January 15, 2026 | Gynecomastia
6 minute read
Gynecomastia is a condition that causes male breast tissue to grow, which can be emotionally debilitating. This blog discusses the different severities or categorizations of gynecomastia, how patients can get diagnosed, and what options they have for treatment.
Table of Contents
- What Is Gynecomastia?
- Who Is a Candidate for Gynecomastia Surgery?
- What Are the Stages of Gynecomastia?
- What Is Pseudogynecomastia?
- How Do I Know What Type of Gynecomastia I Have?
At Greenberg Cosmetic Surgery and Dermatology, Stephen T. Greenberg, MD, FACS; Dr. Jason M. Weissler; Dr. Stephanie A. Cooper; and Dr. Jacqueline Ross have helped thousands of patients restore their figures through customized gynecomastia procedures. Contact our office to learn more about how gynecomastia surgery can provide relief:
- New York City: (646) 846-4544
- Princeton: (609) 699-9442
- Scarsdale: (914) 637-6299
- Southampton: (631) 353-7409
- Smithtown: (631) 614-5760
- Woodbury: (516) 217-8120
- Boca Raton: (561) 923-8661
What Is Gynecomastia?
Gynecomastia is a condition categorized as the enlargement of breast tissue in males, and is caused by a number of factors, including hormonal imbalances, certain medications, and genetic predispositions.
No matter the cause, gynecomastia can be a source of embarrassment and self-consciousness that many men and boys suffer through. Luckily, there is a solution: gynecomastia surgery. This procedure involves removing excess breast tissue and, if necessary, fat, and tightening the skin to achieve a flatter, more masculine result.
Who Is a Candidate for Gynecomastia Surgery?
Gynecomastia surgery is not for everyone; ideal results require the patient to meet specific criteria and address specific aesthetic concerns. Candidates for gynecomastia:
- Are over 18 years of age
- Are close to their goal weight
- Are willing to adopt a healthy diet and exercise to maintain results
- Have enlarged breast tissue that is resistant to diet and exercise
For many men who notice an enlarged breast appearance, their first response is to begin working out and dieting to reduce the appearance of their enlarged breasts. In some cases, increasing muscle mass and reducing fat can help, but true gynecomastia is an enlargement of breast tissue (glandular tissue) that cannot be addressed with diet and exercise alone, especially when it is due to hormonal changes or substance use.
One key determinant of a patient’s candidacy for gynecomastia surgery is the severity of their condition. Gynecomastia typically progresses through stages, with varying physical and aesthetic changes.
What Are the Stages of Gynecomastia?
The four stages or grades of gynecomastia are:
- Grade 1: Small growth without excess skin
- Grade 2: Moderate growth without excess skin
- Grade 3: Moderate growth with excess skin
- Grade 4: Significant growth with excess skin
We’ll discuss each below.
Grade 1 Gynecomastia
If a person has Grade 1 gynecomastia, they will experience mild breast growth, typically centralized around the nipple-areolar complex. This may be accompanied by nipple pain or tenderness. There may be swelling around the nipple, which may appear puffy and be sensitive to touch.
Grade 2 Gynecomastia
Grade 2 is categorized as a more pronounced enlargement of breast tissue that extends across the chest. Excess breast tissue is made prominent when the patient has no shirt on, and can even be visible when clothed. Nipple puffiness and sensitivity/pain are increased.
Grade 3 Gynecomastia
Grade 3 gynecomastia displays more substantial growth of breast tissue, with widening of the chest (fat and skin under the armpits). The enlarged breasts are more visibly pronounced, often showing through clothing. Additionally, Grade 3 is when skin becomes more stretched and excessive, resulting in a drooping appearance of the breasts.
Grade 4 Gynecomastia
This is the most advanced stage of gynecomastia, with breasts resembling female breasts in appearance. The breasts are very prominent, sometimes making the person look top-heavy, with little ability to hide the breasts under clothing. The nipples are often larger, and excess skin becomes more pronounced, contributing to the drooping appearance of the breasts.
What Is Pseudogynecomastia?
Some men and boys have what appear to be large breasts, but their condition does not count as true gynecomastia. Pseudogynecomastia is not an increase in glandular tissue, but an accumulation of fat that builds up around and behind the nipples. If your enlarged breasts are not due to glandular tissue, but fat, you have pseudogynecomastia, not true gynecomastia.
How Is Pseudogynecomastia Treated?
In some cases, diet and exercise can improve the appearance of enlarged breasts caused by fat. Patients may use certain weightlifting techniques or pectoral exercises to target fat in these areas.
For more advanced cases, or if conservative treatments like the above are ineffective, liposuction is used. This surgical procedure removes fatty deposits through a thin tube called a cannula. Your plastic surgeon will make very short, thin incisions around the chest to insert the cannula and suction out the fat to flatten and smooth the chest.
How Do I Know What Type of Gynecomastia I Have?
It can be hard to tell if your enlarged breasts are due to glandular tissue or fat, without an exam from a doctor or plastic surgeon. If you have enlarged breasts that are resistant to diet and exercise, you’ll need to schedule an appointment with your doctor or request a consultation with a plastic surgeon.
If you are ready to explore surgical options, the experienced gynecomastia surgery experts at Greenberg Cosmetic Surgery and Dermatology can provide you with a comprehensive evaluation.
Your Gynecomastia Surgery Consultation
During your consultation, your surgeon will evaluate your chest and determine the severity of your case to determine which surgical approach will benefit you. The following are some surgical options for gynecomastia:
- Excision of glandular tissue and skin. This is for true gynecomastia, not pseudogynecomastia. During this procedure, your surgeon will make a small incision around the nipple and surgically remove the glandular tissue. They may also tighten and remove excess skin to create a more masculine appearance.
- Combination of glandular tissue and skin excision, with liposuction. It is not uncommon for patients with true gynecomastia to require both glandular excision and fat removal. In this case, your surgeon will use liposuction to remove fat and sculpt the area, while also removing skin and tissue as needed.
- Liposuction only. If your surgeon determines that you have pseudogynecomastia, with fat only, they can use liposuction to remove it.
Want to Learn More About Gynecomastia Surgery in Long Island?
At Greenberg Cosmetic Surgery and Dermatology, Dr. Stephen T. Greenberg and his expert team of plastic surgeons will work with you to discover the ideal gynecomastia treatment plan for your needs. Call Greenberg Cosmetic Surgery today at (888) 680-2090 or complete the contact form to schedule a consultation.