Nov 10, 2023
Nov 6, 2023
Your son may not be comfortable discussing subjects like enlarged breasts with you – and teenagers can be very good at covering it up too! However, if it isn’t checked, it can lead to low self-esteem, depression and a lack of body confidence.
Among boys, the development of breast tissue, enlarged breasts or swollen male nipples in puberty is common in teenagers. It usually disappears on its own, but if it doesn’t, there could be an underlying issue such as gynecomastia.
Your son may not be comfortable discussing subjects like enlarged breasts with you – and teenagers can be very good at covering it up too! However, if it isn’t checked, it can lead to low self-esteem, depression and a lack of body confidence. Dr Ivan Puah answers some questions on what to look out for, and runs through the treatment options.
Here are three key signs:
An increase in size of male breasts and changes in appearance of nipples (where the breasts seem identical to a woman’s), including enlarged areolas, could indicate gynecomastia. Your child may also slouch more and opt to wear baggy tops to disguise it.
The child may seem more withdrawn and prefer to be alone; he may opt out of social activities, including ones with the family. And his mood swings may become more erratic.
He may also complain of discomfort, soreness and pain in the breasts. Even slight contact can cause considerable pain and sensitivity. Although rare, there may be nipple discharge as well.
These are just possible indications; they’re not necessarily definitive. If gynecomastia is suspected, striking up a conversation would be a good start; but it has to be done tactfully so that it doesn’t cause (further) embarrassment. He also needs to understand that the issue can be resolved.
If your child allows, a physical check may further help determine the extent of his condition. The presence of a firm rubbery lump around the enlarged breasts, which can be felt with a gentle touch of the fingertips, indicates that he is highly likely to be suffering from gynecomastia.
The stigma surrounding gynecomastia is real, so to help them, we must stamp out any prejudice we may have. Assure your child that gynecomastia is treatable; he is not alone and he has your support and the support of the family to get through this. Your child may be apprehensive and even fearful; do your best to assure them it’s essential to seek help from a medical professional.
If gynecomastia surgery is indicative after the consultation, again, give your son the assurance that you will provide all the support needed. Advise him not to try “quick fixes” like creams, lotions or pills. Also, non-surgical treatments such as fat freezing will not be able to remove glandular tissue. Instead, arrange for him to see a doctor who is well-versed in gynecomastia matters.
Hormonal imbalance and fluctuations during puberty is the common cause. The increased ratio of oestrogen to testosterone is usually the cause of adolescent gynecomastia. Testosterone is the hormone behind male traits, including muscle mass and body hair. Oestrogen, on the other hand, is associated with female traits such as breast development – so an increase in this hormone, particularly in males, leads to gynecomastia and female-looking breasts.
In adolescent boys, most pubertal gynecomastia issues go away within two years. But there are still high numbers whose gynecomastia cannot be resolved.
The best permanent solution – and a proven one – is surgical intervention. In adolescents, gynecomastia surgery is highly effective as the patient’s young and elastic skin can more easily contract and tighten.
Gynecomastia surgery removes the issue permanently when done correctly; the importance of engaging a qualified and experienced doctor can’t be reiterated enough for this.
After surgery, it’s important that the patient follows the post-op care instructions. There is a high chance of recurrence if they use anabolic steroids or are under-prescribed medication for certain medical conditions such as depression. Weight gain may result in fat accumulation on the chest. Hence, the patient must do his part to maintain his post-op results with a healthy lifestyle and balanced diet.
History taking and physical examinations such as pinch tests are the keys to diagnosing for this group of patients. I have treated many gynecomastia patients, successfully performing the procedure for over 15 years. The presence of a mound of fibrous and firm tissue is almost always a good indication. Besides that, I will also assess the patient for skin laxity, and the presence of excess fat on the chest. A detailed medical history, the patient’s experience and the family history will also be taken in account during the consultation.
Gynecomastia comes in varying degrees, so it’s best to leave the diagnosis to a doctor with experience in this area. If you think your child may be suffering from the condition, do not hesitate to schedule an appointment for a private consultation.