Classification of Gynecomastia

There are many ways of classifying Gynecomastia.

It could be classified according to which part is enlarged : (1) True Gynecomastia – gland enlargement (2) False Gynecomastia – Over fat accumulation (3) Mixed Type – Both gland & fat overgrowth.

And, It could also be classified according to its time of onset & cause,

– Newborn gynecomastia

  • Physiological response to high levels of maternal and placental estrogen transferred in utero. A secretion sometimes called witch’s milk can often be expressed.

– Pubertal gynecomastia:

  • Physiological response to the increase in the testosterone-fueled by marked increases in GH, insulin-like growth factor-1, FSH, and LH at puberty
  • Estrogen increases 3-fold, but peaks earlier than testosterone.

– Adult gynecomastia (physiological):

  • Physiological response to the decrease in free testosterone and the increase in adipose tissue that often accompanies aging
  • Testosterone is converted to estrogen in adipose tissue.

– Adult gynecomastia (non-physiological):

Grade of Gynecomastia

The chart below shows the Grade of Gynecomastia and it’s corresponding description. This grade is according to the American Society of Plastic Surgeons(ASPS).

Grade or Type Description Severity
1 A localized button of tissue that is concentrated around the areola Very mild
2 Moderate breast enlargement exceeding areola boundaries
with edges that are indistinct from the chest		 Mild to high
3 Moderate breast enlargement exceeding areola boundaries
with edges that are distinct from the chest with skin redundancy present		 High and visible
4 Marked breast enlargement with skin redundancy and feminization
of the breast		 Severe and visibly feminine

Operation Method of Gynecomastia

The grading that we are using depends on skin sagging.
With that said, It is just natural that our surgery method would also depend on it.
The chart below gives you an idea of what operation will be applicable to you.
It will be confirmed during our face-to-face consultation.