hormones are almost always normal with teen gynecomastia

Though very rare in adolescent boys, if hormone levels are abnormal producing an absolute or relative excess of female hormone (pathological gynecomastia), then a search must be made for some abnormality in the body. This search would include an abnormality or tumor of the adrenal gland or testicles or a genetic condition like Klinefelters syndrome.

Taking gym supplements or anabolic steroids can abnormally stimulate breast tissue creating “male breasts”. In the image below, a young boy was given gym supplements to “build muscle”. Even after stopping the supplements, the teen gynecomastia did not resolve. With surgical treatment, his chest returned to a normal shape.

14 yr old boy who took “gym supplements” to build muscle developed teen gynecomastia from stimulation of the breast tissue under the nipple. After surgical treatment, his chest shape is restored.

What Causes Gynecomastia in Teens?

During mid-puberty ( Tanner 3-4) when pubic hair and testicles are enlarging, there is thought to be a transient flux in hormones. At some point the female hormones are more present than the male hormones and the normal small breast tissue under the nipple gets stimulated to grow.

By late puberty ( age 17) with the male hormone surge, there is a regression of the breast tissue under the nipple. For unknown reason, about 10% of boys age 17 will have persistent gynecomastia that will not go away.

In a study that followed boys with gynecomastia and boys of the same age who did not have gynecomastia, over a three year period: no abnormal hormone levels were found to explain the gynecomastia. There was no difference in hormone levels between groups.

When Should a Teen get the Gynecomastia Treated?

How is a young boy whose body is changing each year to explain to peers that the fullness of his chest (gynecomastia) is a normal part of puberty?

While we know that gynecomastia that shows up early in the teen years may regress, there is still a significant psychological and emotional burden when the chest looks feminine. The taunting and teasing can be very traumatizing.

Imagine being a young athlete, in the locker room or at the gym, wanting to work out, but being uncomfortable to be seen without a shirt. Over the last 25 years, treating a large number of boys with gynecomastia, the decision to have surgery is largely decided by the boy himself. By the time a young boy sees the plastic surgeon with his parents, he has struggled long enough and wants to treat the gynecomastia. By the late teen years 16-18yrs, the gynecomastia is likely to be persistent and not regress.

19 yr old boy with teen gynecomastia before and one year after surgical treatment with excision of glandular tissue. Working out or building chest muscle after gynecomastia treatment reveals an athletic male chest shape.
19 yr old boy with teen gynecomastia treated with Aquashape (water-jet) Liposuction. The only scar is in the axilla (under the arm). Using liposuction, the fatty breast tissue was removed to restore a masculine chest. The nipple (areola) area shrinks resulting in a smaller, darker nipple area.

Gynecomastia Treatment in Charlotte, North Carolina

Dr. Ditesheim and his exceptional staff at Ditesheim Cosmetic Surgery are ready to help you take the first step in your liposuction treatment. Dr. Ditesheim welcomes gynecomastia consultations for the Charlotte, North Carolina area. In your initial consultation with Dr. Ditesheim, he will talk with you, review your medical history, examine you and discuss if gynecomastia is a safe procedure for you to consider. 

Reference:

• Lemaine V, Cayci C, Simmons PS, Petty P. Gynecomastia in adolescent males. Semin Plast Surg. 2013 Feb;27(1):56-61. doi:

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