What are the 4 Stages of Gynecomastia?

Gynecomastia has been classified in various stages based on different factors by researchers, and the most acceptable classification of Gynecomastia stages are as follows:

Simon gives the qualitative classification based on volume and extra skin dictating treatment.

  • 1. Grade I: Minute increase in the breast size, no evident excess breast skin
  • 2. Grade II: Moderate enlargement of breast size, no skin excess
  • 3. Grade IIb: Moderate enlargement of breast size along with extra tissues of the skin
  • 4. Grade III: Evident increase in the breast skin

Classification based on total tissue estimations by Rohrich. The classification predominantly considers breast tissue mass volume with or without an increase in fat or vascular tissues.

Advancement has been made in the classification by considering overall chest size and shape along with the sternal notch to determine treatment options.

Stages of Gynecomastia According to Rohrich classification

Grade I

Minimal hypertrophy or  minimal increase in tissues of breasts (< 250 g of breast tissue) without any drooping of skin or ptosis


Minimal hypertrophy of breast glands


Minimal hypertrophy with increased vascularity and ducts leading to fibrous breast

Grade II

Moderate increase in breast tissues (250–500 g of breast tissue) without drooping appearance or ptosis


Moderate hypertrophy (or increased breast tissue)—primarily relating to breast glands


Moderate increase in breast tissues with increased ducts and vasculature (fibrous)

Grade III

Severe hypertrophy with more than 500 g of extra breast tissue development (> 500 g) and grade I ptosis or visible drooping of skin (incresaed breast glands as well as ductal tissue)

Grade IV

Severe hypertrophy  or increased breast tissues with grade II or may be grade III ptosis or breast skin drooping (with increased breast glands and vasculature)

Identifying stages of Gynecomastia 

  • 1. Mild Gynecomastia: Mild Gynecomastia is common, and according to estimations, 65% of men have some breast enlargement (Gynecomastia). At this stage, surgical treatment is not recommended; this minute breast enlargement can go away on its own.
  • 2. Moderate stage of Gynecomastia: Patients with glandular hypertrophy with lesser skin excess that can be treated with liposuction. Some patients with Gynecomastia with increased vasculature or fibrous tissues have localized nipples and need surgical treatment to get rid of the excess skin frequently. 
  • 3. Severe Gynecomastia: Skin resection or removal is needed in case of severe Gynecomastia. 
  • 4. Severe Gynecomastia with increased drooping of the breast skin (Grade II or III Ptosis): Severe Gynecomastia with excess skin and evident ptosis needs to be treated by laser surgery with minimal incision and scars and as a daycare procedure. This is necessary to prevent further worsening of Gynecomastia and risks of arising complications.

Gynecomastia in Adolescent Males

Gynecomastia or enlargement of adolescent male breasts is often mild (benign) and is considered by adolescents as a matter of psychological distress and embarrassment. According to the research studies, by the adolescent age, which is around 17, about 10% of boys have persistent Gynecomastia.

In one of the studies performed on adolescents, Gynecomastia was prevalent in 4% of males between 10 to 19 years.

Furthermore, in the case of pubertal Gynecomastia, a large number of adolescents have normal levels of hormones (especially estrogen levels). Therefore, pubertal Gynecomastia is a physiological phenomenon mainly observed in mid-puberty.

What Is The Fastest Way To Get Rid Of Gynecomastia?

The fastest way to get rid of Gynecomastia or the enlarged breast in severe Gynecomastia is surgical treatment. Nowadays, various techniques include laser surgical procedures to quickly treat Gynecomastia. 

What foods to avoid if you have Gynecomastia?

  1. 1. Processed Food

Processed meals need to be avoided as much as possible as they have an intense bad effect on your health in terms of the addition of fats in any part of the body. Being convenient and easy to go with processed foods promotes weight gain and enhances man boobs. These foods high in empty calories have excess sugars, sodium, and preservatives.

  1. 2. Canned foods

Any food in cans, plastic wraps, or containers tends to disturb the hormonal balance. They have testosterone-enhancing chemicals ( such as bisphenol A).

  1. 3. Soy Products

Soy dairy products are highly proteinaceous and alternatives to animal dairy products. But they are bad on man boobs, eventually increasing the breast tissues, even after minimal soy consumption. Soy has phytoestrogens (a type of animal estrogen). Although these hormones have certain molecularity differences they still mimic each other and contribute to rising hormonal levels. 

  1. 4. Eggs and other animal products

Eggs that have high protein content and lower fat content are ideal for getting extra pounds. Therefore it is recommended to avoid eggs along with other dairy products to shed extra pounds. However, dairy products and meat from animal sources increase hormonal levels.

  1. 5. Beer

Beer has a lot of empty calories. Beer harms people with Gynecomastia. Therefore, beer consumption must be avoided to get rid of those extra breast tissues. 

It is also essential to stick to the dietician’s healthy dietary recommendations to prevent exaggeration of fats and vasculature in breast muscles and adipose tissues. 

Some of the dietary recommendations to be followed by people with mild or moderate grades of Gynecomastia are :

  • 1. Filling the grocery bag with fresh, healthy vegetables and fresh
  • 2. Sticking mostly to food with low calories, high fiber, and low-fat content. 
  • 3. Have the habit of looking at the food labels while shopping
  • 4. Try to get full fiber-rich food before getting to the main meal  
  • 5. Try reducing your plate size to cut down some portions day by day.

How long does Gynecomastia last in puberty?

Pubertal Gynecomastia is self-limiting in an estimated 75 to 90% of cases having Gynecomastia in adolescents. The pubertal Gynecomastia tends to regress over almost 1 to 3 years. 

It is highly important to get a proper diet and keep observing and getting reassurance from the doctors to be on the safer side. 

Frequently Asked Questions

Does Gynecomastia go away at 18?

Yes, mild adolescent gynecomastia usually goes away by 18 to 21. Adult males beyond 21 years of age are unable to get rid of enlarged man boobs. Such people should not ignore their increasing breast size. 

How to know that an individual’s Gynecomastia will go away?

Gynecomastia at the milder stage is usually self-healing, without any medical treatment. There is evidence that enlarged, milder breasts can flatten out in a few months. In case the Gynecomastia is in the moderate stage, medication can help. And if Gynecomastia is in advanced or the last stage, surgery is the only way to reduce excessive breast size. 

How fast does gynecomastia progress?

There is evidence of gynecomastia progression if it persists beyond 17 to 21 years of age. 

The condition occurs between 10-12 years of age. It alleviates its sown. Eventually, 20 percent of people having gynecomastia conditions beyond 17 years of age have a faster rate of disease progression.

Can diet help Gynecomastia?

Yes, diet may help patients with Gynecomastia of small or moderate stages. Some of the foods like

Food with antioxidant properties

  • 1. Salmon 
  • 2. Leafy green 
  • 3. Sweet potatoes
  • 4. Berries
  • 5. Citrus fruits like oranges and avocados 
  • 6. Beans 

These foods in daily diet help gynecomastia individuals relieve breast tenderness and swelling.

What causes Gynecomastia in teenage males?

It has been documented that teenage boys have a certain degree of Gynecomastia ( breast enlargement) that is not a matter of worry. In teenagers, Gynecomastia occurs due to changes in hormonal levels. The dropping of hormones like estrogen and testosterone causes the growth of breast tissues excessively. Gynaecomastia during puberty can get cleared up as a teenager age, and the hormones stabilize.

Is Gynecomastia common during puberty?

Yes, Gynecomastia is common in almost 70 percent of adolescent males in early puberty or mid-puberty. This is due to normal hormonal alterations that occur in adolescence.

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