Gynecomastia is a medical condition characterized by the enlargement of male breast tissue, resulting from an imbalance between estrogen and androgen activity in the body. It can affect one or both breasts and may present as a firm, rubbery mass beneath the nipple-areola complex or as diffuse chest fullness. Gynecomastia is a common condition and can occur at various stages of life, including infancy, adolescence, and adulthood.

Physiological gynecomastia is frequently seen during puberty due to temporary hormonal fluctuations and often resolves on its own. However, persistent or progressive gynecomastia in adolescents or adults may be caused by hormonal disorders, obesity, medications, anabolic steroid use, chronic liver or kidney disease, endocrine abnormalities, or tumors affecting hormone-producing glands. Pseudogynecomastia, which involves excess fatty tissue rather than true glandular enlargement, is commonly associated with weight gain and requires differentiation during evaluation.

Patients with gynecomastia may experience physical discomfort such as chest tenderness, sensitivity, or pain, particularly during exercise or when clothing rubs against the chest. Beyond physical symptoms, gynecomastia often has a significant psychological impact. Many individuals report embarrassment, low self-esteem, social withdrawal, and avoidance of activities such as swimming or sports due to chest appearance.

Clinical assessment involves a detailed medical history, physical examination, and, when indicated, hormonal evaluation or imaging studies to rule out underlying pathology. It is essential to distinguish between true glandular gynecomastia and fat-related chest fullness, as management strategies differ.

Management depends on the cause, duration, and severity of the condition. Early-stage gynecomastia related to reversible causes may be managed conservatively with observation, medical management, or lifestyle modification. Long-standing gynecomastia with fibrotic glandular tissue often requires surgical correction to restore a flatter, more masculine chest contour.

Surgical management focuses on removing excess glandular tissue and reshaping the chest to achieve natural-looking proportions. The objective is to restore confidence, improve physical comfort, and allow patients to engage freely in daily and social activities. When appropriately evaluated and treated, gynecomastia correction offers high patient satisfaction and lasting results.