What is Bodybuilder Gynecomastia?

What is Bodybuilder Gynecomastia?

Gynecomastia can affect any man, regardless of age or even body fat percentage. One group that is often negatively affected by gynecomastia are bodybuilders or people striving for a lean, muscular body. As people who care greatly about the way their body looks, developing excess breast tissue, even just a little, can be devastating for these men.

Dr. Miguel Delgado is a renowned gynecomastia specialist practicing in San Francisco who can eliminate your gynecomastia, no matter the cause or your condition.

What Causes Bodybuilder Gynecomastia?

The usual suspect for bodybuilder gynecomastia are steroids and other medications people might be taking to attain a certain physique. These drugs can mess with hormone levels, leading to the development of excess breast tissue in a localized are under the nipple or more widespread throughout the chest.

While some fitness buffs might think that simply stopping the medication will allow their chest to go back to normal, this is usually not the case. No amount of exercise or specific chest workouts can remove glandular tissue that may have grown during the course of performance enhancers. Even fat can be stubborn to diet and exercise as it contributes to a more feminine appearing chest and nipples.

Symptoms of Bodybuilder Gynecomastia

There are 4 generally recognized stages or grades of gynecomastia that can affect bodybuilders. Grade 1 gynecomastia consists of a minor enlargement of the normal male chest. Grade 2 is more developed, feminine-looking breasts and grade 3 typically begins to have drooping with excess skin. Grade 4 gynecomastia is significant enlargement coupled with significant excess skin that causes a downward-pointing nipple.

The most common symptoms bodybuilders might experience are steroid induced gynecomastia. This occurs when fat builds up directly beneath the nipple and areola, stretching that skin outward and causing a shiny, rounded, smooth appearance that bodybuilders find concerning.

Treating Bodybuilder Gynecomastia

Fortunately, gynecomastia does not pose any risks to a person’s health or fitness level. The major reason fitness experts seek out male breast reduction procedures is simply due to the appearance of the chest. For people whose bodies are their livelihood, who are passionate about creating a perfectly sculpted figure, it’s a distressing condition that can harm self-esteem and fuel embarrassment about their bodies.

Dr. Delgado treats gynecomastia on an individual basis, since everyone is different and has different goals from the procedure. Techniques like liposuction frequently work for people with puffy nipple gynecomastia or very little glandular tissue that’s causing a problem. However, for any excess skin or more severely enlarged breast tissue, excisional surgery will most likely need to be performed.

Gynecomastia Specialist in San Francisco

If you’ve been using anabolic steroids for performance enhancement and have seen a sudden change in your chest appearance or feeling, you may be experiencing gynecomastia. Stopping the medication sometimes works, but not always, and exercise alone rarely helps the appearance return to normal. For more information on gynecomastia surgery, browse this site or call Dr. Delgado to schedule a consultation today.

What Is Steroid Induced Gynecomastia?

What Is Steroid Induced Gynecomastia?

Man Weight Lifting Dumbbells

Steroid induced gynecomastia can be caused by drugs such as Anadrol and Dianabol (used for medical conditions) and anabolic steroids taken by bodybuilders. Men taking steroids for medical reasons should consult their prescribing physician if they notice any changes in nipple size and tenderness or swelling in the chest area. 

There are various ways to resolve man boobs caused by steroid induced gynecomastia. Here are the options available if you are concerned about steroid use and gynecomastia.

What Is Gynecomastia?

Gynecomastia is the medical term for the growth of breast glandular tissue in men’s chest area. Breast enlargement in men is often unknown, although steroid use is a known cause of bodybuilder gynecomastia. Gynecomastia symptoms can present as puffy nipples and a slight increase in chest size, through to full, feminine-looking breasts or man boobs. 

Do Steroids Cause Man Boobs?

The leading cause of gynecomastia is hormonal imbalance. Steroid use disrupts hormonal balance and may cause higher estrogen levels, which can lead to gynecomastia symptoms. Longer-term steroid use may worsen the symptoms, which is why many bodybuilders develop man boobs. 

