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Gynecomastia in Bodybuilders
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What is Revision Gynecomastia

What Causes Gynecomastia in Bodybuilders?

Bodybuilders in Florida are a unique subset of patients since their gynecomastia is usually small (confined to the area just under the areola) and is largely due to self-medicating with hormones and anabolic steroids. For the most part, bodybuilders have very low percentages of body fat and are in excellent physical and nutritional shape.

Many of them have taken anabolic steroids without proper physician supervision. The obvious goal of these steroids is to help bulk up their muscles. Some men knowingly take anabolic steroids and then attempt to prevent the development of gynecomastia (a common and well-known side effect) by self-medicating with other drugs to block the side effects of the steroids. This often becomes a circus of self-prescribed medications, which can seriously disrupt one’s delicate hormonal balance.

Gynecomastia Surgery for Bodybuilders in Boca Raton

Male breast reduction surgery for Florida bodybuilders is very similar to the standard procedure described elsewhere on this website. There are some significant differences, however.

The difference begins with the actual breast tissue itself. Steroid-induced gynecomastia is solid, white, hard, and extremely fibrotic tissue, as compared to pubertal gynecomastia in which there is somewhat softer, thickened breast tissue under the nipple which then fans out and is interspersed with fat as it extends outward. There is very little peripheral fat in bodybuilders.

In these patients, a peri-areolar incision (incision around the edge of the areola) is done 100% of the time. The solid tissue is removed in pieces through this small incision. A liposuction cannula (frequently without the suction turned on) is used to help re-distribute the skin across the chest. Drains are frequently used to promote faster healing, encourage the skin to attach to the underlying muscle, and prevent the build-up of fluids. The net effect after healing is that of a very thin and uniform layer of skin and fat which is now draped over the large pec muscle, thereby providing the desired “cut” appearance.

Male breast, before Gynecomastia Surgery for Bodybuilders, front view, patient 1
Male breast, after Gynecomastia Surgery for Bodybuilders, front view, patient 1

Man Boobs, a Side Effect of Anabolic Steroids

Male breast, before Gynecomastia Surgery for Bodybuilders, front view, patient 2
Male breast, after Gynecomastia Surgery for Bodybuilders, front view, patient 2

Some men do not specifically take anabolic steroids. But they may take “protein supplements,” prohormones, and other seemingly harmless supplements, available at health food stores or through the internet. The problem is that many of the listed ingredients are not specific and these supplements may indeed have hormone-like qualities. The net effect is that gynecomastia may develop most unexpectedly and sometimes very quickly. And once it has developed, there are no treatments for it other than surgery.

The most visible side effect of anabolic steroids is the development of excess breast tissue (commonly called “bitch tits”). This is due to the conversion (termed “aromatization”) of the testosterone they have taken into estrogen. The estrogen, in turn, then promotes the growth of breast tissue. Bodybuilders complain mostly about very localized gynecomastia (just under or around the areola) and/or puffy nipples, although some very large growths of breast tissue have been encountered. When the pec muscle is flexed, the nipples protrude excessively and detract from the contour of the chest.

There are other side effects as well. By taking extra hormones, the body senses that it has sufficient amounts of testosterone and therefore decreases its own natural production of testosterone. The testes then begin to wither, since they are no longer “needed.” There are also other effects on various organs of the body. Tumors may develop. Finally, there may be emotional issues that occur – the famous “roid rage” for example.

It is our strong professional opinion that tampering with one’s delicately balanced hormonal system – particularly without appropriate physician supervision and blood testing – is totally inappropriate, dangerous to one’s health, and should not be done. Nevertheless, for those bodybuilders who have developed gynecomastia, appropriate surgery is the best answer. The surgery should provide for a flat nipple/areola on a contoured, muscular chest.

Bodybuilder Gynecomastia Surgery Results

The results of gynecomastia surgery are usually permanent provided that additional illicit drugs are not used in the future. There is always a small amount of breast tissue deliberately left under the areola to prevent a crater deformity. Should additional drugs be taken in the future, it is that residual breast tissue that can conceivably re-grow.

Male breast, before Gynecomastia Surgery for Bodybuilders, front view, patient 3
Male breast, after Gynecomastia Surgery for Bodybuilders, front view, patient 3

Bodybuilders Before and After Gallery

View our photo gallery full of patient before & after photos.

Ideal Male Candidates for Breast Reduction Surgery

If you are a bodybuilder who is self-conscious about your enlarged breasts, you should consult with a gynecomastia surgeon about whether you are a candidate for breast reduction surgery. You may be a good candidate for surgery if you:


Are in good health

Older men

Have no medical conditions that will negatively affect your recovery

Patients affected

Live a healthy lifestyle


Have realistic expectations

What to Expect from Recovery

Dr. Jacobs provides his patients with a specific set of instructions to follow during the recovery period. Careful adherence to these instructions will help ensure a positive outcome after the surgery.

You will be given a compression garment which should be worn 24/7 for several weeks. A return to strenuous exercise should be deferred for several weeks as well, to allow for appropriate healing.

What to Expect from Recovery
Benefits of Gynecomastia Revision Surgery

Benefits of Gynecomastia Surgery for Bodybuilders

  • Improved physical appearance
  • Increased confidence
  • Improved self-esteem

Risks of Gynecomastia Surgery

As with all surgeries, there are certain risks and side effects that your surgeon will discuss with you during consultation. Gynecomastia surgery risks and side effects include possible infection, an adverse reaction to the anesthetic, swelling, and breast asymmetry.

Risks of Revision Male Breast Reduction Surgery
Why Choose Dr. Jacobs for Breast Reduction Surgery?

Why Choose Dr. Jacobs for Bodybuilder Gynecomastia Surgery?

Dr. Jacobs is an expert gynecomastia surgeon and he understands the unique concerns and expectations of bodybuilders who seek treatment for their enlarged breasts.

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Reach out to Dr. Jacobs today to schedule your consultation!


FAQ: Search icon

What type of anesthesia do you use?

Anesthesia for this surgery is usually safe “twilight sleep” anesthesia, provided by a separate MD anesthesiologist. Sometimes, if the “bitch tits” are very small and localized directly under the areola, the procedure can be done under local anesthesia. But there may still be some discomfort during the procedure if only local anesthesia is utilized.

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