What causes enlarged breasts in the male, and what can be done?

Understanding Breast Development in Men

Breast development in men occurs when a hormonal imbalance affects testosterone levels and estrogen receptors, leading to enlarged male breast tissue. Gynecomastia occurs when glandular breast tissue grows in one or both breasts, often during pubertal gynecomastia but sometimes linked to health conditions such as chronic liver disease, primary hypogonadism, or even advanced prostate cancer treated with androgen deprivation therapy. Other causes include anabolic steroids, testicular tumors, or pituitary gland dysfunction that alters androgen production and gonadotropin secretion.

While most cases are benign, swollen breast tissue can resemble male breast cancer, making a breast examination important. Treatment ranges from medical management with aromatase inhibitors to surgical treatment, such as male breast reduction, to remove excess breast tissue and restore a more natural chest contour.

Causes and Forms of Enlarged Male Breast Tissue

Enlarged male breast tissue occurs when men develop gynecomastia. There are many causes of gynecomastia in one or both breasts.

Idiopathic Gynecomastia

The most common cause is idiopathic, or unknown.

Pubertal Gynecomastia

Many young men experience pubertal gynecomastia that fades with age, though certain cases of male breast enlargement may follow into adulthood.

Advanced Prostate Cancer

In certain cases, male breast cancer or prostate cancer can lead to enlarged breast tissue. Rare conditions, such as adrenal tumors or testicular tumors, can also cause enlargement of the male breast tissue.

Anabolic Steroids

When hormone changes interfere with testosterone synthesis or decrease androgen production, men may develop gynecomastia with swollen breast tissue, breast pain, or breast enlargement in one or both breasts.

Treatment Options for Male Breast Enlargement

Treatment is typically carried out in the outpatient surgery setting and involves liposuction, direct excision, or a combination of both for comprehensive male breast reduction. Cool Sculpting is also an option for some patients to reduce excess breast tissue. This is done in the office with no downtime. Results are usually very long-lasting, as long as the patient maintains their overall body weight and composition.