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Teenage Macromastia in Males

May 19, 2025

Macromastia in teenagers refers to excessive development of breast tissue, and while it’s more commonly discussed in females, it also affects males. Teenage macromastia in boys is a form of gynecomastia that can lead to significant emotional distress, body image issues, and physical discomfort. Understanding what it is, why it happens, and how to treat it is essential for both teens and their parents.

What Is Teenage Macromastia in Males?

Teenage macromastia in boys is a severe form of gynecomastia, where excessive glandular tissue causes visibly enlarged male breasts. It typically presents during puberty due to hormonal changes, often involving a temporary imbalance between testosterone and estrogen levels.

This condition may affect one or both sides of the chest and can lead to:

  • Puffy, enlarged nipples
  • Firm breast-like tissue under the areola
  • Discomfort during exercise or physical activity
  • Significant self-consciousness or social withdrawal

Causes of Teenage Macromastia

During puberty, fluctuating hormone levels are normal. However, in some teens, these hormonal shifts trigger abnormal breast tissue growth. Contributing factors may include:

  • Genetic predisposition
  • Obesity or high body fat percentage
  • Medications or substance use (including steroids or marijuana)
  • Underlying endocrine or metabolic disorders
  • In some cases, no identifiable cause is found

Most cases of teenage gynecomastia resolve naturally within one to two years. But when breast tissue continues to grow or remains for more than 12 to 24 months, it’s considered persistent and may be classified as macromastia.

Physical and Emotional Impact

The effects of teenage macromastia extend beyond appearance. Many teens experience:

  • Anxiety about removing their shirt in public
  • Difficulty finding clothes that fit properly
  • Avoidance of sports, swimming, or gym class
  • Depression or withdrawal from social situations

The psychological burden can be profound, and parents should take any concerns seriously.

Diagnosis and Evaluation

A medical evaluation can help determine whether the tissue is due to gynecomastia, fat (pseudogynecomastia), or another issue. Diagnosis typically includes:

  • Physical examination
  • Hormone panel and blood tests
  • Medical history review
  • Imaging such as ultrasound if needed

At our clinic, we also assess skin elasticity, gland size, and nipple projection to determine the severity and best treatment path.

Treatment Options for Teenage Macromastia

For mild cases, especially within the first year of development, doctors often recommend a watch-and-wait approach. However, in moderate to severe cases—or when the condition causes distress or social limitations—treatment may be necessary.

Non-surgical approaches include:

  • Weight management and resistance training
  • Hormone therapy in rare cases (if imbalance is confirmed)
  • Psychological counseling or support

When the tissue is dense, painful, or persistent beyond two years, surgical removal is often the most effective option.

Gynecomastia Surgery for Teens

Surgical correction involves:

  • Gland excision through a small incision at the edge of the areola
  • Liposuction for surrounding fat, if present
  • Skin tightening in more severe cases
  • Minimal scarring and fast recovery

At our Newport Beach practice, Dr. Joseph Cruise has extensive experience performing gynecomastia surgery for teens, using techniques that preserve future chest development while providing immediate relief.

When Is the Right Time for Surgery?

Surgery is generally considered when:

  • The breast tissue has remained stable for 12–24 months
  • The teen is emotionally mature enough to understand the procedure
  • The condition interferes with physical or emotional health
  • Hormonal causes have been ruled out

Parents and teens should make the decision together with input from a qualified gynecomastia specialist.

Schedule a Consultation

If your son is struggling with teenage macromastia, early evaluation can make all the difference. Dr. Joseph Cruise is one of the leading gynecomastia specialists in the United States and offers customized treatment options for teens and young adults.

Schedule a macromastia consultation today to learn more about diagnosis, non-surgical options, and whether surgery may be appropriate. In-person and virtual appointments are available for families nationwide.

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 lagynecomastia.org. 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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