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ADULT GYNECOMASTIA

There are many potential causes of adult gynecomastia. It can simply be a remnant of youth; however the following bring on the majority of causes:

  • Persistent adolescent gynecomastia:25 percent
  • Drug-induced: 10 to 25 percent
  • No detectable abnormality: 25 percent
  • Liver disease and malnutrition: 8 percent
  • Primary hypogonadism (atrophy of the testes): 8 percent
  • Testicular tumors: 3 percent
  • Secondary hypogonadism: 2 percent
  • Hypothyroidism: 1.5 percent

As shown above, 25 percent of cases that present are the remnant of adolescent gynecomastia. For the most part, the rest either have unknown causes, or are drug- or hormone-induced. As men age, testosterone is increasingly converted to estrogen. The gradual decrease of testosterone production accounts for many hormone-induced gynecomastia cases in adult men. Drugs, over-the-counter or otherwise, are another common cause of gynecomastia. For this reason, it is especially important to carefully review and think about any potential risks that may be associated with a substance you are considering taking. In some cases, breast cancer may be present; however, this is seen primarily in men over 70 years of age.

Pseudogynecomastia is male breast enlargement with fat deposits, rather than glandular enlargement, which is the case with gynecomastia. This is commonly associated with significant weight gain. In these cases, the typical patient will state that his breast enlargement was not present as a teenager, but developed later in life as his weight increased. For these patients it is often a possibility to produce a desirable result using liposuction alone.

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All men with enlarged breasts are candidates but the more extreme cases of gynecomastia will require more extensive surgery and possibly skin excision. It is important for the patient to be healthy and emotionally stable. Men whose gynecomastia is exacerbated by drugs should take this into consideration prior to surgery.

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