Gynecomastia in men is defined as the appearance of the sagging breast in men and an increase in its size resulting from the imbalance between the ratios between male and female hormones (testosterone and estrogen levels) in men , which leads to an increase in the ducts and branches of the breast in men and the spread of glands and bumps around the nipple in men. Excess fat in the breast causes what is called false gynecomastia, and gynecomastia is divided into two types: homogeneous gynecomastia affecting both breasts and heterogeneous gynecomastia affecting one breast without the other.
There are degrees of gynecomastia in men and doctor’s diagnoses are based on whether or not surgery is required.
First degree: in which gynecomastia presents as a protrusion around the nipple and it cannot be diagnosed easily. At this stage, the doctor advises exercise and certain medications.
Second Degree: In this degree, the swelling around the nipple increases to reach the areola of the breast in men, but no excess skin or sagging is noticed. Also in this degree, the doctor may not resort to surgery, but to exercise and prescribe medication or liposuction.
Third degree: where the swelling begins to appear even when wearing normal, loose clothing, and in this case the doctor may resort to surgical removal of the excess tissue.
Fourth degree: At this stage, the shape of the male breast is closer to the shape of the female breast, in which the doctor uses surgery to remove the enlarged tissue, but may need using certain medications first before surgery to reduce swelling