What You Need to Know About Unilateral Gynecomastia, or "One-Sided" GynecomastiaAustin Gynecomastia Center

Gynecomastia is defined as the appearance of a female like breast in a male. It is related to excess proliferation of breast tissue due to an imbalance of the sex hormones estrogen and testosterone. While it is a benign condition that will not physically harm the individual, it can have a profound negative impact mentally. It's important for men with gynecomastia to seek treatment for gynecomastia with surgery. Gynecomastia typically presents as two-sided or "bilateral" growth, but in small percentage of men (less than 5-10%), it can present as single-sided "unilateral" or asymmetrical gynecomastia. Like bilateral gynecomastia, unilateral gynecomastia is a benign condition that is no different in terms of diagnosis and treatment. Unilateral gynecomastia is harder for men to deal with compared to the symmetrical or bilateral type.

What Causes Unilateral Gynecomastia?

The clinical appearance of unilateral gynecomastia varies considerably. The gynecomastia can either be large or small in size and can appear very similar in appearance to a true female breast. For unknown reasons, it is more common to develop on the left side of the chest. It may or may not be associated with tenderness, which usually persists for only a short period of time unless you are taking medications that are causing inflammation of the tissue. The actual gynecomastia tissue itself is more commonly glandular - rather than the fibrous variety - for unknown reasons.

We really don't know why some men develop unilateral gynecomastia. Most cases of bilateral gynecomastia result from pubertal development or hormone use. Some studies have shown unilateral gynecomastia associated with various drugs. For instance, oral Finasteride or "Propecia" used to treat male androgenic alopecia (MAGA) has been associated with unilateral gynecomastia.

Unilateral gynecomastia can be caused by an acute infection process of the chest. This typically results in enlargement of the chest, pain, swelling and redness with fever and chills. It is treated with antibiotic therapy or possibly an evacuation of the infection collection, also known as an incision and drainage procedure. I have never seen this firsthand in my 30 years of practice. Benign masses and cysts can also occur on only one side of the chest and are usually easy to diagnose by an experienced clinician. These are treated by surgical removal of the benign mass. View more before and after gynecomastia surgery photos in our gallery.

A more serious cause of unilateral gynecomastia is male breast cancer. This is uncommon compared to cancer of the female breast and makes up less than 1% of all breast cancer diagnoses. Male breast cancer presents itself differently than gynecomastia, is typically clinically obvious and not challenging to diagnose. It is usually described as a firm mass that has been present for quite some time that may be stuck to the surrounding tissue. It is non-tender and may be associated with changes in the overlying skin, enlarged lymph nodes in the arm pit, drainage from the nipple, and dimpling of the skin just above the mass. Keep in mind that male breast cancer is diagnosed in less than 1% of all gynecomastia cases. Still, any unilateral breast mass in a male should be evaluated by a skilled clinician to ensure the absence of malignancy.

Most importantly, unilateral gynecomastia can be treated just like bilateral gynecomastia with a combination of tissue removal and sculpting. The keys to success are an accurate evaluation, knowing what to remove, stopping the bleeding from all the little vessels present, and contouring out the entire chest area. This requires the talent and judgment of an experienced surgeon.

If the origin of the gynecomastia is from an underlying medical condition or medication, it would be best to eliminate the causative agent so recurrence is less likely. Most cases of gynecomastia develop during puberty and, for unknown reasons, persist into adulthood. Treatment of unilateral gynecomastia is geared toward surgical removal of the tissue, elimination of the collection of blood and fluid in the cavity using drains, and compression garments after treatment. More importantly, the experience of a seasoned gynecomastia surgeon is the best guarantee that you will be quite happy with the result.

Curious whether your one-sided case needs specialized planning? Request a consultation and speak directly with a trusted Austin gynecomastia surgeon who can review your photos, rule out red flags, and outline the right surgical approach.