Medical Care ,  Aesthetics

Adolescent And Teen Male Gynecomastia: Causes And What Can Be Done

November 06, 2023

Parental support is crucial. The stigma surrounding gynecomastia is real and can be overwhelming even for an adult.

Adolescent And Teen Male Gynecomastia: Causes And What Can Be Done

What Is Gynecomastia?

Gynecomastia, also known as "man boobs", is a common condition in which boys' and men's breasts swell and become larger than normal. It is caused by an increase in the amount of breast gland tissue brought about by an imbalance of estrogen and testosterone hormones. It occurs in 65 to 70 percent of boys and men worldwide and can affect one or both breasts.

Gynecomastia can happen at different phases of a person's life. These include:

At Birth

More than half of male newborns have enlarged breasts or breast buds. This is due to the mother's estrogen levels. The enlarged breasts will usually go away within a few weeks.

During Puberty

Some degree of breast enlargement occurs in more than half of teenage boys. Fluctuating hormones, including decreases in testosterone and increases in estrogen, causes the growth of breast tissue.

In Adulthood

Men produce less testosterone as they age. They may also have more body fat, which is a stimulant for estrogen production and breast tissue growth.

What Causes Gynecomastia In Adolescents & Teens?

Gynecomastia grade by Simon et al [1]: Grade I: Small enlargement without skin excess. Grade IIa: Moderate enlargement without skin excess. Grade IIb: Moderate enlargement with minor skin excess. Grade III: Marked enlargement with excess skin, mimicking female breast ptosis.

The most common cause is hormonal imbalance, such as an imbalance in the ratio of estrogen to testosterone. Testosterone is the hormone associated with male characteristics, responsible for muscle mass and body hair, while estrogen is associated with female traits, such as breast development. An increase in estrogen in males causes the appearance of female characteristics. During puberty, hormones fluctuate, causing an increase in estrogen levels.

In adolescent boys, most pubertal gynecomastia issues disappear within two years. Nonetheless, the problem still persists among a significant number.

Puffy Nipples In Adolescents & Teens

Puffy nipples may be a sign of potential gynecomastia. Other physical Indications include:

  • Nipple protrusion that is too noticeable or excessive, which is aggravated when stimulated.
  • The surrounding pigmented skin or areolas is generally flat.

Nipple reduction surgery is a viable option to address the issue of enlarged nipples but it is important to understand the difference between enlarged and puffy nipples as the treatment differs.


What Treatment Options Are Available For Gynecomastia Or Enlarged Male Nipples In Adolescents & Teens?

Surgery is the best proven permanent solution for gynecomastia and enlarged nipples. In adolescents, gynecomastia surgery is very effective because of the patient's young, pliable, and elastic skin, which can contract more easily.

Pubertal gynecomastia usually resolves on its own. Therefore, treatment is usually not recommended at first. Instead, the patient's condition will be observed for any changes in size for several months. In most cases, it will disappear within six months to two years. In boys, the condition may develop between ages 10 and 12, and most commonly between ages 13 and 14. In up to 20 percent of individuals, the condition persists beyond 17.

It is best to seek a qualified doctor's advice and confirmation when an issue is detected. The appropriate treatment can then be recommended befitting the issue at hand.

What To Do As A Parent


Parental support is crucial. The stigma surrounding gynecomastia is real and can be overwhelming even for an adult.   

Assurance needs to be relayed to the affected person that the condition is treatable. Be patient with them, as apprehension and even fear are common reactions among those afflicted with gynecomastia. Advise them not to seek or fall victim to purported "quick fix" solutions because there is none in reality. Even non-surgical treatments such as fat freezing do not work. The only solution is gynecomastia surgery.

Choosing a qualified gynecomastia surgery doctor in Singapore is important and may take effort. Gynecomastia comes in varying degrees, and only a truly qualified and experienced doctor can diagnose an issue accurately and dispense the appropriate treatment that is effective and, most importantly, safe for the patient.

If your child is exhibiting symptoms of gynecomastia, do not hesitate to schedule a consultation for your son with Dr Ivan Puah from Amaris B. Clinic for a detailed assessment and private discussion. 



[1] Simon B E, Hoffman S, Kahn S. Classification and surgical correction of gynecomastia. Plast Reconstr Surg. 1973;51(1):48–52.


Dr. Ivan Puah B.K.
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