By Stacey Chia

When we talk of breasts, women naturally come to mind. But some men develop breasts too.

The condition, typically referred to as man boobs, or "moobs", is medically known as gynaecomastia.

It results when a man develops excessive breast tissue, visible as an enlargement of the breast. While it can occur in males of any age, it is more common in men above the age of 50, said Dr Colin Tham, a plastic surgeon at Asia Healthpartners.

"This is due to the increased conversion of male hormones to female hormones and the decreased production of testosterone as men get older," said Dr Tham.

Even infant males can suffer from gynaecomastia due to the high oestrogen state of pregnancy.

An estimate is that 60 to 90 per cent of infants have transient gynaecomastia, he said. Dr Marco Correa, a plastic surgeon at Dr Marco Faria Correa Plastic Surgery, said gynaecomastia is becoming increasingly more common worldwide due to more people being overweight.

"This increased fat that men carry will result in increased female hormone oestrogen in their bodies," said Dr Marco.

However, there are also other reasons behind gynaecomastia, such as puberty.

As a result of hormonal fluctuations during puberty, even a boy who is not overweight may have a localised button-like lump growing inside his breast.

It is usually hard to the touch and if it is painful, it can be surgically removed although the problem usually goes away after two to three years.

Men with liver conditions like fatty liver are also prone to gynaecomastia as their liver is unable to metabolise the female hormones and the result is a rise in their oestrogen level.

It can also be caused by genetic conditions such as Klinefelter's syndrome. Men suffering from this have an extra X chromosome and hence possess more female characteristics.

In most cases, however, there is no obvious cause, Dr Tham said.

For those suffering from gynaecomastia due to hormonal imbalances, medication may be a solution.

Testosterone injections may help men who have gynaecomastia as a result of low testosterone levels, said Dr Peter Eng, endocrinologist at Peter Eng Endocrine Clinic.

"But the injections are not always effective and usually do not result in complete regression of the breast tissue," he cautioned.

The most effective way of getting rid of unwanted gynaecomastia is through surgery in the form of an open procedure or liposuction, said Dr Marco.

"Losing weight also helps," he added.

If the enlarged breast is formed due to hard glandular tissue, open surgery is done because it is too hard to be removed by liposuction.

If the breast is enlarged due to soft fat tissue, liposuction is performed.

Both procedures can cost between $6,000 and $12,000, with liposuction being the more expensive of the two.

Surgery is necessary when the enlarged tissue becomes cancerous.

However, gynaecomastia can affect a man's self-esteem. Dr Marco advises men to have the procedure if it affects them psychologically too.

staceyc@sph.com.sg