Dr. Khalil responds to a question from a potential patient.

Dear Dr. Khalil,

As a man, I feel embarrassed by my enlarged, woman-like breasts. I try to hide my chest under baggy clothing and I don’t like going to the pool or beach. Dating is completely out of the question. I am wondering if an exercise routine would help to improve my prominent breasts, or will I need surgical correction?

{name redacted}

Dear {redacted},

Thank you for your question. Before I discuss treatment, I would first like to explain why some men, like you, develop large, woman-like breasts.

One likely answer is that you have a medical condition known as gynecomastia. If true, this means your breasts are composed of dense glandular tissue, which has swelled due to a hormonal imbalance. The glandular tissue is probably localized behind your areolas and may be surrounded by excess fatty (adipose) tissue as well.

Though gynecomastia usually isn’t painful, having large breasts can seriously affect a man’s self-confidence, as you have noted. Men who struggle with gynecomastia may experience stress, anxiety or depression because of their appearance, and may become withdrawn from social activities.

Unfortunately, glandular tissue (and therefore true gynecomastia) does not respond to exercise. Some men with gynecomastia notice that exercise in fact makes the condition look worse. As the chest muscles get stronger with targeted strength movements, the muscles can push the tissue out farther from the chest, causing the breasts to protrude or look tuberous.

The only solution to true gynecomastia is a surgical procedure to remove the excess tissue (and redundant skin, if needed) and re-sculpt the chest to create a flatter and firmer contour.

However, without examining you in person, it is impossible to diagnose you with true gynecomastia. You might actually have a similar condition, known as pseudogynecomastia, which would mean your breasts are composed of fatty tissue only. Maybe you struggle with being overweight or obese, and your breasts reflect that. If that is the case, increasing the frequency and intensity of your workouts may help. Exercise will reduce the surplus fat and build the pectoralis muscles, giving the chest a more sculpted appearance.

Without a professional’s opinion, it is difficult to ascertain the composition of your over-developed breasts and thus, recommend the appropriate treatment. It is best to seek out the expertise of a board-certified plastic surgeon that can examine your breasts and determine whether they are composed of glandular tissue, fatty tissue or both. Based on this information, the surgeon can recommend the best plan of treatment — whether that is male breast reduction or a fat reduction method.

If you would like to discuss your case in person, please schedule a consultation at my practice. I would be happy to help. Please call 310.385.8601 or email our practice today to make your appointment.

Kind regards,

Dr. Khalil