Gynecomastia is produced by a hormonal alteration that can develop, fundamentally due to two reasons: one, the decrease in the production of androgens (testosterone) and an elevation in the production of estrogens, and two, an increase in the transformation of the precursors of androgens into estrogens.

In most cases Gynecomastia is nothing more than excess fat accumulated in the breasts


In these cases, the solution lies in a non-surgical treatment called Hydrolipoclasia. However, when the mammary gland is regrown, a more complex surgical intervention must be performed, in which in addition to fat, glandular tissue is removed from the breasts.

What is gynecomastia?

The term gynecomastia indicates the abnormal development of breast size in men. The resulting swelling of the breast gives it a typically feminine appearance.

In most cases, this resemblance has important psychological repercussions. Usually, the difficulty of living with the disease translates into social and sexual problems. The problem is so widespread that the number of males who have undergone surgery in recent years has increased considerably.


Gynecomastia can be unilateral or bilateral, and initially manifests itself with increased sensitivity and the appearance of painful lumps under the nipple area. At a later stage there is increased swelling associated with the deposition of adipose tissue and increased glandular tissue.

Causes of gynecomastia

There are numerous causes for the appearance of gynecomastia, among the main ones are genetic, hormonal, pharmacological and those dependent on other diseases.

Drugs such as anabolic steroids, those used in the treatment of HIV, antiandrogens or antidepressants are just some examples of medications that may favor the appearance of the disorder.

Similarly, pathological conditions such as hypogonadism or certain types of cancer can cause hormonal imbalances leading to the development of gynecomastia.

Considering what has been said so far, it is therefore clear that the main cause of the appearance of this condition lies in the disturbance of hormonal balance. In particular, an imbalance is created in the metabolism of testosterone and estrogen in favor of the latter. The increase in estrogen and/or the body's sensitivity to estrogen can occur due to:

Excess testosterone: it occurs naturally at puberty (pubertal gynecomastia), or "artificially" as a result of taking anabolic steroids. The body tries to protect itself from an excess of androgens by converting part of them into estrogens, typically female hormones that are responsible, among other things, for breast development.

Excess estrogen: it is produced naturally (genetic predisposition) or due to promoters, such as drugs, pesticides, and other pollutants.

Types of gynecomastia

Depending on its origin, gynecomastia is classified into:

Pubertal ginecomastia: it is a physiological process that occurs at pubertal age (12-17 years) when intense hormonal production causes excessive development of the mammary glands. This phenomenon usually subsides in a couple of years.

Congenital gynecomastia: the main cause is given by the alteration of the hormonal balance that can have a family connotation (inheritance).

Induced gynecomastia: in these cases, the causes are found in the assumption of certain drugs that can compromise the natural hormonal function.

Depending on the distinctive characteristics of gynecomastia, it can be classified into:

True gynecomastia: the increase in breast volume is due to an increase in the glandular component.

False gynecomastia (or pseudogynecomastia): the increase in breast volume is due to increased adipose tissue in the breast area.

Mixed gynecomastia: the increase in breast volume is due to the interaction of the two factors described above.

Nowadays, gynecomastia is a widespread phenomenon, especially if we also consider the so-called "false gynecomastia". The significant increase in the number of cases in the last decade suggests that in the future there will be a further spread of the problem (especially in industrialized countries).

Surgical treatment of gynecomastia

In the case of "true gynecomastia" regression of the disease can only occur at puberty, after this period the chances of spontaneous regression are extremely low. This type of pathology requires surgery.

On the contrary, if the gynecomastia is due only to localized fat and muscle relaxation, the chances of recovery are higher. Surgery is not always necessary, as the condition can be treated simply with a dietary program aimed at reducing body fat and toning muscles.

Surgical intervention strategies differ depending on the nature of the problem.

If for excess adipose tissue it is usually sufficient to perform a "simple" liposuction under local anesthesia, for excess glandular tissue it is necessary to perform surgical removal of the mammary gland.

In the latter case, the operation lasts about an hour and is performed in the day hospital. A small incision is made in the lower half of the areola to allow the removal of the glandular tissue. After a few days, the patient can resume daily activities.




Minimum rest 3-5 days


1 month without sports


Local o Full


1 month


1 month

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