Breast development in boys during puberty is quite common. The condition is called gynaecomastia. Firm breast tissue grows underneath the nipples and in severe cases this can become very noticeable. In the most severe cases enlargement of one or both sides may reach female proportions.
Occasionally gynaecomastia development can be due to hormonal problems, but often no cause is identified. Gynaecomastia may run in families. People who develop gynaecomastia in puberty should ideally see a paediatric endocrinologist.
Gynaecomastia often disappears spontaneously over a period of one or two years. If it persists however it can be a very embarrassing problem and can normally be treated surgically. The type of operation required depends on the degree of gynaecomastia. Small degrees of gynaecomastia can often be treated by liposuction alone although normally some of the breast tissue that has developed beneath the nipple needs to be removed surgically through an incision based at the margin of the nipple areolar complex (edge of the nipple). For very severe gynaecomastia it may be necessary to excise some skin from the anterior chest which leaves a long scar that extends beyond the nipple margin.
Gynaecomastia reduction is usually undertaken under general anaesthesia and requires one night in hospital after the procedure. A tightly fitting garment needs to be worn for 4-6 weeks after surgery.