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What Contributes to Gynecomastia?

April 9, 2021

Men with gynecomastia are often surprised to learn the complexities of the condition and the many considerations that plastic surgeons have to take when it comes to gynecomastia surgery. Gynecomastia consists of excess breast tissue with or without fatty tissue. It may also have a skin laxity component. During a consultation, Dr. Cruise can determine the most likely contributor to your gynecomastia and develop an effective treatment plan.

Excess Breast Tissue

True gynecomastia is caused by excess breast tissue or glandular tissue in men. This is typically due to either genetic factors, hormonal imbalance, or side effects from drugs. For patients with excess breast tissue, gynecomastia surgery is typically recommended as the only real option to restore a masculine chest contour.

Excess Fat

Excess fat may be present as well. Often, men who are overweight may have the appearance of enlarged breasts. However, fat in the chest can occur for men who are at a healthy weight as well. It is typically located around the breast such as the breast roll, axilla, pre-axilla and upper abdominal rib fat. This can contribute to the feminized appearance of the chest. For some, it may be recommended to follow a healthy diet and exercise routine to lose weight before pursuing a surgery. In rare cases, liposuction alone may be an option for improving the chest, however in most instances glandular tissue needs to be removed along with the fatty tissue.

Excess Skin

Excess skin is often an issue for those who have lost a significant amount of weight. Excess loose skin can play a role in gynecomastia. Often, this will create a drooping or sagging appearance with the areolas pointing downward. Excess skin must be removed to tighten up the chest for an optimal result.  

How Can I Tell What Type of Gynecomastia I Have?

Generally speaking, it can be difficult to identify what is contributing to your gynecomastia. Dr. Cruise will carefully examine and evaluate your chest area to determine what components are causing your gynecomastia.. 

Dr. Cruise categorizes gynecomastia into five basic types: classic gynecomastia, puffy nipple, fatty gynecomastia, saggy gynecomastia, and breast roll. Determining which type you have can help predict the contributing type of tissue based on the appearance. For example, saggy gynecomastia is commonly due to excess skin, while fatty gynecomastia is unsurprisingly due to excess fat.

By categorizing your gynecomastia, Dr. Cruise can then develop a treatment plan that will be most effective in restoring a masculine chest contour.

Schedule a Consultation

To learn more about gynecomastia surgery, what is contributing to your gynecomastia, and how surgery can help, schedule a consultation with Dr. Cruise in Newport Beach, CA. Call (949) 644-4808 or contact us online


Plastic Surgeon | Website | + posts

Dr. Joseph Cruise is a board-certified plastic surgeon with over 20 years of experience. Regarded as one of the top gynecomastia surgeons in the world, Dr. Cruise has gynecomastia-specific content that can be found at Dr. Cruise has dedicated his career to cosmetic surgery but has also had extensive training in General Surgery, Hand Surgery, and Microvascular Surgery. Dr. Joseph Cruise is also a member of the Rhinoplasty Society as well as the American Society of Plastic Surgeons.

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