Severe Cases Of Gynecomastia: How Extreme Gyno Happens And What Is The Best Treatment Option For It?

Severe cases of Gynecomastia can be caused by different kind of medications or previous health issues. Here, you will learn why this condition can appear and what are the best otions to get rid of it.

Many, if not most, men with severe gynecomastia feel hopeless and helpless against their too-feminine breasts for many reasons.

Causes of severe gynecomastia and treatment options

Do you have a very large breast that you can’t get rid of ?

If yes, then you may have extreme gynecomastia, a condition characterized by enlarged breasts that jut out prominently from the chest wall.

Emphasis must be made that it isn’t just a case of excess fat tissue in the breast area, a condition known as pseudogynecomastia (i.e., pseudo means fake).

Instead, it’s excess male glandular breast tissue that manifests itself as enlarged breasts, which may sag like true female breasts.

What It Looks Like And When It Happens

The American Society of Plastic Surgeons (ASPC) has established a grading system for classifying gynecomastia.

Grades 1 and 2 are relatively mild while Grades 3 and 4 are considered as moderate to severe; Grade 4 is obviously the most severe form.

In Grade 3 gynecomastia, there’s moderate breast enlargement that makes the breast appear high and visible on the chest wall.

How severe gyno looks likeThe edges of the breast are more pronounced and the skin has a distinctive angle where the breast starts its enlargement.

There may be some skin redundancy, thus, a patient who decides to undergo severe gynecomastia surgery will have part of his skin removed.

In Grade 4 gynecomastia, the breasts are more feminine in appearance with their markedly enlarged size.

The breasts also start sagging due to their larger size while their nipples may also be longer.

The overall close-up appearance is, indeed, female breasts that, when measured, may be in the C- and D-cup sizes.

With severe gynecomastia, surgery is the best option to remove the excess breast tissue and restore the breasts’ masculine appearance.

Other treatments will not provide the best results because of the extent of breast enlargement. 

Men can, of course, choose not to undergo surgery because of the costs and complications involved. But given the choice, many men will understandably go for surgery because of its benefits, both physical and psychological.

Take note that the amount of swelling in each breast should also be noted.

If one breast is significantly bigger than the other breast, then it should be checked out by a doctor. It may not be Grade 3 or Grade 4 gynecomastia but a breast abscess or breast cancer.

If both breasts appear to be similar in size, then it may likely be severe gyno.

Grade 3 and 4 gynecomastia can often be seen in adolescents due to changes in hormone levels caused by puberty.

It is also prevalent in older men between 50 and 69 years old (i.e., the peak age for the condition), in men who use androgens or anabolic steroids for enhancement of athletic performance, and in men with certain health conditions like liver, kidney, or thyroid disease.

Adolescent boys are arguably the most affected by the condition. They may be subjected to bullying, teasing and even physical harm, as well as stay away from activities that require wearing tight-fitting shirts and going shirtless.

But in many cases, the condition resolves on its own in 6-24 months, which may be an eternity for an adolescent boy.

Why It Happens

Extreme cases of gynecomastia are typically triggered by an imbalance in the body’s testosterone production in comparison with estrogen production.

This can be caused by several factors that may or may not work simultaneously in the body.

The major causes include but aren’t limited to the following: 

  • Natural changes in the hormone levels, such as during puberty and aging
  • Medications like androgens, anabolic steroids, anti-androgens, AIDS medications, antidepressants and anti-anxiety medications, heart medications, and chemotherapy
  • Street drugs like marijuana, amphetamines, and heroin, as well as alcohol
  • Health issues like kidney or liver failure; tumors in the testes, pituitary gland, and adrenal glands; hypogonadism; and hyperthyroidism

Your doctor will perform a physical examination, take your medical history, and instruct laboratory tests to determine the possible causes of your extreme breast enlargement.

While surgery and medications are necessary for the removal of the excess breast tissue, the treatment of an underlying cause is also a must for best results.

Otherwise, your condition will recur and surgery may not be an option anymore.

How It Is Treated

Treatments for extreme gynecomastia

For extreme gyno cases, the best way to treat them is through a combination of medication and surgery.  One without the other will not produce excellent results so be sure to follow your surgeon’s instructions to the letter.


Doctors can prescribe drugs used in the treatment of breast cancer to manage the condition. These drugs include Raloxifene, Tamoxifen, and aromatase inhibitors.

These aren’t approved by the Food and Drug Administration (FDA) for gynecomastia treatment, however, although there have been cases of successful treatment.


If medications don’t work in your case, then your doctor will suggest surgery. There are two types of surgery that can be used, namely:

  • Liposuction, which removes the excess fat in the breast. The breast gland tissue, however, will be left intact.
  • Mastectomy, which removes the breast gland tissue. This is less invasive than liposuction since only small incisions are made on the site.

You and your doctor should discuss which of these two options will work best in your case. For example, liposuction may work best if your enlarged breasts have more fat than tissue in them.

Mastectomy, however, is the more common option because the excess breast tissue will be removed and, thus, the feminine breasts are less likely to recur.

In many cases, doctors perform both liposuction and mastectomy to reduce the risk of post-surgery puffy nipple appearance.

Don’t limit yourself to medications and surgery either! You may want to consider natural supplements that can be useful in the treatment of severe gynecomastia.

You may take them before your surgery to reduce the size of your breasts and after your surgery to maintain their smaller size; ask your doctor about it though.

You should also adopt a healthy diet and exercise habits along with taking these natural supplements for sustained results.

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