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Company logo: Elliot W. Jacobs, MD, FACS - Diplomate, American Board Of Plastic Surgery

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Challenging Online Gynecomastia Information

gynecomastia New York

We have become fairly accustomed to seeing misinformation about gynecomastia on the web. Some organizations make big money by marketing non-surgical “cures” for man boobs to guys who are feeling desperate – they don’t work, by the way. And many bloggers who write about banishing moobs with diet and exercise simply don’t know enough about the condition.

It’s another story, though, when we spot an article covering gynecomastia on a medical website that contains misleading statements, as we did just the other day. It’s disappointing to think that men may visit a medical site to gain a better handle on their problem only to come away with input that muddies the issue.

We won’t name the most recent online piece we object to because the website does offer news, articles and infographics that can be helpful in keeping up on health matters. But here are three statements made about gynecomastia we’d like to challenge.

The condition is usually reversible when you stop the cause. The article maintains that it’s important for patients to find the root cause of their man boobs, then eliminate the cause to reverse breast tissue growth.

We’ll rate this input as questionable. First, as the article itself mentions, many times there is no apparent cause for gynecomastia. The authors maintain that as much as a quarter of the time a cause can’t be found; our experience suggests it’s even more often.

But even when the trigger seems to be a medication or a street drug, once breast gland has grown it often does not simply “go away” by discontinuing the drug. If the patient stops a drug immediately, it’s possible that breast swelling may diminish. But more often we find that once breast gland has grown, it’s there to stay.

The most common cause is spironolactone. Spironolactone, used to treat fluid retention, is often taken by people with heart failure, high blood pressure and other conditions. As noted on the website, it can cause gynecomastia.

But we find the notion of spironolactone as “the most common [drug related] cause” to be a bit silly. There are literally dozens of FDA approved drugs, such as medication used for baldness, that are both very popular and known to cause breast tissue growth. Then there are prescription drugs used to treat diseases that can also lead to man boobs such as antibiotics, AIDS medications, antidepressants and many others. In addition, anabolic steroids are common triggers, as are other ubiquitous street drugs like amphetamines and alcohol. And although it has not been scientifically proven, most physicians in the know believe marijuana can play a role as well.

Why would the article’s authors choose just one drug from a very long list and label it “the most common cause?”

Pubertal gynecomastia resolves on its own. As the piece notes, hormonal imbalances in men and boys can prompt breast tissue growth. Male infants often have slightly swollen breasts due to residual estrogen from the mother, for example. In this case, the condition almost always dissipates by itself.

Boys going through puberty can suffer enlarged breasts as well. In our experience, most gynecomastia shows up during puberty. Unfortunately this time the condition may not go away (and we suspect a genetic factor may be found one day). We find the assertion that teen gynecomastia resolves on its own “not helpful.” We have treated hundreds of teens whose primary care doctor has advised them that moobs disappear in time; when it doesn’t happen, patients sometimes feel worse about their case than they did before. “Am I the only one?” “Am I even weirder than I thought?” “Is something really wrong with me?”

Adolescent gynecomastia can resolve by itself, but not always. We want young guys and their parents to know that sometimes it does persist, usually for unknown reasons. If a teen has moobs for two years or longer, surgery is the only way to get rid of them.

There are many bits of input we agree with in this article. The principal one is that when a young man or adult notices breast growth, they should see their doctor. Sometimes a cause can be found, and even if breast tissue growth can’t be reversed, it is helpful to know what’s behind it. And since gynecomastia is a condition sometimes associated with an underlying disease, it’s important to get it checked out.

Patients should know, however, that it’s not unusual for medical professionals to lack full information about gynecomastia, or even have misconceptions. There’s much the medical world still does not know about the condition, and many doctors don’t see lots and lots of cases.

After visiting a primary care physician, if a guy wants more input we strongly suggest a consultation with a board certified plastic surgeon who’s highly experienced with gynecomastia. Not because we want to push male breast reduction surgery as the next step—though it is for many people. It’s because cosmetic surgeons who have treated several hundred patients have unique experience with man boobs they are eager to share.

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