Gynecomastia is the non-cancerous enlargement of male breast tissue caused by a proliferation of the glandular component. This results from an imbalance in the ratio of estrogen and androgen hormones, often due to natural shifts, medications, or underlying health issues. Treatment is not singular and often involves collaboration between different medical specialists. The specific doctor specializing in the condition depends on whether the patient requires medical diagnosis and non-surgical management or definitive physical correction.
The Initial Consultation and Screening
The journey for a patient with gynecomastia typically begins with a Primary Care Physician (PCP), Family Doctor, or Internal Medicine Specialist. This provider performs a physical examination to distinguish between true glandular enlargement and pseudogynecomastia, which is primarily excess fat tissue. The PCP also takes a detailed medical history, focusing on medications, supplements, and substance use, as these frequently contribute to hormonal imbalance.
The initial workup involves ordering specific blood tests to determine if a systemic issue is present. These lab tests measure hormone levels, including testosterone, estrogen, LH, and FSH. Tests also evaluate the function of organs that process hormones, such as the liver and kidneys, and may include a thyroid function test. The PCP assesses for “red flag” symptoms, like rapid enlargement or suspicious masses, and then refers the patient to the appropriate specialist based on preliminary findings.
Specialists for Medical Evaluation
If the initial screening reveals a hormonal irregularity or suggests a systemic cause, the patient is referred to an Endocrinologist. This specialist focuses on disorders of the endocrine system, including hormones and glands. Their expertise is interpreting lab results to pinpoint the exact nature of the hormonal imbalance.
The Endocrinologist investigates potential underlying conditions driving the estrogen-androgen imbalance, such as testicular or adrenal gland disorders. They manage the condition non-surgically, which may involve adjusting causative medications or treating the underlying disease. For recent-onset gynecomastia, they may prescribe medications like selective estrogen receptor modulators (SERMs), such as tamoxifen, which block the effect of estrogen on the breast tissue. This medical approach is most effective when the condition is caught early, before the glandular tissue has become dense.
Specialists for Surgical Treatment
For patients whose gynecomastia is long-standing, does not respond to medical therapies, or involves substantial residual glandular tissue, a surgical specialist is required. The Board-Certified Plastic Surgeon is the primary specialist for the physical correction of gynecomastia. Their focus is on male chest contouring to remove excess tissue and create a more masculine aesthetic.
The surgeon determines the appropriate technique, which often involves a combination of procedures. Liposuction is used to remove excess fat tissue, and it is paired with surgical excision to remove the firm glandular tissue. Excision often requires a small incision around the border of the areola to remove the dense breast disc. A plastic surgeon experienced in this procedure is best equipped to minimize scarring and achieve a natural-looking result.
Selecting the Right Provider
Choosing the most qualified physician requires patients to consider the stage and cause of their condition, as well as the physician’s specific training. For a surgical solution, verifying the surgeon’s credentials is the first step, specifically confirming they are Board-Certified by a recognized body like the American Board of Plastic Surgery. This certification ensures they have met high standards for training and patient safety.
Patients should seek a surgeon who can demonstrate significant experience with male breast reduction and chest contouring, often by reviewing before-and-after photographs. The consultation should involve a detailed discussion of the procedure, anticipated outcomes, and potential risks. For a medical evaluation, patients should ensure their Endocrinologist or PCP is comfortable interpreting hormone assays related to male endocrine health.