ژنیکوماستی چیست؟
Gynecomastia is defined as a condition in which a man’s breasts become larger than normal. This condition can occur naturally during hormonal changes such as at birth, adolescence, or old age. It can also occur abnormally due to congenital or hereditary factors, or as a result of steroid use, medications, and medical conditions such as hypogonadism, liver failure, and kidney failure.
According to Dr. Mohammad Hadadi Aval, the best gynecomastia surgeon in Mashhad, most of the patients who visit his clinic have congenital or hereditary disorders. However, it is said that in the majority of cases, the cause of breast enlargement in men remains unknown.
What does breast enlargement in men indicate?
Male breast reduction surgery in Mashhad is an effective method for treating enlarged breasts in men, which may be caused by genetic factors, obesity, or hormonal imbalances. In this procedure, excess fat and glandular tissue are removed to create a more natural and masculine chest appearance. In Mashhad, specialized surgeons like Dr. Hadadi Aval perform this surgery using advanced techniques, achieving desirable results with minimal complications. If you are suffering from gynecomastia, you can book an appointment with Dr. Hadadi in Mashhad to receive expert consultation and the most suitable treatment.
What is Gynecomastia in Men?
Gynecomastia is a condition associated with an imbalance of the body’s hormones, primarily estrogen and testosterone. When this hormonal balance shifts in favor of female hormones—either due to low testosterone levels or high estrogen levels—gynecomastia is likely to occur.
At birth, it is naturally seen due to elevated maternal estrogen levels in the newborn’s bloodstream. Among adolescent boys, it occurs as a result of an imbalance between estradiol and testosterone. In men over 60, breast enlargement is caused by a decrease in testosterone levels and a change in the testosterone-to-estrogen ratio.
Abnormal enlargement of the male breasts may result from the following factors:
Abnormal Breast Enlargement in Men Due to Medications
Anabolic steroids, narcotics, cimetidine, marijuana, spironolactone, ketoconazole, finasteride, anti-ulcer drugs, anti-anxiety medications, digoxin, thiazides, estrogens, phenothiazines, theophylline, and certain chemotherapy drugs can cause abnormal enlargement of the male breasts.
Abnormal Gynecomastia in Men Due to Medical Conditions
Breast enlargement in men can occur as a result of medical conditions such as: testicular cancer, obesity, testicular hypofunction, adrenal gland tumors, hyperthyroidism, cirrhosis, kidney failure, malnutrition, and tumors of the pituitary gland and lungs.
Types of Male Breast Enlargement
Male breast enlargement is classified into five main types:
Physiological (Temporary) Male Breast Enlargement
Breast enlargement can occur naturally in newborns due to hormonal imbalances. Gynecomastia also commonly begins in boys during adolescence, potentially lasting into early adulthood before gradually resolving. A natural increase in breast size can also reappear in older men as they age.
Pathological (Permanent) Male Breast Enlargement
Male breast enlargement can result from acquired factors such as marijuana, heroin, alcohol consumption, hair loss medications like finasteride, steroid and testosterone use. Additionally, thyroid disease, kidney failure, cirrhosis, and certain cancers such as tumors of the testicles and adrenal glands can cause breast enlargement in men.
Congenital and Hereditary Male Breast Enlargement
Male breast enlargement can occur in a hereditary form, affecting one or both breasts. Individuals with this condition experience it from childhood and adolescence, and after puberty, due to the peak of growth hormone and sex hormones, they observe an increase in their breast size.
Unilateral Gynecomastia
In this type of male breast enlargement, only one breast is affected. Click to view images of the unilateral type.
Gynecomastia in Athletes
Following the use of anabolic steroids and testosterone, often aimed at preparing for bodybuilding competitions, breast enlargement is common among athletes. Click to view images of gynecomastia in bodybuilders.
Pseudogynecomastia (False Male Breast Enlargement)
False breast enlargement in men occurs due to the accumulation of fatty tissue in the chest, often following weight gain. In most cases, this condition can be treated with exercise and a proper diet. In severe cases, surgical correction may be recommended.
Is Every Male Breast Enlargement Equivalent to Gynecomastia? (What Does Breast Enlargement in Men Indicate?)
In response to the question, “What does breast enlargement in men indicate?” according to the professional experience of Dr. Mohammad Hadadi Aval (the best gynecomastia surgeon in Mashhad), male breast enlargement must meet the following conditions to be considered gynecomastia:
- The breasts are enlarged beyond the usual size.
- The condition has been present for several years.
- The size and color of the areolas have changed.
- The condition has not improved with exercise and dietary changes.
In abnormal gynecomastia, the size and diameter of the areolas are larger than those of a normal male breast, and their color resembles that of female areolas—sometimes lighter or darker than usual—differing significantly from the areola color of a normal male breast. In most patients, breast enlargement is bilateral, but it can also be unilateral. In bilateral cases, usually one breast is larger than the other. Patients sometimes complain of breast pain and tenderness. The size of the areolas may change under certain conditions such as exposure to cold or heat, or by finger stimulation, which is a common finding. Occasionally, patients report clear or white discharge from the nipples.
For more information about male breast enlargement and its stages, watch the comprehensive video by Dr. Mohammad Hadadi Aval, the best gynecomastia surgeon in Mashhad.
