Grades and Types of Gynecomastia

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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.

Gynecomastia Grades

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.

Gynecomastia Types

Types of gynecomastiaIn 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, 5.0 out of 5 based on 5 ratings
About Mike Davis MD

I've been practicing over 25 years now. I got my main medical degree from the prestigious CUNY and later on interned at St. Vincent’s Health Center and Hospital.

Comments

  1. I need suggesion for type1 , i don’t want to surgery , is it possible to come in good shape , which medication i need to use ?

  2. Hammad aqib says:

    hi i am also suffering from this disease…but my problem is with nipples…it comes out mostly but whenever i go for bath and put water on it it squeezes.and comes to its origional position
    but after 5 or 6 mins again same problem..my age is 22…and having a problem from 2 years…please help me

    • Mike Davis says:

      Hi Hammad

      Thanks for getting in touch.
      By looking at the image above, what type of gynecomastia you think you have? If it’s anything worse than Type 3/4 then you have 2 options:
      1) Go and see your doctor so they can help to diagnose the exact cause and treatment for you
      2) 2nd option is not exactly a cure but just to improve your appearance – Compression garments – there are shirts and vests specifically designed for men suffering from gynecomastia. You can read more about those shirts in here: Gynecomastia Compression Garments.

      But if it’s Type 1 or 2 then you could have a look at the recommended pills article we have written. Do keep in mind though that as men are different not everybody gets guaranteed results with pills.

      Good luck,
      Mike

  3. Hammad aqib says:

    Yeah i think its type 1…..only nipple problem not whole breast…..its come in bigger shape..and whenever i put water on it it comes to its origional shape….is it will be resolved it?
    doctor prescribed me supplements…

  4. michael says:

    Hi, I also got male boobs ( type 4) . Went through hell back when I was in school. Am 29 now and working but when I wear certain shirts, the boobs become noticeable and people start looking at u funny( really embarrassing) . Want to know if the surgery is the last solution or maybe the pill can help out.

    • Mike Davis says:

      Hi Michael

      I hope you are well.

      Have you tried compression garments? Type 4 is quite severe so I can’t promise Gynexin (click here) will help you completely but if you think it’s worth trying before opting for surgery then get at least couple of bottles and see how it goes. Or as a temporary solution, get one of those compression shirts/vests.

      Good luck,
      Mike

    • even i hav i think type 3

  5. Mudit Arora says:

    Hi I’ve got the ones in type 7 and I have reduced like 15 kgs but there is no effect on my chests(though I still weigh 95 kgs)
    So is there any chance that if I use fat burning supplements it will also reduce my chest fat ??

  6. hi, I’m 18 years old and I’m a type 1. Is it permanent or temporary?

  7. Hi , i have the type 1 , i’m 24 years old ,male,180 cm , 86 kg i don’t want to surgery can you suggest me ? plz

  8. Hi! I am 16 and i am type 2 and i am worried , please help how can i get rid of them?

    • Mike Davis says:

      Hi

      As you are still young your condition might improve on its own in the next year or two.

      Good luck!
      Mike

  9. Shelley says:

    My 23 year old son has been diagnosed with type 2. Is his only option surgery or is there another form of treatment for this?

    • Mike Davis says:

      Hi Shelly

      You would probably have to go with what the doctor said. Gynecomastia pills do work for some but not for everyone, so you could try Gynexin and if no improvement then have the surgery.

      Good luck to your son.
      Mike

  10. Hi I’m 19 and I have type 3 and I was wondering if I should have surgery or not, i’m too embarassed to take my shirt off in front of people and I have been for the past 4 years.

  11. I’m not quite sure whether or not I have gyno, i’m 17 and am quite out of shape, but am working on fixing that (healthy diet, 4 mile run every day), but my breasts are large, larger than than you’d think for regular fat deposits, my nipples have no puffyness and and are not sensitive at all, I can press them all the way into my chest, and they shrink in the cold. Just wondering what an experts opinion would be as I am very worried they won’t go away, I have already lost 10 pounds and there appears to be no difference. Please help.

  12. Hi there!Im 14 years old and I have this problem too!I think I have the second version.Im 180cm tall and 78 kg heavy.I have this problem ever since I know for my self.Same thing with the nipples.Warm=big,cold=small.Does that mean I have to wait until Im 18 so I can go to surgery,or should I try something else before that?I do pushups every day.My upper chest is strong,but my lower chest is soft.Please help!

    • Mike Davis MD says:

      Hi Sandro

      Thanks for getting in touch.
      You shouldn’t worry too much since you are still 14. Gynecomastia can be caused by hormones, especially in young men. So give it few years, probably even till you are 18-19 and see if there has been any improvement. If not then best thing is to go and visit your local specialist who can advise you.
      Good luck,
      Mike Davis MD

  13. What’s the best corse of treatment for type 7

    • Mike Davis MD says:

      Hi Mike
      Thanks for getting in touch.
      As this is the most severe form of Gynecomastia there is no way around a surgery unfortunately.
      Best wishes,
      Mike

  14. Mudit Arora says:

    Hi I’ve got the ones in type 7 and I have reduced like 15 kgs but there is no effect on my chests(though I still weigh 95 kgs)
    So is there any chance that if I use fat burning supplements it will also reduce my chest fat ??

  15. Shardul says:

    I a 14 year old boy having gynecomastia grade 3.( type 2) .my boobs are stiff and conical.i also have puffy nipples.what shall I do .actually manboobs is not a problem,I only want puffy nipples to go away

    • Mike Davis MD says:

      Hi Shardul

      Thanks for your question.
      It’s the hormones in your body what cause it, and once you are a bit older your body might get it’s hormonal balance back and you’ll get rid of the puffy nipples. I know it’s embarrassing but unfortunately there’s nothing you can do before you hit 18-19.

      All the best,
      Mike Davis

  16. I am a 14yr old boy,mine is type 1.how could i get rid of my man boobs.Im am also not sure mine isit genetic or is just fats..How do i know if mine is genetic or just fats

  17. Im a 14yr old boy,i have type 1.i am not sure mine is genetic or fats.Does doing sitting up helps?Does it helps alot?

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