Gynecomastia or large breasts in men, is common in two age groups. The first is young men around puberty when it usually goes away without treatment and the other, men over fifty, when it does not usually resolve without surgery.
The cause is usually never identified and is often a nonspecific change in the breast. In some cases there is a specific cause such as thyroid or testicular problems, liver disease or drugs, such as marijuana, digitalis or steroids. In some cases large breasts can be due to obesity and weight loss may help.
Gynecomastia usually develops as one of two patterns, either a firm button of tissue beneath the nipple or a diffuse pattern of fatty change with poorly defined margins. Sometimes both patterns are present. The pattern determines the type of surgery recommended for the gynecomastia.