Being a parent, it is my responsibility to teach my kids to be confident and that confidence isn’t all about outward appearance. I am personally not a proponent of aesthetic plastic surgery for minors. But as a father of boys, I feel very empathetic towards boys and young men with gynecomastia. It is the only aesthetic surgery I perform on minors. And if my boys are ever candidates for this procedure and have the desire, I would fully support their decision, even as teens, to have gynecomastia surgery.
Gynecomastia, often referred to derisively as ‘man-boobs’, is endemic in the United States. While gynecomastia can be associated with excess body mass and obesity, many males I see for gynecomastia reduction surgery are not overweight but simply have experienced the spontaneous proliferation of fibrous breast tissue on one or both sides of their chest, for reasons that medical science currently cannot fully explain.
For young men and teens with gynecomastia, the problem can create a vicious cycle of self-consciousness and social withdrawal. With breast area enlargement, a boy gradually becomes insecure about his appearance without a shirt or even in workout clothing. They begin to avoid social situations in which their chest appearance is obvious (the gym, the pool, pickup games), and sometimes come to avoid sporting activity of any kind. This can potentially damage their psychosocial development and has a profoundly negative effect on their sense of well-being and quality of life.
There are many theories as to why there has been such a dramatic increase in the incidence of gynecomastia over the last few decades. Some believe it is because of the increase pro-estrogenic hormones and chemical compounds such as antibiotics in meat and dairy products, and/or chemicals that we are exposed to in the environment (building materials, flame retardants, pesticides, etc). No one can be absolutely certain what has caused the significant increase in gynecomastia, but I see enough gynecomastia patients with a normal body weight to know for certain that it is not simply due to the rising incidence of obesity.
Gynecomastia patients are among the happiest with their results. They are not only pleased with the enhancement of their personal appearance after surgery, but also become better integrated socially. The outcome of surgery can be truly life changing, with young men immediately more socially confident and more socially active.
One very grateful set of parents recently shared with me that their son, who would never even remove his shirt around his family in the privacy of their home, was so happy with his improved appearance that he was frequently shirtless around the house, was back to hanging out with his buddies at the pool and was thinking of trying out for soccer for the upcoming school year. This kind of story is very typical of the adolescent male patient who has undergone gynecomastia surgery.