When steroid use is stopped, gynecomastia will not simply go away. The breast glandular tissue growth is permanent. The only recognized way to resolve bodybuilder gynecomastia is with surgery.   

Can I Prevent Gynecomastia?

The only way to prevent steroid induced gynecomastia is to not use steroids. If you require steroids for medical conditions, speak to your physician about your concerns. 

Do Antiestrogens Prevent Man Boobs?

Bodybuilders often use antiestrogens to prevent man boobs, including Tamoxifen (Nolvadex® or Soltamox®) and Arimidex®. These drugs are not FDA-approved gynecomastia medications and although they do work for some men, when they don’t work, it’s too late to do anything as the  breast glandular tissue will have already started to grow. Bodybuilders who take steroids should also consider that antiestrogens have a range of side effects, including weight gain and erectile dysfunction, and some more severe side effects such as reduced bone density, leading to bone fractures and stroke.

Can Supplements Prevent Man Boobs?

Numerous companies advertise supplements as estrogen blockers. However, not only are they extremely unlikely to make any difference, supplements have been found to contain dangerous ingredients. Supplements are not regulated by the FDA and are usually produced in countries with little or no regulations.

Gynecomastia Surgery For Steroid Induced Gynecomastia

Gynecomastia surgery is a fast and safe way to eliminate man boobs caused by steroid use. Gynecomastia symptoms are divided into four grades that determine how severe the symptoms are. Grade 1 and some grade 2 gynecomastia can be treated with surgery requiring only a small incision at the edge of the periareolar, called the pull-through technique.

Grade 2 gynecomastia that can not be effectively treated with the “pull through” technique can be treated with standard gynecomastia surgery. This only requires a slightly larger incision at the edge of the areola. Both types of surgery leave small scars that are well hidden by the change in skin color from the areola to the surrounding skin. Once healed (within a few months), the scar will start to fade. After around six months, the scar will be difficult to detect.

Grade 3  gynecomastia can sometimes be resolved with a two-stage procedure which involves the pull-through technique, followed by standard gynecomastia surgery four to six months later. This is the preferred gynecomastia surgery option for men who are concerned about scars and all incisions are made at the outer edge of the periareolar. This means that once healed the scars will be well hidden and hard to see.

In the case of more severe grade 3 and 4 gynecomastia symptoms, a double incision mastectomy is usually recommended. This will create larger scars across the chest. Most men prefer scars that fade and become less evident over time than living with man boobs. The patient satisfaction rate is high for all types of gynecomastia surgery, and unlike medications, results are reliable and always permanent (as long as steroid use is avoided).

Why Choose a Board-Certified Plastic Surgeon for Gynecomastia Surgery?

Gynecomastia surgery can be performed by any physician with a medical license. Gynecomastia surgery cost may be a consideration. However, many plastic surgery companies offer reduced rates by employing surgeons without appropriate training or experience. Unfortunately, the revision rate for gynecomastia surgery is high, and poor results may not be reversible.

Not all board-certified plastic surgeons specialize in gynecomastia, and many will only perform a few gynecomastia procedures each year. Board-certified plastic surgeon and gynecomastia specialist Dr. Miguel Delgado has been providing gynecomastia surgery for all grades of gynecomastia for over 30 years. Over 40% of his patients come to him unhappy with the results of gynecomastia surgery performed elsewhere. Whether you are considering initial gynecomastia surgery or gynecomastia revision surgery following unsatisfactory results, Dr. Miguel Delgado always discusses your concerns and explains the surgical options available. All gynecomastia surgery is performed at the Gynecomastia Center of Excellence — Marin Cosmetic Surgical Center*, with the highest level of patient safety and care.

*Federal and state-accredited surgical facility.


