What Is Gynecomastia? Causes, Symptoms, and Treatment Options

What is gynecomastia, and how is it different from chest fat?

Gynecomastia (also spelled gynaecomastia) is a benign, non-cancerous increase in the glandular tissue of the male breast. Glandular tissue is the firm, gland-like tissue behind the nipple, as opposed to soft fat. It typically feels like a rubbery, button-sized growth under the nipple. It may be tender and can affect one or both sides.

Gland and fat often occur together. Fat-only fullness is called pseudogynecomastia. Telling the two apart takes an examination, and sometimes imaging.

Who gets gynecomastia, and is it normal?

Gynecomastia is normal at three stages of life: the newborn period, puberty, and older age. Hormone levels shift at each of them.

• Newborns: a mother’s hormones can cause small breast buds in baby boys, which usually go away by themselves.
• Puberty: testosterone and oestrogen rise unevenly, and breast tissue can grow on one or both sides.
• Older men: the change is common after about 50 as hormone balance shifts. Chronically low testosterone can stop the tissue from settling.

In adult men outside these stages, medicines, substances, weight gain, and medical conditions are worth ruling out. That is why the checks below matter.

For parents of teenage boys: teenage gynecomastia usually settles within 6 to 24 months, so your son does not need to be rushed into treatment. See a doctor sooner if it is painful, growing fast, hard, or on one side only. Keep the conversation matter-of-fact and supportive. The change is common and not his fault.

What causes gynecomastia?

Gynecomastia develops when oestrogen’s effect on breast tissue outweighs that of testosterone. The triggers are natural hormonal changes, medicines, substances, weight gain, and medical conditions (Cleveland Clinic, 2024).

In 45–50% of adult men with gynecomastia, no cause is found, as per a Deutsches Ärzteblatt International 2025 review. That is common, and it does not mean a doctor has missed something. It does mean the medicine, substances, and health checks are worth doing, because those are the causes that can be changed.

Do not stop a prescribed medicine without asking your doctor. Bring any supplement or gym product to your appointment too.

What are the symptoms of gynecomastia, and which signs need a doctor first?

The usual gynecomastia symptom is a firm or rubbery, button-sized growth under one or both nipples, sometimes tender. Many adults notice only a change in chest shape and feel no pain.

These signs need a doctor before anything else:

• A hard or fixed lump: one that feels stony or irregular, or does not move under the skin.
• A lump on one side only: gynecomastia can be one-sided, but a one-sided lump is examined to rule out other causes.
• Skin changes: dimpling, puckering, redness or a sore.
• Nipple discharge or bleeding, or a nipple pulled inwards.

Also see a doctor about ongoing breast or nipple pain. Older guidance from the American Academy of Family Physicians (2012) also lists enlarged glands in the armpit and rapid growth.

See a doctor first, and do it before consulting any surgeon. Male breast cancer is rare. These signs are exactly what an examination is for.

A simple at-home check can help you decide whether to book a visit. It is a home check only. A normal result at home does not clear you, and any sign above needs a doctor, regardless of what you feel at home.

Gynecomastia can affect confidence and mood, especially in teenagers, and that is a valid reason to seek care. Tell your doctor if it is affecting school, work, relationships, or sleep.

How do doctors assess gynecomastia, and who needs tests first?

Doctors assess gynecomastia with a history and an examination of the chest, armpits, and testicles. When those findings call for it, they add blood tests and imaging. This medical check comes before any surgical plan. A physician or endocrinologist (a hormone specialist) usually leads it.

• Blood tests: hormones such as testosterone and oestrogen, plus liver, kidney, and thyroid tests, when the history or examination points to them.
• Imaging: breast and testicular ultrasound, and mammography if cancer is suspected.

Use this table to decide who you see first. The time frames are our recommendation.

Before your appointment, prepare:

• Medicines list: every tablet, injection, cream, supplement, and gym product, with the month each started. Ready when a stranger could read it and see what you take.
• Timeline: when you first noticed it, which side, and whether it is growing.
• Family history: relatives with breast, testicular, or hormone conditions. Ready once you have asked parents and siblings.
• Questions: at least three written down, for example, “Do I need blood tests or imaging?”

What are the gynecomastia treatment options?

Gynecomastia treatment ranges from watching to changing a medicine, treating a cause, specialist-led therapy, and surgery. The right choice depends on how long the tissue has been there and why it appeared.

Do not take hormone-affecting tablets, supplements or online products on your own. Medical therapy belongs with a specialist, and it works best before the tissue turns fibrous.

When is surgery the right answer for gynecomastia?

Surgery is considered when firm glandular tissue has remained despite time and weight loss, once causes have been checked and addressed. It is also considered when the change causes significant distress.

Who is a suitable candidate for gynecomastia surgery?

Surgery usually suits men in good general health when:

• firm glandular tissue sits beneath the nipple and has not eased with time, exercise or weight loss;
• the tissue has been present since adolescence, or for well beyond two years;
• medicines, substances and hormone conditions have been checked and addressed;
• the change affects confidence, clothing choices, swimming or training.

