Gynecomastia in Body Builders


Dr. Adrian Lo, MD, FACS, FRCS (C), see’s gynecomastia patients who have developed enlarged male breasts as a result of taking anabolic steroids, and other similar drugs, to boost their performance. Although using steroids does not always cause gynecomastia, it is a familiar side effect with this drug. That is why it is important for anyone taking anabolic steroids to understand the risks of the drug.

Why Does Anabolic Steroid Use Sometimes Lead to Gynecomastia?

When the body processes the most common type of anabolic steroids, it converts the steroids into estrogen. This process is called aromatization. Aromatization leads to a hormone imbalance: too much estrogen, not enough testosterone. This estrogen-rich hormone imbalance can cause glandular tissue to grow. Compounding this breast tissue growth is the fact that an extra source of hormone in the body signals the testes to slow their production of testosterone hormone (as part of the body’s “negative feedback mechanism”), deepening the divide between estrogen and testosterone. This leads to further growth of the glandular tissue.

Body Builders' Gynecomastia

Body Builders’ Gynecomastia

Unfortunately, once formed, the enlarged breast tissue does not return to normal even if you stop taking steroids. This results in “manboobs” or true gynecomastia. Neither prescription nor over-the-counter medications can treat true gynecomastia. The only real solution for enlarged breasts is surgical removal and cutting out the tissue which is called subcutaneous mastectomy. Any other proposed solution simply does not work.

Treatment for Body Builders’ Gynecomastia

Philadelphia and South Jersey plastic surgeon Dr. Lo treats body builders’ gynecomastia with male breast reduction surgery, or subcutaneous mastectomy. Because body builders’ enlarged breasts are caused by the steroid-induced growth of glandular tissue, not fat tissue, Dr. Lo must surgically remove the excess glandular tissue. Dr. Lo calls this “cutting out the glands” and once this is done, the breast tissue is permanently removed and will not come back.


To begin male breast reduction surgery, Dr. Lo makes an incision along the bottom edge of the areola, the color area of skin around the nipple. Through this incision, he removes excess breast tissue. Puffy nipples are corrected as well with removal of the glandular tissue behind the nipple. The areola will become smaller as well.


The amount of glandular tissue removed will depend on how much extra breast tissue is in the chest area. The tissue may range from the size of a marble to a large donut-size. If there is extra fat in the area, Dr. Lo performs liposuction in conjunction with male breast reduction surgery. He offers tumescent liposuction, ultrasonic liposuction and power-assisted liposuction (PAL) to sculpt and contour the chest. In addition, Dr. Lo may find it necessary to excise excess skin in the chest area to provide optimum aesthetic results. In doing so, he can provide a certain degree of lift and skin tightening throughout the treated area for a smoother chest contour.


Hey Doc!
You did a great job on my gynecomastia! I am a national level bodybuilder and you can’t even really see any scars. Thanks again!
— JS

December 2013

Once Dr. Lo is satisfied with the newly contoured chest, he closes all incisions with dissolvable sutures. Body builders do not need to worry about visible incision scars from gynecomastia surgery because they are hidden in the pigmented skin of the areola. The incisions used for liposuction of the chest area are hidden in the underarm area and will not be seen after complete healing. During your consultation, Dr. Lo will discuss his gynecomastia surgery techniques with you and recommend the best surgical treatment options to fit your individual anatomy and aesthetic goals. To learn more about gynecomastia and how it affects body builders, or to schedule a personal consultation with Dr. Lo, please contact his office by calling (215) 829-6900.

To learn about additional cosmetic surgery enhancement options for men, please visit Cosmetic Surgery For Men