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Gynecomastia in Teens

Gynecomastia is a common occurrence in boys going through puberty. Categorized as physiologic gynecomastia, up to 2/3 of boys going through puberty develop some form of gynecomastia. This form of gynecomastia is due to the surges in testosterone and estrogen which often lead to an imbalance of the testosterone:estrogen ratio. Puberty is a difficult time for most boys, with many changes occurring not just physically but also emotionally. Developing gynecomastia during this age can affect the self-image and confidence of a teenager. The peak incidence occurs around 14 years of age.

Dr. Dadvand Discusses Gynecomastia on Healthy Lifestyle WMCN Watch Video: Dr. Dadvand Discusses Gynecomastia on Healthy Lifestyle WMCN with Host Eraldo

In up to 75% of boys who develop pubertal gynecomastia, it will disappear without treatment within 2 years. In 90% of boys with pubertal gynecomastia, it will disappear without treatment within 3 years. So deciding who needs surgery is very important in this age group because a majority of these boys will not need any intervention.

The two most important questions to ask when dealing with a teen with gynecomastia are:

1) How long has the gynecomastia been present?

2) Are there any other causes of gynecomastia in that patient?

If there are no other identifiable medical causes, and hormone levels are normal, then surgery is recommended if they have had gynecomastia for over two years. While there is no “youngest age” to undergo gynecomastia surgery, Dr. Dadvand makes sure that his teenage patients have had gynecomastia for at least two years and have no other identifiable causes for their gynecomastia. Below is a before and after photo of a teen with physiologic gynecomastia of his left chest. He underwent surgery in our Los Angeles facility to correct the gynecomastia.

GYNECOMASTIA IN TEENS before and after photo

In cases of physiologic gynecomastia where the onset of puberty led to the gynecomastia, the surgical result is typically permanent. Teens that develop gynecomastia through puberty and have surgery should not expect a recurrence unless they gain excessive weight or begin taking medications that are known to have an increased risk of causing gynecomastia (e.g. steroids). Fortunately, we all go through puberty only once in our lives!

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