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Blog. How Bad is Your Case of Man Boobs?

How bad are my man boobs? How does my case look in comparison to other guys you treat?

These are questions we field frequently from patients with man boobs in South Florida. The shortest answer we can give is, it truly doesn’t matter! Gynecomastia is gynecomastia, no matter what the size. Why drive yourself crazy trying to determine “how bad” it is? Does it make a difference? Nope!

If you think you have moobs of any size and they bother you, then surgery is your best answer. And to your doctor, as long as he or she is a highly experienced gynecomastia surgeon, it truly doesn’t matter what size you are either.

That said, we understand some guys want to know. They may be trying to make peace with their man boobs, or simply want a thorough understanding of the severity of their case. If you’re seeking an objective view, here are some tools to help you assess your condition.

Gynecomastia Classification Systems

One of the earliest models, created by Simon, Hoffman and Kahn almost 40 years ago, groups cases as follows:

  • Grade 1: Small enlargement, no skin excess
  • Grade 2a: Moderate enlargement, no skin excess
  • Grade 2b: Moderate enlargement with extra skin
  • Grade 3: Marked enlargement with extra skin

This system and two others are explained in detail in a chapter of the textbook Grabb and Smith’s Plastic Surgery by Charles H. Thorne. The Journal of the American Medical Association offers a synopsis.

The American Society of Plastic Surgeons (ASPS), uses a similar classification system as follows:

  • Grade I: Small breast enlargement with localized button of tissue that is concentrated around the areola
  • Grade II: Moderate breast enlargement exceeding areola boundaries with edges that are indistinct from the chest
  • Grade III: Moderate breast enlargement exceeding areola boundaries with edges that are distinct from the chest with skin redundancy present
  • Grade IV: Marked breast enlargement with skin redundancy and feminization of the breast

Our View

We’ve developed our own model for treating Boca Raton man boobs patients. It’s more detailed than most; at the same time it’s simple enough to assist us in talking with guys seeking treatment:

  • Class 1A: Like a squashed grape directly under the areola
  • Class 1B: Like a squashed small lemon under the areola
  • Class IIA: Like a squashed orange under the areola and extending beyond the borders of the areola
  • Class IIB: Like a squashed orange with lax skin and a nipple that is at or lower than the fold
  • Class IIIA: Like a squashed grapefruit under the areola and extending way beyond the borders of the areola
  • Class IIIB: Like a squashed grapefruit with lax skin and a nipple that is at or lower than the fold
  • Class IVA: Like a squashed cantaloupe under the areola and extending beyond the borders of the areola and onto the lateral chest
  • Class IVB: Like a squashed cantaloupe with lax skin and a nipple that is lower than the fold

Using this system also helps our team communicate and share a basic idea about where the treatment plan might start for a given patient.

Your Own Assessment

If you believe it’s important to get a sense of how your case of gynecomastia compares to that of other guys, there are a couple of things you can do. First, flex and tense one side of your chest. Then, with the other hand, pinch the excess skin and tissue. You can then begin to get a sense of how much extra there is on top of your pectoral muscles, keeping in mind that gynecomastia is a bit like an iceberg. There will be more under the skin and spreading across the chest than you might expect just by feeling around.

If you haven’t done so already, you can also visit There you’ll find articles, photos, and discussion forums touching on a huge variety of man boobs-related topics. The forums can be especially helpful if you have some time to browse and participate. Whether you’re working up the courage to visit a cosmetic surgeon or determining whether you might be able to live with your moobs, other members will have input for you.

Finally, please take a moment to visit our before and after gynecomastia surgery photos. You’ll see we don’t categorize the images by degree of severity. Instead, we arrange our patients into groups with similar characteristics: adults, adolescents, body builders, puffy nipples, and so on. You’re sure to find cases you can relate to in our gallery.

Here’s the real key: if your man boobs inhibit you from living the life you want, it really doesn’t matter how small or large they are. If they bother you–whether they’re grapes or cantaloupes–surgery is the way to put them behind you forever.

We hope you will consider arranging a consultation with us. To all guys with man boobs in South Florida and beyond, we pledge a process of education and exploration with no pressure at all. We would be glad to help you too, no matter where you live and what you ultimately decide.

Give us a call at 561-367-9101 to find out more.


Dr. Elliot William Jacobs is a board-certified aesthetic plastic surgeon who specializes in FTM top surgery, gynecomastia surgery, revision gynecomastia surgery and male breast reduction. He is a native of New York and has over 40 years of experience in his field. Dr. Jacobs is a highly respected and sought-after surgeon who is known for his skill, experience, and compassion. Whether you are interested in gynecomastia for the first time, or are looking to correct a gynecomastia you aren’t happy with, Dr. Jacobs can deliver amazing results.


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