For personalized information about gynecomastia plastic surgery procedures, please complete Dr. Delgado’s inquiry form


Miguel Delgado, M.D, F.A.C.S is a world-renowned Board-Certified Plastic Surgeon granted by the American Board of Plastic and Reconstructive Surgery and a member of the American Society of Plastic Surgery and Aesthetic Society. Dr. Delgado has a surgical practice solely dedicated to cosmetic plastic surgery. He specializes in gynecomastia surgery and is the medical director of Gynecomastia.org, the oldest and largest gynecomastia forum dedicated to supporting, educating, and providing solutions for men with breast enlargement. Dr. Delgado celebrates 30 years of practice in San Francisco, California. He was voted the “Best Plastic Surgeon of 2017-2021.” 


Does Steroid Use Cause Man Boobs?

Does Steroid Use Cause Man Boobs?

Man Using Steroids

Often referred to as man boobs, this medical condition is called gynecomastia by the medical community, and is usually caused by a hormonal imbalance. Research has shown that a high level of estrogen found in men is usually the cause of gynecomastia symptoms. Hormonal imbalance can happen for various reasons, including anabolic steroid use. The high associated risk that steroids cause gynecomastia is a huge concern in the bodybuilder community.

What Is Gynecomastia?

The medical term for man boobs is gynecomastia, which causes excess growth of breast glandular tissue in the male chest. Gynecomastia symptoms are often a combination of glandular tissue and fatty tissue. Another condition, pseudogynecomastia, is the growth of only fatty tissue in the chest area in overweight and older men. This is not true gynecomastia and is rarely experienced by men who are not overweight.

Women and men produce estrogen and testosterone. In women, the estrogen levels are higher than the testosterone levels, and in men, the testosterone levels are higher than the estrogen levels. This is why estrogen is often referred to as the female hormone and testosterone as the male hormone. 

Causes of Gynecomastia 

There are various known causes of gynecomastia symptoms, and it is crucial to have an accurate diagnosis. Dr. Miguel Delgado can diagnose gynecomastia with a physical examination and the gynecomastia pinch test. When there is no known cause of gynecomastia symptoms, blood tests may be requested, to check for any other underlying medical problems.  

The Male Menopause or Andropause

Men between 50 and 60 years old will typically experience the male menopause or andropause. When this occurs, testosterone levels naturally start to decrease, which may cause glandular tissue growth. During the menopause, the body ratio of muscle to fat will normally change. Both of these developments can cause gynecomastia symptoms and man boobs

Pubertal Gynecomastia

During puberty, estrogen levels are higher than testosterone levels, which often causes glandular tissue to grow and results in man boobs. This is likely to be more pronounced if an adolescent is overweight. Pubertal gynecomastia will usually resolve within two to three years, although occasionally, it will remain.  


Medical Conditions and Medications

Steroids and Gynecomastia 

Bodybuilders can rarely achieve significant size using exercise, diet and weightlifting, to produce the muscle mass needed to compete professionally. This has led to a high incidence of anabolic steroids use in the professional bodybuilder community. Steroids help men increase muscle mass faster and induce larger muscles when combined with weightlifting.   

Recognized by the world as one of the top professional bodybuilders, seven-time Mr. Olympia winner and four-time Mr. Universe winner Arnold Schwarzenegger admitted he used steroids when competing. Although at the time he was competing, steroids were legal, the lack of testing is still a controversial issue for many bodybuilders. The International Federation of Bodybuilding Professional League (IFBB) rules state that steroid use is not allowed, and all competitors are subject to IFBB random drug testing. Yet tests do not routinely take place. Even though steroids are now illegal in the US, it is generally accepted by the bodybuilding community that bodybuilders who want to compete in more challenging competitions, will take steroids

Anabolic steroids cause gynecomastia by disrupting the endocrine system that regulates hormones, increasing the enzyme responsible for converting testosterone into estrogen. In many men, this leads to the growth of breast glandular tissue and man boobs. One of the main issues caused by anabolic steroid use is gynecomastia. In the bodybuilding community, gynecomastia symptoms are often referred to as “bitch tits” and are a real problem for many men. Even when steroids are no longer used, gynecomastia will not go away.

