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types of gynecomastia

Six types of gynecomastia

On first glance, gynecomastia may seem like a very straightforward condition. A male patient presents to the physician as having "woman-like" breasts, and is eager to find a solution that can help restore his physique to a more traditionally masculine aesthetic. In reality, there are six different types of gynecomastia, and correctly diagnosing which type the patient is suffering from is the key to a successful, customized procedure. Below we will give an overview of each type and its attending special issues, however meeting with your surgeon in private consultation is the best way to learn more about your treatment options.

Type one gynecomastia

Type one gynecomastia occurs most often in younger men, typically teenagers and those in their 20's. The skin is firm and tight, however the nipple over-protrudes and may cause a poor self-image and social anxiety. This condition can occur even in those who are in excellent physical shape, such as bodybuilders or other athletes. The cause of over-projected nipples is primarily excess glandular tissue, which can be surgical removed through a simple procedure. The doctor will make an incision around the areola, which typically heals with minimal scarring, thanks to the areola's darker coloring. The procedure is performed under local anesthesia on an outpatient basis.

Type two gynecomastia

With type two gynecomastia, the breasts are slightly rounded, extending just barely over the edge of the pec muscles. This can be especially troublesome when wearing fitted clothing. As with type one, this brand of gynecomastia tends to strike during puberty, but may also affect those in their 20's and 30's. For teens, it is sometimes advisable to wait and see if the problem resolves on its own as the body matures. If this is not the case, it can become a serious issue for a young man, causing him to avoid social activities, sports and dating. When diet and exercise fail to solve the problem, a surgical approach may be unavoidable. With type two gynecomastia, the incision is usually well hidden in the areola, causing minimal scarring. The treatment takes place at the doctor's outpatient medical facility and is performed under local or general anesthesia.

Type three gynecomastia

Type three gynecomastia is usually found in adult men who dread having to take off their shirts in social situations, and who may experience limited personal relationships as a result of poor self-image and embarrassment. Ignoring type two gynecomastia may mean that it progresses to type three, where the breast tissue spills out several centimeters over the chest crease, mimicking a female profile. Because type three occurs in older men, the skin may have lost some of its elasticity, and is therefore slightly more difficult to treat. The doctor will remove the excess glandular tissue from the breasts through a combination of crescent incisions at the areolas, thus flattening the chest and restoring the silhouette to a more conventionally masculine appearance. Treatment is performed either under local or general anesthesia, depending on what is discussed with the doctor in consultation.

Type four gynecomastia

As with type three, type four gynecomastia involves the rounding of the breast, in this case creating a small yet significant roll below the chest crease. The nipple is also drooping. Type four gynecomastia is often found in those men who experienced the problem earlier in life but did nothing about it. Now, at an older age, things may have taken a turn for the worse as the aging process accelerates and the skin further loses its elasticity. Going without one's shirt in public tends to cause a great deal of discomfort and social anxiety at this stage, and the patient may avoid social activities, even with friends and family. After surgery is performed to remove excess glandular tissue, additional steps may be needed to resolve the issue of skin laxity. Incisions may be made at both the nipple and at the chest crease, both of which are well camouflaged.

Type five gynecomastia

Those suffering from type five gynecomastia may have experienced significant weight loss, or may still be quite overweight. The body may feel like a prison, and these individuals may completely avoid looking in the mirror. Surgery presents a lifeline, a chance to start over. Because type five gynecomastia is more complex and challenging than the other types, the surgeon performing the treatment must be highly skilled and experienced, such as Dr. Lahijani, who has performed hundreds of successful body sculpting procedures. In this case, the skin may sag quite a bit, and the excess glandular tissue affecting the breasts may also spill over into the armpit. The doctor will best determine which choice of anesthesia is the right one for each situation. Surgery is performed on an outpatient basis.

Type six gynecomastia

Like those afflicted with type five gynecomastia, patients with type six may be obese, or may have undergone major weight loss only to discover they still have giant unwanted breasts. For those that are still overweight, gynecomastia may be accompanied by comorbidities, including hypertension, diabetes and sleep apnea. In addition to the chest imperfections, there may be a significant amount of sagging, drooping skin which makes wearing any type of fitted clothing an obstacle. Personal style is often a thing of the past with this group, as there are few garments that can adequately hide the condition. Patients may suffer from depression, anxiety or both. In this case, surgery can act to improve quality of life and restore a sense of self-confidence. Treatment is performed under general anesthesia at an accredited outpatient facility.