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Gynecomastia: A First-Steps Guide for Those Just Starting to Wonder

Author : Dr. Young-jin SimMay 26, 2026 at 11:06 AM 219

Gynecomastia: A First-Steps Guide
for Those Just Starting to Wonder

"Is this the first time you've searched the word gynecomastia?"

Many people assume gynecomastia is an extremely rare condition,

but in fact, some degree of breast tissue change has been reported in roughly 30-60% of adult men.

It is more common than you might think, and far more men are quietly worrying about it than you'd expect.

The problem is that most people simply have no idea where or how to start looking into it.

1. What Is Gynecomastia?

Gynecomastia is a condition in which a man's glandular tissue develops abnormally, causing the chest to protrude. It is different from a chest that has simply grown larger due to weight gain.

True Gynecomastia

Glandular tissue itself has proliferated

Pseudogynecomastia

Caused by fat accumulation

Mixed Type

Glandular tissue and fat develop together

The causes are varied. Temporary hormonal changes during puberty, declining testosterone after middle age,

certain medications, and increased body fat are the most common. In consultations, we find that quite often

the cause cannot be pinned down to any single factor.

Either way, if the chest protrusion persists and it troubles you, it's worth going through the process of identifying the cause.

2. How to Check: From Self-Palpation to Grading

When gynecomastia is suspected, confirmation usually happens in three steps.

•

Step 1: Self-Palpation

If you press gently with your fingertips just beneath the nipple and feel a firm, round mass distinct from the surrounding fat, developed glandular tissue may be suspected. However, touch alone cannot accurately determine the type or degree.

•

Step 2: Ultrasound Exam

An ultrasound objectively distinguishes whether the tissue is glandular, fatty, or mixed. In following post-surgical outcomes, the difference between cases where tissue composition was accurately identified at this stage and cases where it wasn't tends to be quite clear.

•

Step 3: Simon Classification Grading

Because the grade determines whether observation is appropriate or a surgical approach is needed, going through this step is important. Of course, even at the same grade, the direction can vary depending on individual body shape and skin elasticity.

3. Treatment Options: Observation vs. Surgery

A diagnosis of gynecomastia does not automatically mean surgery is necessary.

Depending on the condition, observation may be appropriate in some cases, while a surgical approach may be considered in others.

Category	Observation	Surgery
Suitable for	Within 1 year of pubertal onset, mild in degree	Persisting for 2+ years, clearly developed tissue
Tissue condition	Glandular tissue not large and trending smaller	Glandular tissue fixed with no change
Psychological impact	No major disruption to daily life	Ongoing self-consciousness in clothing, activities, etc.
Expected outcome	May resolve naturally once hormonal balance is restored	Direct removal of the tissue causing the protrusion
Precautions	Regular follow-up checks needed	Prior understanding of complications and individual variation needed

Which direction is right is decided by weighing the tissue composition, how long it has persisted, and the discomfort you personally feel. Honestly, a great many people try to make this decision entirely on their own. We recommend getting an evaluation from a specialist.

GUIDE — What to Prepare Before Your First Consultation

01. Note when you first noticed the chest protrusion and how it has changed over time.
02. Bring a list of any medications or supplements you are currently taking.
03. If you have a history of weight changes, sharing it helps with the diagnosis.
04. Be honest about the everyday discomfort and psychological burden you feel as well.

With gynecomastia, the hardest moment is typing it
into the search bar for the first time.

But if you've taken that one step, you're already halfway there.

Don't struggle alone. It's more common than you think — and simpler than you think.

References

Simon classification — Simon BE, Hoffman S, Kahn S. Classification and surgical correction of gynecomastia. Plast Reconstr Surg. 1973;51(1):48–52. doi:10.1097/00006534-197301000-00009
Gynecomastia review (etiology, mechanism, course) — Braunstein GD. Gynecomastia. N Engl J Med. 2007;357(12):1229–1237. doi:10.1056/NEJMcp070677
Drug-induced gynecomastia — Bowman JD, et al. Drug-induced gynecomastia. Pharmacotherapy. 2012;32(12):1123–1140. doi:10.1002/phar.1138

References for the medical classification, disease code, and mechanisms mentioned in this article. Diagnosis and treatment decisions are made through individual consultation.

ABOUT THE AUTHOR

Dr. Young-jin Sim

Myeongdong Branch · Urologist · Master of Medicine

# 디테일의완성# 진심의진료# 후회없는선택

Key Background

· 비뇨기과전문의 / 의학석사
· 경북대학교 의과대학 졸업

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"결과로 증명하고, 진심으로 기억되는 의사. 디테일이 다른 수술의 완성도."

"수술은 기술의 영역이지만, 환자를 대하는 일은 언제나 마음의 문제라고 생각합니다. 결과뿐 아니라 과정까지 솔직하게 설명하고, 환자가 충분히 이해한 뒤 선택할 수 있도록 함께 고민합니다. 남성 체형과 남성수술을 경험하며 변하지 않은 기준은 하나입니다. 환자가 이 선택을 후회하지 않도록, 수술 전부터 이후까지 책임을 다하는 것. 그것이 제가 생각하는 진료의 본질입니다."

· 서울 삼성의료원 전공의
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· 대한 전립선학회 정회원
· 국제 비만체형학회 정회원
· 前 트루맨남성의원 강남점 원장
· 대한 요로감염학회 / 비뇨기과 감염학회 정회원

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Gynecomastia: A First-Steps Guide for Those Just Starting to Wonder