Gynecomastia Progression (Grades)
Gynecomastia in men is usually classified into 4 grades:
Grade 1 Gynecomastia
In grade 1 gynecomastia, the individual feels a small lump in the central area of the chest. The breast size is not significantly enlarged yet. In some cases, the person may complain of chest pain. This is the typical form seen in adolescents and often resolves on its own over time. Medications are usually effective at this stage. The image below shows grade 1 gynecomastia.
Grade 2 Gynecomastia
According to the gynecomastia specialist in Mashhad, in grade 2 gynecomastia, the issue extends beyond a simple lump, and the individual begins to notice abnormal growth of one or both breasts. The size and color of the areola have changed. At this stage, the person may also complain of pain. The image below shows grade 2 gynecomastia.
Grade 3 Gynecomastia
Most patients seek medical attention during grade 3 gynecomastia. At this stage, the breasts are usually significantly enlarged. The size and color of the areolas have changed. The individual often experiences a decrease in self-confidence and prefers to wear loose-fitting clothing. These individuals tend to avoid gyms and swimming pools, or they try to hide the condition by slouching their head and shoulders forward while walking. Over time, this posture may become permanent, resulting in a hunched appearance. Grade 3 gynecomastia is more commonly seen in adolescents. The image below shows grade 3 gynecomastia at the specialized clinic of the top gynecomastia surgeon in Mashhad.
Advanced Gynecomastia – Grade 4
Grade 4 gynecomastia is the most advanced stage. The breasts are severely enlarged and have a sagging appearance. At this stage, the nipples are noticeably pointed downward. Grade 4 gynecomastia significantly affects the patient’s self-confidence, and the individual may experience confusion regarding their gender identity. Some patients may also suffer from varying degrees of depression and psychological distress. The image below shows grade 4 gynecomastia.
Contrary to popular belief that fat is the sole cause of male breast enlargement, gynecomastia actually results from the enlargement of glandular tissue in addition to fat accumulation. Estrogen is the hormone responsible for stimulating glandular growth. It also suppresses luteinizing hormone (LH), which is responsible for testosterone production in the testes, and this hormonal imbalance leads to the development of gynecomastia.
In the natural form seen during adolescence, a more rapid rise in estradiol compared to testosterone creates a temporary hormonal imbalance, which typically resolves over time as testosterone levels increase.
Tumors of the adrenal glands, pituitary gland, and testes, as well as certain liver and thyroid disorders, can also increase the ratio of estrogen to testosterone, resulting in gynecomastia.
From a pathological perspective, three histological types of gynecomastia have been identified: florid, fibrous, and intermediate, which are generally related to the duration of the condition. The florid type is usually seen in the early stages and is characterized by an increase in vascular and ductal tissue. The fibrous type is observed after about one year and consists predominantly of stromal tissue with fewer ducts. The intermediate type is believed to represent the transitional stage between florid and fibrous forms.
In the differential diagnosis of male breast enlargement, conditions such as breast cancer, lymphoma, lipoma, and dermoid cyst should be considered.
Complete Excision of Bilateral Gynecomastia Tissue Without Liposuction in an 18-Year-Old
Male Breast Reduction in Mashhad
If you are looking for male breast reduction in Mashhad, choosing the best gynecomastia surgeon in Mashhad plays a crucial role in the outcome of your surgery. Dr. Hadadi (Gynecomastia Specialist in Mashhad), with extensive experience and expertise in gynecomastia surgery, is considered one of the leading options for this procedure. To book an appointment with Dr. Hadadi in Mashhad, you can use the online scheduling page and receive a detailed consultation to choose the most suitable treatment method. Gynecomastia surgery can improve your self-confidence and give your chest a more proportionate and masculine appearance.
How Is Gynecomastia Diagnosed?
Gynecomastia is diagnosed based on clinical examination and medical history.
Patients are usually young men or adolescent boys who visit a doctor due to varying degrees of breast enlargement. Most commonly, they report decreased self-confidence. Some patients also seek medical attention because of pain in one or both breasts.
In the medical history of individuals with gynecomastia, factors such as family history, duration of the condition, associated symptoms, and potential issues with certain organs—including the liver, kidneys, adrenal glands, prostate, lungs, testes, or thyroid—are particularly important.
موارد مورد ارزیابی در کوچک کردن سینه مردان در مشهد
بررسی دقیق سابقه خانوادگی، سابقه ژنتیکی، داروها و مصرف مواد مخدر نیز باید در نظر گرفته شود. معاینه فیزیکی کامل ودقیق ضروری است. معاینه سر و گردن برای کشف توده غیر طبیعی یا بیماریهای تیروئید میبایست انجام شود. سینهها از نظر ماهیت بافت، وجود توده، تغییرات پوستی، ترشحات نوک سینه، عدم تقارن و وجود درد به بطور کامل باید ارزیابی شوند.
بیضهها باید از نظر عدم تقارن، بزرگ شدن یا کوچک ماندن بررسی شوند. در مردانی که خصوصیات زنانه دارند درخواست آزمایشات هورمونی و آزمایشات ژنتیک ضروری است.
نوع کاذب ژنیکوماستی را میبایست ازنوع واقعی آن افتراق داد. در نوع کاذب تجمع بافت چربی وجود دارد و این وضعیت اغلب دوطرفه است. در بیشتر موارد، توده چربی برای سالها باقی میماند. هنگام مشاهده چنین مواردی باید محتاطانه تصمیمگیری شود.
هر تغییر در ظاهر گامی است در جهت اعتماد به نفس بیشتر.
