Dear Dr G,

I am a 34 year-old man who is asking for help during the month of breast awareness – Pink October.

I am someone who has always been on the heavy side and admittedly not a keen sportsman. I recently met a nice lady who encourages me to exercise more.

Despite losing weight successfully over the last 12 months, I don’t seem to be able to shed the chest size.

I was never too self-conscious about the man boobs until recently.

My girlfriend mentioned if the man boobs become any bigger, we would need to share the bra in the future.

Truthfully, the man boobs are getting me very depressed and quite moody.

I know the Pink October is meant for women breast cancer awareness.

I guess since men possess a pair of boobs too, I am entitled to put Dr G on the spot this month on the issue of breast enlargement in men.

Can you tell me how common are man boobs and what are the causes?

I went to the doctors, who asked me to lose weight. Despite losing my beer belly, my man boobs are still there.

Can weight lost or exercise help to reduce the size of man boobs?

I am keen to go for the knife, before my girlfriend starts asking me out to go bra shopping with her. Can you tell me the risks of boob jobs for man boobs?

Regards

Moody Moobs.

The swelling of the breast tissue in men is the most common benign disorder of the male breast, also known as gynecomastia.

Common slangs or derogatory terms such as man boobs or moobs are often used, which can cause tremendous distress in self-conscious men.

Generally, the enlargement of the breast tissues is caused by the imbalance of male and female hormones, namely testosterone and estrogen.

Despite being associated with physiological changes in men, pathological causes of gynecomastia are also well documented.

Man boobs are common in three stages of a man’s life. Newborn gynecomastia occurs in almost all male infants, and mostly resolves naturally.

Persistent adolescent breast swelling is documented to affect up to 70% of teenage boys, which can be a source of embarrassment and distress, in addition to other growing pains.

Man boobs also commonly affect men above the age of 50, sadly known as senile gynecomastia. I guess at a certain “senile” age of a man’s life, the protruding sagging boobs are the least of his concerns.

The prevalence of gynecomastia in men is believed to be under reported although on the rise in recent years.

The exact cause and the epidemiology of the disorder are not fully understood.

The utilisation of anabolic steroids, chemicals in pesticides and plastics than mimics the estrogen has been widely implicated.

Although the chemicals that mimic estrogens are thought to cause the male-female hormonal imbalance, the side effects of certain medications inducing gynecomastia are estimated to affect 10-25% of men suffering from man boobs.

Commonly used drugs such as ketoconazole (antifungal), cimetidine (antacid) and finasteride (prostate enlargement) are noted to be associated with the swelling of the breast.

The cessation of the medications will generally return the mammary tissues back to its former state. However, persistent swelling may still be an issue for many men.

Gynecomastia is treated conservatively in most men, as they post no medical or oncological threats. Men with mild cases of man boobs are advised to exercise with a balanced diet.

Moderate or severe cases may cause significant psychological distress in needing medical or surgical interventions.

In a statistics in 2016, the American Society of Plastic Surgeons (ASPS) revealed that nearly 28,000 men opted for breast-reduction surgeries.

This is an increase of nearly 40% since 2000. The surgical removal glandular breast tissue is generally a straightforward operation involving some degree of liposuction.

Liposuction-assisted mastectomy, laser-assisted liposuction or laser-lipolysis are some of the available options.

Despite the advancement in minimally invasive medical technology, men contemplating boob jobs should seriously consider the potential complications of sensory changes of the breasts, necrosis of the nipples, painful scars and contour deformities.

The month of October marks the Breast Cancer Awareness Month, an annual international health campaign to increase awareness of the condition and to raise funds for breast cancer research.

The gorgeous Italian actress Sophia Loren once said during a campaign: “I think quality of sexiness comes from within. It is something that is in you or it isn’t. It really doesn’t have much to do with breasts or thighs or the pout of your lip.”

For men who are troubled by the sight of the protruding sagging chests, it is natural to be tempted by surgical modification.

A healthy lifestyle and regular exercise are often the solution for balanced hormone, and sustained firm chest.

Dr G’s advice is: “Put on a loose shirt to rouse your sexiness from within, then you can spare the bra and the knife for your moobs!”

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