Adolescent Gynecomastia is caused by a hormone imbalance between estrogen (female characteristics) and testosterone (male characteristics). Gyno is triggered by a higher level of estrogen that causes an increase in breast tissue producing gynecomastia. This occurs naturally in the growth of an infant, adolescent boys, and older men. This is termed physiologic gynecomastia.
During adolescence, the hormones fluctuate and rise to various levels resulting in a state of elevated estrogen. Research has shown that this occurs in up to 65 percent of adolescent boys. Most cases of gynecomastia in boys regress within two years of its development. However, in approximately five percent of males the gyno breast tissue remains. This is termed persistent pubertal gynecomastia. In such cases, the tissue becomes firm and fibrous in nature upon reaching adulthood. At this point, the only treatment option is surgery.
Fortunately, gyno-reduction surgery is a great procedure for adolescent boys. The young, elastic, and pliable skin contracts back to the muscle after the gland is removed very well. The surgical treatment is gynaecomastia gland excision with liposuction.
The medical treatment of adolescent gynaecomastia is currently under investigation. As of 2014, there are no drugs approved by the Food and Drug Administration (FDA) for the treatment of gynecomastia. Some of the drugs under investigation are tamoxifen, which blocks estrogen receptors; danazol, an androgen or testosterone that blocks estrogen production; and dihydrotestosterone, an androgen. Obviously, much further research is needed to develop an effective drug that will be approved by the FDA for the general public
Some of the more common questions that parents ask are as follows:
Will the breast tissue re-grow after surgery is performed at 13 or 14 years old?
The answer is possible because the levels of the hormone are still fluctuating at that age. However, I have only seen this on rare occasions. The surgery does not remove all the breast tissue. This is not a male breast cancer operation but a cosmetic one. Therefore, some breast tissue will remain and can be further stimulated. It never seems to return like it was and Dr. Delgado has never had to re-operate.
What is the best age to have gynecomastia surgery?
The best time is when the gynecomastia is starting to affect the young man socially. If he is depressed because friends or acquaintances are making fun of his chest this is significant. If your son no longer wants to go to the beach or the swimming pool with his friends, this will start to affect his social behavior in a negative way. Dr. Delgado believes that this continued insult on a boy’s self-esteem can affect him for life. We like to have involvement from the young man’s pediatrician and an endocrinologist for their opinion. If everyone is positive about having surgery and the young man feels good about the decision, then surgery is performed.