Types and Classifications of Gynecomastia

big male breast

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  • The American Society of Plastic Surgeons classifies gynecomastia under four grades, with 1 being the mildest and 4 being the most severe
  • Basically, men with bilateral gynecomastia have noticeable enlargement in both breasts, while unilateral gynecomastia means that only one of the breasts has noticeable growth — the other appears normal in terms of size and shape

Gynecomastia does not occur similarly among men — there are certain factors that may differentiate one case from another. For example, the size of the breast enlargement and feminization of the breast may be considered.

4 Grades of Gynecomastia

The American Society of Plastic Surgeons classifies gynecomastia under four grades, with 1 being the mildest and 4 being the most severe.1 This table shows a more detailed description of each one:

Grade or Type

Severity

Description

1

Very mild

The male breast appears to have a localized button of tissue around the areola.

2

Mild to high

There is moderate breast enlargement that goes beyond the areola boundaries, wherein the edges are noticeably indistinct from the chest.

3

High and visible

Aside from moderate breast enlargement that goes beyond the areola boundaries and have edges that are indistinct from the chest, skin redundancy is also noticeable present.

4

Severe and visibly feminine

The breast enlargement is highly noticeable, and comes with skin redundancy and breast feminization.

Gynecomastia May Be Classified According to Symmetry

Another common way that gynecomastia may be classified is according to its symmetrical aspect — or, to put it in simpler terms, whether it appears in just one breast or in both. This is why gynecomastia may be identified as either bilateral or unilateral gynecomastia. Basically, men with bilateral gynecomastia have noticeable enlargement in both breasts,2 while unilateral gynecomastia means that only one of the breasts has noticeable growth — the other appears normal in terms of size and shape.3

Gynecomastia Versus Pseudogynecomastia

There may be instances when a man immediately assumes that the appearance of "man boobs" means he has gynecomastia, but here's the truth: Just because you have breast growth does not automatically mean that you have this condition. Rather, it could be what's called pseudogynecomastia.

So, what's the difference between the two? Basically, it all boils down to what's causing the chest enlargement. If you have true gynecomastia, it means that the swelling is caused by excess breast tissue. However, if it's pseudogynecomastia, the culprit is fat, and not tissue. Men who are obese or overweight are prone to pseudogynecomastia.

For a physician to properly identify a patient's condition, this simple diagnostic procedure is performed: The patient will be asked to lie down with his hands behind his head. The physician will palpate the sides of your chest, to see if there is a firm or rubbery area around the nipple. If this is present, it indicates gynecomastia, but if there's none, it's pseudogynecomastia.4

MORE ABOUT GYNECOMASTIA

Gynecomastia: Introduction

What Is Gynecomastia?

Gynecomastia Symptoms

Gynecomastia Causes

Gynecomastia Types

Gynecomastia Treatment

Gynecomastia Surgery

Gynecomastia Diet

Gynecomastia Prevention

Gynecomastia FAQ



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