What is it? Enlargement of the male breast

When does it occur? Typically it may occur at three different times during a patient’s life, in the newborn phase, during adolescence and in later life.

Why me? It occurs for different reasons at the different stages of one’s life. In the newborn period it is associated with pregnancy hormones that quickly dissipate after birth with the resolution of the gynaecomastia in 1-2 weeks. In the adolescent group, changes in hormone concentrations seen during puberty cause enlargement of breast tissue. While it often resolves of it’s own accord there can be significant psychological trauma associated with the condition. In later life it is once again associated with changes in hormone levels or responsiveness of the breast tissue to the internal, hormonal environment.

Causes? As frustrating as this might sound, an underlying cause cannot be identified in the vast majority of cases. Identifiable causes include endocrine conditions and drug side effects (medical and recreational). They will be tested for under certain circumstances.

Management? As the gynaecomastia will resolve in many patients, a wait-and-watch approach can be employed in the first instance. For patients in whom the condition persists, surgery is required. Surgical options include liposuction, minimal access surgical excision or a combination of both.