Controversy Over Treatment for Gynecomastia in Teens

It is not only women who seek cosmetic surgery. And it is not only women who worry about the size of their breasts. While some teenage girls may struggle through school and other social functions lacking self-esteem due to overly large or small breasts, it turns out that boys also face jeering and the consequent alienation due to breast growth, gynecomastia. About half of all teenage boys develop it to some degree during puberty. In most cases, it does not progress to the point of being noticeable. However, in those cases that gynecomastia does become noticeable, it also causes noticeable distress, emotional problems, and reduced self-esteem. These effects were recently reported by researchers at Boston Children’s Hospital.

The April issue of Plastic and Reconstructive Surgery included a study of the effect of gynecomastia on boys. The study consisted of a series of psychological tests that were administered to 47 boys who were being evaluated for gynecomastia. The average age of the boys was 16 years old. As is often the case, many of the boys were overweight, in fact, 64% included in this study were overweight or obese. 62% of the boys had mild to moderate breast enlargement. Quality of life, self-esteem, attitudes toward food, social functioning and mental health evaluations were included in the battery of psychological tests. The results were compared with the control group of boys, who were also tested but did not have gynecomastia. By the way, only 41% of the boys in the control group were overweight. The results showed that the boys who had gynecomastia scored lower in self-esteem, social functioning, attitudes towards food, and general and mental health. These results were due directly to the gynecomastia, not being overweight. The researchers concluded that “Merely having gynecomastia was sufficient to cause significant deficits in general health, social functioning, mental health, self-esteem, and eating behaviors and attitudes compared with controls.” Consequently, the severity of the problem was not the issue, nor was weight. Losing weight may not be enough to improve the quality of life for overweight boys with gynecomastia, although this is often a step in the right direction.

It may be helpful for teenage boys who are struggling in school and other social venues and have obvious breast development to be tested for gynecomastia. These boys effected must consult with an endocrinologist to test for true gynecomastia, as opposed to pseudo gynecomastia which is purely weight induced. It is helpful if a psychologist is sought to help with emotional, social, or academic problems that are connected to the physical problem until the natural resolution of gynecomastia comes with the end of teenage development or surgery is sought. Surgical interventions for adolescent gynecomastia have been considered controversial in boys under 17, however researchers of this new study stated, “early intervention and treatment for gynecomastia may be necessary to improve the negative physical and emotional symptoms.” So when do the emotional consequences of this problem outweigh the controversy of cosmetic surgery for teens? Essentially, more research is needed.

At Little Rock Cosmetic Surgery Center, gynecomastia is treated surgically in adult men with male breast reduction surgery. Arkansas patients can contact us for a consultation.

Dr. Branman

Call Melinda at  the front desk to set up your consultation 501-227-0707