Puberty / Adolescent Gynecomastia Surgery in Boston

The most common presentation of gynecomastia is someone who developed it at puberty, and it persisted throughout their life. This is often referred to as idiopathic gynecomastia, puberty gynecomastia, adolescent gynecomastia, or, “I’ve had gynecomastia my entire life.”

Young boys go through a time in their life, during puberty, when their hormones change causing secondary sex characteristics like hair growth, a deeper voice and pimples. It also typically causes tissue growth behind the nipples that can become larger and tender BUT usually disappears after a year. Unfortunately, in some cases, there is persistence of this tissue (even growth) that eventually becomes established gynecomastia.

Pubertal or ‘adolescent’ gynecomastia

Also called (inaccurately, by the way) ‘congenital’ or ‘hereditary’ gynecomastia, this condition generally appears between ages 9 and 14 and may be seen transiently in as many as 30 to 50 percent of boys. In some cases pubertal gynecomastia recedes with age, but about a third of all patients will have breast tissue that persists into their young adulthood, and improvement can only be achieved through surgical excision. Because pubertal gynecomastia can spontaneously regress, it is our practice policy not to provide surgical treatment for this group of patients until they are at least 16 years of age.

The introduction and eventual decline of the male sex hormone testosterone can have varying effects on the male anatomy. A surge in testosterone or a sudden decrease in it can be responsible for structural changes to a man’s body. This is extremely evident during a boy’s adolescent ascension through puberty. From puberty, the sudden influx of testosterone can rattle the biological balance in his body and cause an endocrine reaction to release unequal amounts of estrogen. This can cause breast tissue to grow in excess and/or to swell up and protrude, sometimes severe enough to even resemble female breasts. Commonly, if generated by puberty only, the condition will subside over time and improve and regress as the rest of the endocrine system levels out. All too often, however, this is not the case and gynecomastia remains.

The “Puffy-nipples” form of  gynecomastia, is fairly common among pubescent boys. affecting around 66% of boys going through puberty. Most cases occur between the ages of 13 and 14, although this condition can happen at any point during puberty. Needless to say, puberty is an extremely challenging time for young boys as many of them go through physical and emotional changes that affect their development. At this age, gynecomastia can affect a teenager’s self-image and confidence and even their general health as they withdraw from physical and social activities, so it is important to consult with a gynecomastia specialist in Boston.

Persistent gynecomastia during adolescence may require surgical intervention to alleviate both the physical discomfort and emotional distress experienced by these teenagers. At the Boston Gynecomastia Specialists, we specialize in providing comprehensive care for adolescents dealing with gynecomastia. Our team of dedicated specialists has the experience and expertise to address the unique concerns and challenges faced by these young individuals. With a focus on compassion and treatment customization, we strive to offer the best solutions to ensure optimal outcomes for our adolescent gynecomastia patients.

Gynecomastia Surgery for Adolescents

The assessed underlying cause of the enlarged breasts helps determine the most appropriate procedure to address the gynecomastia. The enlargement could result from excess fat, enlarged glandular tissue or a combination of both.

When fat is the cause of the gynecomastia, liposuction is used to remove the fat and contour the breasts. This would involve using one or two small incisions placed in strategic locations. A thin tube, known as a cannula, would be inserted through the incisions to remove the offending fat with suction. If excess, enlarged breast tissue is the reason for the gynecomastia, then surgical excision of this tissue will be necessary. For this procedure, Dr. Ishoo would make an incision along the lower half of the areola and precisely remove the offending tissue. True “Puffy-nipples” gynecomastia can also be treated with the minimally invasive technique of PEXsculpt developed by Dr. Ishoo which avoids the chest incision and opening of the breast tissue and the resultant scars. This technique also allows for better contouring and faster recovery for the appropriate individual.

When the cause of the enlarged breasts is the result of both excess fat and breast tissue, then a combination of both liposuction and direct surgical excision would be needed to achieve the desired goal.  Finally, if there is also excess, lax and sagging skin, this can be removed at a later time to allow healing and skin contraction, avoiding unnecessary trauma and scars in most cases. 

At the Boston Gynecomastia Specialists, surgical treatment of adolescent gynecomastia, especially “Puffy nipples” is safely performed under local anesthesia as an outpatient, which expedites recovery and return to school and activities.
At the Boston Gynecomastia Specialists, surgical treatment of adolescent gynecomastia, especially “Puffy nipples” is safely performed under local anesthesia as an outpatient, which expedites recovery and return to school and most activities in days.