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Types And Grades Of Gynecomastia

Medical Author: Miguel Delgado, M.D.

Dr. Delgado is a highly skilled surgeon specializing in gynecomastia surgery. Dr. Delgado has committed a significant amount of his practice to the care and education of men and boys with gynecomastia. Dr. Delgado’s practice philosophy is to provide the highest quality of patient care to the people who seek out his professional services. Dr. Delgado and his staff are committed to understanding their patients concerns, educating them on their options, and executing the best surgical outcome for each patient. Dr. Delgado is the new owner of Gynecomastia.org since 2010. He has dedicated a significant part of his life and practice to improving the Gynecomastia.org community.


Gynecomastia is the enlargement of the breast tissue in men due to an imbalance of hormones. It can affect males at all ages. It is a fairly common disorder that affects, in some degree, up to 70% of adolescent boys due to their hormonal changes at this age. Within two years 75% of cases resolve themselves without treatment. Gynecomastia can also affect adult males to varying degrees. Although it is often confused with obesity and weight gain, gynecomastia is a disorder of the endocrine system and has nothing to do with a person’s weight. This medical condition, despite being quite frequent, can be a source of great physiological and social stress since it can greatly alter a man’s physical appearance.


Four Different Types of Gynecomastia

The American Society of Plastic Surgery (ASPS) has created a descriptive classification system that enables specialists to discuss the issues and treatment of gynecomastia in a more standardized fashion. Gynecomastia is classified into four groups according to the severity of the breast tissue enlargement. The four grades are as follows:

small breast enlargement - front viewsmall breast enlargement - photo
small breast enlargement with localized around the areolasmall breast enlargement - side view

Grade I
Is defined as small breast enlargement with localized button of tissue around the areola, or the surrounding nipple area. The small enlargement of this tissue has a different color than the breast tissue in that area. At this grade the condition is generally not very noticeable with clothing on. Surgery is not commonly performed at this grade as the condition can often be treated with dietary supplements, prescription medication and or exercise recommendations.

moderate breast enlargement - photomoderate breast enlargement - front viewmoderate breast enlargement exceeding areola boundaries

Grade II
Is defined as moderate breast enlargement exceeding areola boundaries with edges that are indistinct from the chest. As well, the breast tissue expands over the pectoralis muscle area. This grade is often unnoticeable when wearing loose clothing. Altering ones diet to reduce estrogen high foods can help but it is not as efficient as targeted supplementation. If these natural solutions fail it is often recommended to try prescription medication instead of surgery.

image moderate male breast enlargementfront view moderate male breast enlargementmoderate breast enlargement exceeding areola boundaries with edges distinct from the chest

Grade III
Is defined as moderate breast enlargement exceeding areola boundaries with edges that are distinct from the chest with excess skin. Although the enlargement of the breast tissue is considered moderate, this grade is considered high and visible. While surgery is not recommended in adolescents, it is often used to treat this condition in older men when medication and less invasive options have failed.

marked male breast enlargement - photomarked male breast enlargement - front viewmarked male breast enlargement with excess skin and feminization of the breast

Grade IV
Is defined as marked breast enlargement with excess skin and feminization of the breast. This grade is considered severe and highly visible, giving the person a feminine breast appearance. Surgery is often performed at this grade when other treatments have failed.

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The content on Gynecomastia.org is for educational purposes only. It is not intended as medical advice. It does not replace the need to meet with a physician who will accurately diagnose your condition and suggest treatment options.

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