Types + Grades of Gynecomastia

Gynecomastia can be classified into different degrees related to the amount of fat and glandular tissue build up. The condition is classified by the volume of buildup, stretching and sagging of the skin, and deformation of the nipples and areolas. A surgical treatment plan is based on the grading of the condition.

Mild cases consist of cherry sized lumps just behind the nipples, most often occurring in athletic, young men. The nipples appear to be sticking out, especially with the chest muscles relaxed, or in warmer weather. Although not always noticeable to other people, puffy nipples can be more apparent when wearing tightly fitted shirts.

More severe cases will outwardly resemble female breasts with significant amounts of fat and glandular tissue, and typically cause men significant psychological distress. The image illustrates and classifies the range of conditions that can occur.

mild Gynecomastia

For mild cases of gynecomastia, the glandular lump is about the size of a cherry, and the breast mound is not very apparent. Some fat build-up may have occurred, but there is no serious permanent stretching of the skin or areolas. In most situations, the condition is not very noticeable.

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Moderate Gynecomastia

For moderate cases of gynecomastia, the glandular lump is about the size of a plum, and the breast mound is apparent at all times. The lump is surrounded by a significant fat build up, which may fluctuate in size with weight gain and loss, but always remaining as clearly defined breasts. As the condition advances, glandular tissue can extend outwards towards the sides of the chest and armpits. The nipples and areolar remain permanently stretched, and may begin sagging slightly.

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Severe Gynecomastia

Severe cases resemble developed female breasts, and may be distinguished by a degree of sagging. The volume of excess tissue can extend to the sides of the chest wall creating additional folds under the armpits. Skin becomes stretched, and will likely not fully retract with just glandular tissue excision and liposuction. For these cases, to achieve a flatter, smoother result, some excess skin is removed. However, for these types of cases, the final result will not be a perfectly flat and smooth chest.

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