Except for occasional cases in which excess fat alone is the culprit, most cases of gynecomastia are triggered by a hormonal imbalance: too much estrogen, not enough testosterone or both.  You probably know that these hormones govern the development of female and male traits.  What you may not know is that men produce estrogen as well as testosterone, albeit at much lower levels than women do.  Hormone levels for men can become “out of whack,” as we sometimes say for short, and man boobs can be the result.

Hormone levels change during puberty, obviously.  Some young men develop gynecomastia during their teen years and many lucky adolescents see their moobs shrink as they get older.

You may have heard that some drugs can cause gynecomastia.  This is true of some prescription medications, such as antidepressants and cancer drugs, as well as street drugs like anabolic steroids and possibly marijuana.  In this case, hormones again are the underlying culprits as many drugs cause changing hormone levels in the body.

Hormones are also the bottom line when it comes to health conditions that contribute to gynecomastia.  Kidney failure, liver failure, some tumors and even malnutrition can contribute to fluctuating hormones and are potential factors in the development of enlarged male breasts.

Today, there’s a lot we know about gynecomastia, including the way hormones are involved.  There are also some aspects of the condition we don’t yet understand.  For instance, because it’s so common for men to experience fluctuating hormone levels at various times in their lives, why don’t more men develop lasting gynecomastia?  It could very well be that there’s a genetic aspect to the condition that hasn’t yet been identified.

If you’d like some help in understanding your particular case, you can contact our office in New York City.  Or visit a gynecomastia forum like gynecomastia.org and join the discussion.

More men in the United Kingdom (UK) are having their “moobs,” (short for man boobs) reduced through the procedure known as gynecomastia surgery.

The British Association of Aesthetic Surgeons (BAAPS) says the procedure to produce a more masculine, flat chest increased 44 percent in the UK during 2008 – despite the recession.

In the United States, 17,902 men had gynecomastia surgery in 2008, according the American Association of Plastic Surgeons (ASPS).

And it’s not a cheap procedure! In the UK, gynecomastia surgery costs an average $6,922.00. (Read more about the report that includes male breast surgical reduction.)

But why would more patients be showing up in surgeons’ offices with large male breasts in the first place?

It may literally be something in the water.

Back in 2005, British surgeons and others studied water supplies and found that, while the water was clean, it nonetheless contained an unusually high concentration of female hormones. The source?  Birth control pills for women. Also, hormones are given to many large farm animals. All that can leach into the water.

(Read more about hormones causing gynecomastia.)

Could a similar situation be happening in the United States? Possibly. Some scientists have found populations of fish in which the males are developing female characteristics.

Gynecomastia can also be caused by:

• Use of illicit street drugs
• Side effects of some medical treatments
• Having large amounts of the female hormone, estrogen
• True female breast tissue that is too sensitive to even small amounts of estrogen

With 1,450 gynecomastia treatments via surgery under my belt, I have noticed that true breast tissue in males looks under the microscope identical to that of females. But the tissue is very dense and hard and can not be liposuctioned. Instead, it is removed surgically.

Take a look at how some males and teens look, before and after, in their gynecomastia pictures.

T.V. comedian Seinfeld once touched on the issue in a show, telling a large chested male friend, he should not wear a bra for gynecomastia, but a “bro.”

However, in real life, male breast enlargement in a young lad or is anything but a laughing matter.

We’ll touch more on some actual cases, next post.