The enlargement of breast tissue in males, or gynecomastia, is categorized into four grades and seven types. Knowing the grade and type of gynecomastia is important for the doctor to determine the appropriate course of treatment. A variety of medicines, as well as surgery, are options for patients, however, finding the right path can be rather tricky until the grade and type is found.
There are four grades of gynecomastia, including:
Grade 1: a localized button of tissue concentrated around the areola, or the area surrounding the nipple that is a different color than that rest of the tissue.
Grade 2: moderate enlargement going beyond the areola boundary with edges that are not distinct from the rest of the breast. At this grade, the condition is not noticeable under a loose shirt and has not yet become a huge psychological concern.
Grade 3: moderate enlargement going beyond the areola boundary with edges that are distance from the rest of the breast. There appears to be extra skin in the breast area. This grade is noticeable to others and can begin to negatively affect the patient psychologically.
Grade 4: marked, distinct enlargement, making the breast(s) look extremely feminine. This grade, like the previous one, is extremely noticeable and can affect patients negatively.
In addition to the four grades of gynecomastia, there are also seven types of the condition that help doctors determine the patient’s treatment plan. These types include:
Type 1: Puffy nipples. For puffy nipples, the excess tissue is located inside and outside the areola’s border. The puffy nipple is usually the size of a large egg and creates a cone shape appearance of the areola and nipple. The tissue is rather firm and primarily glandular. The areola can enlarge and take on a shiny appearance.
Type 2: The excess tissue is spread out across the chest and consumes the entire area. The skin across the chest is tight. Typically, the chest angle is less than 45 degrees. The enlargement below the areola is usually firm and glandular. The area furthest away from the nipple and areola feels like fatty tissue deposits. The tissue removed during type 2 surgery is usually the size of a tennis ball and can be as large as a softball.
Type 3: The excess tissue is spread out across the chest, but it is starting to sag. The skin no longer feels tight. The chest angle is between 45 and 60 degrees. The chest starts to push outward and the nipple is beginning to shift into a lowered position. The amount of tissue removed does not differ much from type 2.
Type 4: The excess tissue is spread out across the chest, but is sagging significantly. The chest angle is between 60 and 90 degrees. The chest sag is extremely noticeable. Treatment for this type of gynecomastia would require skin removal as well to prevent future sagging of the chest area. Again, the tissue amount removed is not different from types 2 and 3.
Type 5: The excess tissue sags significantly, falling below the fold of the chest. The bottom of the areola is located above the chest fold, in this type. The chest angle is more than 90 degrees. The amount of tissue removed is not different than types 2, 3, and 4.
Type 6: The patient has sever breast sag. The top of the areola is located above the chest fold, which can extend under the arm pit and towards the patient’s back. At this point, doctors have to determine much more invasive surgery to treat the condition, including anchor lifts and free nipple grafts.
Type 7: In this most sever type of gynecomastia, the top of the patient’s areola is below the chest fold and there is extreme breast sag. The areola appears to point directly downward. The breast roll would contain noticeable volume and will extend towards the back.
Different grades and types of gynecomastia require different treatments. Typically, those suffering the condition at the first two grades or types can decrease their tissue through the use of medication or various dietary supplements. Beyond the first two grades and types, however, surgery may be the right treatment, depending on the patient.Grades and Types of Gynecomastia,