Types of Gynecomastia

There is more than one kind of gynecomastia condition. The following types, which are due to hypertrophy of the male breast, generally have the same basic features, but vary in shape, size, and the extent to which they are affected by the surrounding tissues.

There are also types related to one of the breasts and are called unilateral gynecomastia.

1. Normal Gynecomastia

• Neonatal (estrogen via the placenta). Regresses on its own.
• Adolescent: 60-70% in boys 12-15 years old. Sensitivity to palpation / asymptomatic. Regresses on its own in 1-2 years. High estradiol
• Men> 65 years old. Reduction of testosterone. Along with fat deposition leads to increased estrogen and gynecomastia

2. Fluctuating in size nipples

In this type of gynecomastia, the glandular tissue lies underneath the nipple-areola and is extended slightly outwards, giving a conical form to the breast.

3. Pure glandular gynecomastia

It concerns bodybuilders and is caused by anabolic steroid use. Due to low fat level, athletes in this category have a purely glandular form of gynecomastia. In this case, the solution is provided by the surgical removal of the gland. Liposuction is rarely recommended.

4. Adolescent Gynecomastia

This is the congenital and hereditary type of gynecomastia that occurs in boys 9-14 years old. 30-60% of boys of this age have large male breasts. Some of them may live with enlarged male breasts for the rest of their lives, in other cases the gynecomastia will recede with age and the rest will undergo surgery after the age of 18. However, severe forms of adolescent gynecomastia may require a surgical intervention, in consultation with the patient, the parents, endocrinologists and child development professionals.

5. Adult Gynecomastia

It is the most common type of gynecomastia. In this type, the glandular tissue contains a varying extent of fat deposits.

6. Pseudo-gynecomastia

It is composed not of glandular tissue, but of adipose tissue ,that is fat. It looks much like real gynecomastia, but requires different treatment. Exercise and diet may help to some extent. In most cases surgical treatment is required. This is generally the only type of gynecomastia which can be improved with liposuction, though in some cases excision is also indicated.

7. Asymmetric or unilateral gynecomastia.

In this case, the breast enlargement concerns one of the breasts while the other is typically normal in size and shape. Asymmetric gynecomastia occurs when gynecomastia is present in both breasts, each to a different degree.

8. Severe gynecomastia.

It is characterized by excess and/or saggy skin and severely enlarged breasts. This type occurs in older people who have lost skin elasticity. Obese people who have lost a lot of weight either by dieting or through bariatric surgery for obesity belong to this category too.