Surgery is usually not the first step when:

• the patient is a teenager whose puberty-related tissue may still settle;
• the fullness is mainly chest fat (pseudogynecomastia), where weight loss, or liposuction alone, may be enough;
• a medical, hormonal, or other cause has not yet been ruled out;
• body weight is still changing, because stabilising it first gives a more reliable result.

Our gynecomastia surgery combines liposuction with removal of glandular tissue. Severity follows the four gynecomastia grades set out below, and the grade shapes the plan. In suitable cases, our OCCULT technique, a lateral-incision approach, avoids a scar on the front of the chest. It was described in an Indian Journal of Plastic Surgery 2025 series of 967 patients from our practice, and results vary with anatomy and grade.

What are the four grades of gynecomastia?

Most men who consult Dr Gupta fall into Grade 1 or Grade 2. Higher grades may need additional skin tightening, which is discussed openly at consultation. See how OCCULT compares with standard gynecomastia surgery.

In a 4,996-patient series cited in the Deutsches Ärzteblatt International 2025 review, 4.4% of patients had complications, including infection or impaired wound healing in 1.8%. Satisfaction after gynecomastia surgery is reported at 62.5% to more than 80%. Risks include bleeding, infection, asymmetry, contour irregularity, and scarring, and we discuss your suitability and these risks at consultation.

Gynecomastia can return if the cause persists, such as weight gain or steroid use. Men with a history of keloid or thick, raised scarring should mention it at consultation, and a written consent document sets out procedure-specific risks before surgery.

Two case snapshots from our practice

These are individual results. Outcomes vary with anatomy, grade, and healing.

• A 28-year-old man (80 kg, 5’9″) with Grade II gynecomastia was treated with the OCCULT technique, with no scar on the front of the chest.
• A 32-year-old man (78 kg, 5’11”) had gynecomastia and stubborn abdominal fat despite regular exercise. His chest correction was combined with liposuction of the abdomen, flanks, and lower back, using MicroAire and VASER, to shape a V-shaped torso.

Photographs are on our before and after page.

What does gynecomastia surgery cost in Delhi?

Cost depends on the grade, how much gland and fat is removed, whether skin tightening is needed, surgical and anaesthetic time, and follow-up care. A personalised estimate is given after examination. Our guide to gynecomastia surgery cost by body type explains this in more detail.

These ranges are indicative, not a quote. Check them with the clinic before publishing, as pricing changes. If your checks are done and you want to discuss surgery, request a consultation.

How can Delhi, outstation and international patients take the next step?

Delhi, outstation and international patients can start with a video consultation, after which we give a written surgical plan. We assess your medical history and candidacy and discuss options and risks.

Our page on the male breast reduction procedure sets out the operation. In person, we are at RG Aesthetics, BN 56, East Shalimar Bagh, Delhi 110088, Monday to Saturday, 10 am to 7 pm.

What should you do if you have noticed a change in your chest?

Gynecomastia is usually benign, common, and treatable. Start by looking for the red flags: a hard or fixed lump, a one-sided lump, skin changes, or nipple discharge. If you have any, see a doctor first. If not, work out the likely cause from your medicines, substances, weight and age.

Teenage and recent-onset cases can usually be watched, and our guide on whether gynecomastia goes away on its own covers that decision. Long-standing firm tissue that has not responded to time or weight loss, once causes are checked, is where surgery becomes a reasonable conversation. Surgery gives no guarantee of a perfect or permanent result, and recurrence is possible if the cause persists.

When you are ready to talk it through, book a Consultation. You can also call or WhatsApp us on +91-9560156136 or +91-9090696951.

About the author: Dr Rajat Gupta, MBBS, MS (General Surgery), DNB (Plastic Surgery), leads RG Aesthetics, an aesthetic and reconstructive plastic-surgery practice. Last reviewed October 2026.

Frequently asked questions

Discuss gynecomastia surgery with Dr Rajat Gupta

Once your checks are done, request a consultation with Dr Rajat Gupta at RG Aesthetics in Delhi to discuss your suitability and the risks.

Sources

1. Deutsches Ärzteblatt International, 25 July 2025: Diseases of the Male Breast: Gynecomastia and Breast Cancer (Faridi, Gerber, Hartmann)
2. Cleveland Clinic: Gynecomastia (reviewed 9 July 2024)
3. NHS: male breast enlargement guidance (reviewed 31 May 2024)
4. Italian Society of Andrology and Sexual Medicine (SIAMS) clinical practice guideline on gynecomastia, Journal of Endocrinological Investigation, 2026
5. American Academy of Family Physicians (AAFP), American Family Physician: Gynecomastia clinical summary, 2012 (older guidance)
6. Indian Journal of Plastic Surgery, 2025: OCCULT technique series of 967 patients