What causes Man Boobs or Gynecomastia?


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Male Breast Reduction

Common Causes of Man Boobs or Gynecomastia

Breast tissues and nipples in men of all ages may become puffy-looking or protruding due to a number of varying factors. But enlarged, puffy breasts may occur more frequently at different times of life. This is the condition known as either Gynecomastia, Male Breasts or ‘Man Boobs’

Dr Richard Sackelariou is a leading plastic surgeon for Gynecomastia surgery in both Melbourne and Sydney. He helps patients who are seeking body confidence or a more toned looking chest. With over 20 years of experience, he is not only calm and caring, but he is also a precise surgeon.

Who is likely to develop Man Boobs or Gynecomastia?

Newborns, young males reaching puberty and ageing males may develop Gynaecomastia. This tends to relate to natural changes in hormone levels, though other causes also exist, and sometimes body weight and obesity conditions are involved. Gynecomastia can also affect just ONE of your breasts/nipples. However, more commonly, it is a condition that affects both breasts/nipples. That being said, like most of the body, they may still be uneven in size or protrusions (asymmetry is very common). Generally, gynecomastia isn’t a serious problem, but it can be emotionally tough to cope with the condition. Both men and boys with gynecomastia sometimes have pain in their breasts and may feel embarrassed.

Man Boobs male breast reductionCommon Symptoms of Gynaecomastia include:

  • Swollen breast gland tissue
  • Either puffy looking nipples or breasts that protrude
  • As well as, Breast tenderness

Causes of Gynecomastia

Several health conditions may cause protruding breast tissues or larger breasts in males.  These include conditions that impact normal hormone balances in the body and may include;


  • Hormone changes that occur with ageing may also be linked to weight or BMI (obesity is a contributor to enlarged male breasts/Gynecomastia).


  • If your thyroid gland produces too much of the hormone thyroxine, this may contribute to enlarged or puffy breast tissues.
  • You may be asked to have a blood test to assess your thyroid functions.



  • Certain tumours are those involving the testes, adrenal glands or pituitary gland, can produce hormones that alter the male-female hormone balance.

Kidney failure.

  • About half the people being treated with regular hemodialysis experience gynaecomastia due to hormonal changes.

Liver failure and cirrhosis

  • Hormonal fluctuations related to liver problems as well as medications taken for cirrhosis are associated with gynecomastia.

Malnutrition and starvation

  • When your body is deprived of adequate nutrition, testosterone levels drop, but estrogen levels remain constant, causing a hormonal imbalance. Gynecomastia can also occur once normal nutrition resumes.

Generally, gynecomastia isn’t a serious problem, but it can be tough to cope with the condition. Men and boys with gynecomastia sometimes have pain in their breasts, they may also feel embarrassed.

Natural hormone changes and Gynecomastia

The hormones testosterone and estrogen control the development and maintenance of sex characteristics in both men and women. Testosterone controls male traits, such as muscle mass and body hair. Whereas, Estrogen controls female traits, including the growth of breasts.

Most people think of estrogen as an exclusively female hormone, but men also produce it — though normally in small quantities. However, male estrogen levels that are too high or are out of balance with testosterone levels can cause gynecomastia.

  • Gynecomastia in infants. More than half of male infants are born with enlarged breasts due to the effects of their mother’s estrogen. Generally, the swollen breast tissue goes away within two to three weeks after birth.
  • Gynecomastia during puberty. Gynecomastia caused by hormone changes during puberty is relatively common. However, in most of these cases, the swollen breast tissue goes away without treatment within six months to two years.
  • Gynecomastia in men. The prevalence of gynecomastia peaks again between the ages of 50 and 69. At least 1 in 4 men in this age group are affected.

Medications and Man Boobs

A number of medications can cause gynecomastia. These include:

  • Anti-androgens are used to treat prostate enlargement, prostate cancer and also some other conditions. Examples include flutamide, finasteride (Proscar, Propecia) and also spironolactone (Aldactone).
  • Both anabolic steroids and androgens.
  • AIDS medications. Gynecomastia can develop in HIV-positive men who are receiving a treatment regimen called highly active antiretroviral therapy (HAART). Efavirenz (Sustiva) is more commonly associated with gynecomastia than are other HIV medications.
  • Anti-anxiety medications, such as diazepam (Valium).
  • Tricyclic antidepressants.
  • Antibiotics.
  • Ulcer medications, such as cimetidine (Tagamet HB).
  • Cancer treatment (chemotherapy).
  • Heart medications, such as digoxin (Lanoxin) and calcium channel blockers.
  • Gastric motility medications, such as metoclopramide (Reglan).

Street drugs and alcohol may cause ‘Gyno’

Substances that could cause gynecomastia include:

  • Alcohol
  • Amphetamines
  • Marijuana
  • Heroin
  • Methadone

Herbal products & Gynecomastia / Man Boobs

Plant oils, such as tea tree or lavender, used in shampoos, soaps or lotions have been associated with gynecomastia. This is probably due to their weak estrogenic activity.

Surgical and Non-Surgical Treatments for Gynecomastia or Man Boobs

The first consideration for reducing your breasts is to understand WHY you suffer from either enlarged breasts, fatty-looking breasts or puffy looking nipples.

There may be one or more underlying conditions that contribute to enlarged breasts in males.

It’s important you and your surgical team understand whether or not the condition is related to an illness, medications, lifestyle choices such as substance use, hormonal changes, or simply being overweight.

  • You may need to see a doctor for evaluation of the causes of your Gynaecomastia.
  • Causes can range from an imbalance of the hormones estrogen and/or testosterone to a serious medical condition. It can also be a result of simply going through puberty, getting older or becoming overweight.
  • Sometimes gynecomastia goes away on its own with lifestyle changes, but often it doesn’t, leading men to seek a surgical alternative such as male breast reduction or liposuction.

See your doctor for an assessment of your suitability for male breast reduction and/or a Referral to a Specialist Plastic Surgeon if you have:

  • Suspected hormonal imbalances or a genetic/chromosomal condition
  • Substance use or medication side effects genetic Swelling
  • Ongoing Pain in the breast area
  • Either tenderness or nipple discharge in one or both breasts

Find out more about options for Male Breast Surgery options here.


About Dr Richard Sackelariou Plastic Surgeon

Dr Richard Sackelariou MBBS FRACS(Plas) is a Specialist Plastic, Cosmetic and Reconstructive  Surgeon in Melbourne, Victoria and Sydney, Australia.

Dr Sackelariou is a highly sought-after Plastic Surgeon for precision procedures like nose reshaping, tummy tucks, breast surgery including transaxillary incision methods, implant removal/replacement and Breast Lift procedures.

His signature surgeries include – neck lift, facelift and eyelid rejuvenation procedures. He also performs expert cosmetic injections for facial rejuvenation.

Patients love his caring manner, his dedication to excellence and his extensive expertise in surgical planning for a natural-looking, harmonious result.

What’s Next

Book a Consultation with Dr Sackelariou in Melbourne or Sydney. A caring discussion with a Plastic Surgeon about all your options can really help. The best thing is to start with a phone enquiry and consider having a Consultation with Dr Sackelariou. Try the Free Nose Simulation Tool.


If you are considering cosmetic plastic surgery then Dr Richard Sackelariou is the specialist plastic surgeon for you.

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