January 14, 2026 | Gynecomastia
7 minute read
Gynecomastia is a frustrating condition that afflicts boys and men with enlarged breasts due to a hormonal imbalance. Patients seeking treatment have a few options, including prescription drugs and surgery. This blog discusses one medication, tamoxifen, to help readers learn about their options for gynecomastia treatment.
Table of Contents
- What Is Gynecomastia?
- How to Treat Gynecomastia
- Tamoxifen to Treat Gynecomastia
- Gynecomastia Surgery
- Tamoxifen Vs. Surgery: Which Is Best?
What Is Gynecomastia?
Gynecomastia is a condition that affects men and people assigned male at birth, in which a hormonal imbalance causes the breast tissue, sometimes called glandular tissue, to swell abnormally. In some cases, there is both an increase in glandular tissue and breast fat, which contributes to the appearance of enlarged breasts. However, true gynecomastia is unrelated to fat and is characterized solely by an increase in glandular tissue.
Other types of gynecomastia:
Unilateral gynecomastia: One of the breasts is enlarged.
Pseudogynecomastia: The breasts are enlarged due to extra weight; the breast fat causes the appearance of large breasts, not the breast tissue.
What Causes Gynecomastia?
Hormones can become imbalanced for a variety of causes, some natural, some caused by external factors. Common causes include:
- Natural stages of hormone changes, such as puberty and andropause (hormone drops after about 50 years old)
- Low testosterone
- Thyroid issues
- Obesity
- Alcohol use disorder
- Chronic stress
- Opioid use
- Recreational drugs
- Anabolic steroids
How to Treat Gynecomastia
If you are exhibiting gynecomastia symptoms such as puffy nipples or gradually enlarged breasts, you may be eligible for gynecomastia treatment. Generally, you have a few treatment options.
For very mild and early cases, or for pubescent boys, the treatment may begin with lifestyle changes such as dieting, exercise, or the cessation or adjustment of certain medications. Especially for younger boys, it is usually recommended to just wait for hormone regulation as they get older.
For men who do not respond to lifestyle changes or who want to pair these conservative treatments with other treatments, they have the option of surgery or medications. We’ll discuss both options below.
Tamoxifen to Treat Gynecomastia
Not every patient wants or is eligible for surgery to treat their gynecomastia symptoms. Because gynecomastia is influenced by the fluctuation of hormones, specifically an increase of estrogen or a decrease in testosterone, anti-hormone receptor medications like tamoxifen have been used to improve gynecomastia symptoms.
What Is Tamoxifen?
Tamoxifen is an FDA-approved prescription drug that is used to treat a specific type of breast cancer that uses estrogen to grow. Tamoxifen is a type of antiestrogen drug that blocks estrogen activity in the breasts.
Because gynecomastia is caused by an imbalance of hormones, specifically an increase in estrogen, tamoxifen’s antiestrogen properties make it a possible treatment for the condition. However, the drug’s efficacy depends on a number of factors, and may only be ideal for a select group of candidates, such as:
- Patients who have more glandular swelling than fatty tissue. Tamoxifen only works for patients whose gynecomastia is primarily due to glandular or breast tissue expansion, and is ineffective in treating excess fatty tissue that can also contribute to a larger breast appearance.
- Patients who are in the early stages of gynecomastia symptoms. Tamoxifen inhibits estrogen production in the breast, so it essentially stops the progression of gynecomastia. This means that ideal results while using the drug are in the earliest stages of the condition, so patients must be aware of the condition and seek help early, which may not always be practical, especially if conservative methods are attempted first.
- Patients who are younger and have a more active lifestyle. Tamoxifen may not be suitable for older men or those with certain health conditions. Ideal patients are young, otherwise healthy, and lead an active lifestyle. This demographic may not represent the most common group susceptible to gynecomastia.
Gynecomastia Surgery
Perhaps the more common treatment for gynecomastia is surgery. Paired with lifestyle changes such as the cessation of certain drugs or activities that cause gynecomastia symptoms, gynecomastia removal surgery can achieve remarkable, permanent results that help men look and feel their best.
How Does Gynecomastia Surgery Work?
Like most cosmetic surgery procedures, gynecomastia surgery is tailored to the needs, anatomy, and goals of the patient. This makes it a more flexible option as opposed to medication. Gynecomastia patients have a few options for surgical breast reduction:
- Excision (removal) of the excess tissue. This is the primary means of treating gynecomastia surgically. Your surgeon will use the best incision type that will both address the correct amount of tissue removal (how much needs to be removed) and will most easily hide a potential scar.
- Options include: intra-areolar, periareolar, or a periareolar and inframammary combination.
- Liposuction for fat removal. Depending on the severity or cause of the gynecomastia, some patients may have both glandular and fatty tissue that is causing the enlarged breasts. When fat needs to be removed, liposuction is an effective option. Your surgeon will inject a tumescent solution for ease of fat removal, insert a small cannula, and carefully remove fat while also sculpting a contoured shape.
- Skin tightening and removal. In severe cases, or in older men, the enlarged breast tissue can result in the breast skin becoming sagged and stretched. Once the fat and tissue are adequately removed, your surgeon can also tighten the skin to a more pleasing appearance and remove the excess. This provides an additional aesthetic result that cannot be achieved with medication alone.
Gynecomastia Surgical Candidates
As with medication, surgery requires that patients meet certain health standards for their safety. To be a candidate for gynecomastia surgery, patients should:
- Be generally in good health with no conflicting health conditions
- Be nonsmokers or be willing to quit at least six weeks in advance
- Be close to their goal weight and be able to adopt healthy diet and lifestyle habits to maintain their results
- Have followed their doctor’s instructions for improving their gynecomastia condition as necessary by stopping certain drugs, alcohol, and making the necessary lifestyle changes, like losing weight
Tamoxifen Vs. Surgery: Which Is Best?
While medication can be effective for a select group of patients, gynecomastia surgery paired with lifestyle changes provides the most consistently positive results for a larger group of candidates. Of course, following your doctor’s instructions is always the first step, so if medication is the recommended option, that may be your best option.
But if surgery seems like the ideal choice, it can provide both aesthetic and emotional benefits, as it not only treats the condition by permanently removing the excess tissue but also provides a stronger contour as sculpted by an experienced plastic surgeon. Gynecomastia surgery offers a wide range of benefits for men who want lasting, satisfying results.
Want to Learn More About Gynecomastia Surgery in NYC?
Greenberg Cosmetic Surgery and Dermatology is the premier plastic surgery practice, spanning seven luxury locations to offer patients from New York to Florida the highest level of care and expertise the field has to offer.
If gynecomastia symptoms are affecting your emotional and mental well-being, call Greenberg Cosmetic Surgery today at (888) 680-2090 or fill out our contact form to schedule a consultation with one of our experienced, board-certified plastic surgeons in New York City, Southampton, Smithtown, Woodbury, Scarsdale, Princeton, or Boca Raton.