Gynecomastia Symptoms

The most obvious gynecomastia symptoms are the appearance of man boobs or moobs, which vary in size. The difference is defined by gynecomastia grades, a system adopted by the American Society of Plastic Surgeons. 

Grades 1 To 4 Of Gynecomastia

There are five gynecomastia grades:

  • Grade 1 gynecomastia symptoms refer to a slight increase of glandular tissue and often cause the appearance of puffy nipples. 
  • Grade 2 gynecomastia symptoms cause a more significant growth of glandular tissue, resulting in small man boobs and a more feminine appearance of the male chest.
  • Grade 3 gynecomastia symptoms will produce feminine-looking breasts with a slight mammary (breast) crease.
  • Grade 4 gynecomastia symptoms are the most severe and result in extremely feminine-looking breasts that are full and noticeable, with a significant drop and mammary crease. 

Treatment for Gynecomastia 

Treatments for gynecomastia fall into three types: natural supplements, medications, and gynecomastia surgery. Numerous companies sell a range of supplements they claim will inhibit estrogen production, which prevents and reduces gynecomastia. There is no scientific research to back up these claims, and supplements are not regulated by the Food and Drug Administration (FDA). 

Treatment for Gynecomastia With Tamoxifen (Nolvadex® or Soltamox®) 

Tamoxifen (Nolvadex® or Soltamox®) is widely used by bodybuilders to prevent and reverse gynecomastia. Research shows that men only experience a partial reduction of gynecomastia with tamoxifen, and the associated severe side effects of tamoxifen include stroke, vision impairment, and liver disease. To date, the FDA has not approved any medications for gynecomastia treatment. 

Gynecomastia Surgery for Steroid Induced Gynecomastia 

Gynecomastia surgery is the only guaranteed way to eliminate man boobs from steroid use. It is highly advisable that bodybuilders wait until they have stopped using steroids before having gynecomastia surgery. Otherwise, the symptoms are likely to return. Grade 1 and some grade 2 gynecomastia symptoms will usually require standard gynecomastia surgery, with gland excision to remove the excess breast tissue. This requires a small incison on the edge of the areola of around 2.5 to 3 cm. Once healed the scar will normally be well hidden by the change in skin color between the areola and chest skin. Another type of gynecomastai surgery that is often referred to as scarless gynecomastia surgery is the pull-through technique.

The pull-through technique is normally only suitable for grade 1 gynecomastia and only requires a small incision of around 5 to 10 mm cm in length, made at the edge of the periareolar, which means the scar  will be almost invisible when it has healed.  

Dr. Miguel Delgado performing the pull-through gynecomastia surgery technique

Grade 3 and grade 4 gynecomastia symptoms will generally require a double incision mastectomy or a two stage procedure. This is due to excess skin that needs to be removed for tight, masculine chest contours, as well as glandular and fatty tissue. Patient satisfaction for gynecomastia surgery is high, with research showing that 98% of bodybuilders receiving gynecomastia surgery are pleased with the results


For personalized information about gynecomastia plastic surgery procedures, please complete Dr. Delgado’s inquiry form. 


Miguel Delgado, M.D, F.A.C.S is a world-renowned Board-Certified Plastic Surgeon granted by the American Board of Plastic and Reconstructive Surgery and a member of the American Society of Plastic Surgery and Aesthetic Society. Dr. Delgado has a surgical practice solely dedicated to cosmetic plastic surgery. He specializes in gynecomastia surgery and is the medical director of Gynecomastia.org, the oldest and largest gynecomastia forum dedicated to supporting, educating, and providing solutions for men with breast enlargement. Dr. Delgado celebrates 30 years of practice in San Francisco, California. He was voted the “Best Plastic Surgeon of 2017-2021.” 

Gynecomastia.org does not provide medical advice, treatment, or diagnosis.