Gynecomastia is a common condition among males that generally presents itself early on, in puberty, or between the ages of 50 and 69. Here, people suffer from enlarged male breast tissue, puffy nipples or areolas with possible discharge, and experience breast/chest tenderness over a period of 6 months or more. When dealing with this condition, males often develop anxiety and psychological discomfort and often become overly concerned about developing breast cancer. Nevertheless, it's best to get an understanding of what causes this condition, what the different stages are, and your available treatment options first before overwhelming yourself with the what-ifs. That said, here's a summary of the four stages of gynecomastia, its causes, symptoms, and treatment options if necessary. 

What are the Different Stages of Gynecomastia? 

As briefly mentioned, there are four stages of gynecomastia. It's important to know the various stages of this condition because effective treatment depends on which stage or grade of gynecomastia you have. Moreover, once you know what stage you are dealing with, you will better understand the appropriate treatment options. Therefore, ranging from mild to severe, below are the four stages of gynecomastia. 

Grade I 

This phase of gynecomastia is the initial stage. Here, a person suffering from this condition in its initial stages will likely develop small breast enlargement, which is relatively undetectable when wearing clothing. Often, there's some tissue growth around the nipple area or areola, and the nipples themselves have a puffy or almost cone-like look to them. The glandular tissue growth is also a different color from the breast tissue that a person would normally have. In this first phase or grade I stage, most treatment options are highly effective, and people often get the results they are looking for. 

Grade II 

People dealing with Grade II gynecomastia also have tissue growth and enlarged breasts. However, tissue growth has become broader or more widespread throughout the chest. In terms of appearance, Grade II gynecomastia is still relatively undetectable under loose-fitting clothing, but here, breast enlargement is moderate in nature. In addition, an increase in tissue growth, patients suffering from Grade II gynecomastia report tightness in their chest, a firm, almost hard nipple area with soft yet fatty tissue edges. This stage is often best resolved by undergoing liposuction and gland excision. 

Grade III 

In this grade, a person's skin around their areola's has become droopy and excessive. Here, there's so much breast enlargement that the person's chest or at least the width of their chest has also increased. This stage of gynecomastia is classified as moderate to severe, mainly because the enlargement/sagginess of a person's breast is visible even when he is wearing loose-fitting clothing. With stage or Grade III, male breast reduction surgery is often a topic of discussion. 

Grade IV 

The fourth and final stage of gynecomastia is also known as Grade IV. At this stage, male breasts have typically become so large that their appearance only differs slightly from that of female breasts. As a result, Grade IV is classified as severe because the enlargement is very apparent. The only effective treatment option is liposuction with gland excision. 

Is There More Than One Type? 

Along those same lines, there are two main types of gynecomastia—Glandular and Fatty. True or glandular gynecomastia occurs when there's excessive production of estrogen or unusually high estrogen levels in the body. This type is where you see large breasts development, common in older men. The other type of gynecomastia, fatty gynecomastia, is caused by excessive weight gain/the accumulation of fatty cells in the chest/breast area. The latter type is often attributed to a sedentary lifestyle and poor dietary choices such as excessive alcohol consumption and junk food. Note, enlarged breasts in men/gynecomastia may affect one or both breasts. 

How do You Know if You Have Gynecomastia? 

A person can tell if they are suffering from this condition if they notice changes in the appearance of their breast or chest area. Once you have detected enlarged breast tissue, you should go see a doctor. After a thorough physical examination, which should include questions regarding possible medications/drugs, illegal drug use, and family history, plus blood tests and a full workup, then possible treatment options may be discussed. 

Does Gynecomastia Go Away? 

As suggested, depending on the stage, type, and patient's age, gynecomastia occasionally goes away on its own. Typically, this is seen with prepubertal gynecomastia, which affects pubescent boys or children going through puberty. In this instance, within six months to two years, this condition generally resolves itself after the boy's or child's hormones have become balanced again, and puberty is complete. Similarly, for those dealing with fatty gynecomastia, once efforts are made to lose excess weight and maintain a healthy lifestyle, this condition tends to go away as well. 

What Causes Gynecomastia? 

A variety of factors can cause gynecomastia. For instance, this condition can be caused by hormonal changes or imbalance, puberty, side effects due to medications/drugs, illegal drug use, being overweight, or underlying causes/differential diagnoses. Other potential causes are thyroid issues, kidney disease, and liver disease—just to name a few. This is why it's important to see a doctor or physician—you want to be able to rule out any underlying conditions as well as find the appropriate treatment for your stage and type of gynecomastia. 

What Treatment Options are Available? 

Lastly, a quick overview of available treatments includes liposuction, gland excision, male breast reduction surgery, a healthy lifestyle, medication changes, and time (when dealing with prepubertal gynecomastia). For those dealing with  gynecomastia, speciality garments and nipple covers may help to manage your condition and reduce its appearance. Moreover, compression garments are also a part of the recovery process after any surgical solutions or procedures to treat gynecomastia.