At just 17 years old, this patient came to the Charlotte Gynecomastia Center with a frustrating and confusing issue. He had developed noticeable swelling in both sides of his chest shortly after beginning a gym routine that included over-the-counter “prohormone” supplements.
These supplements are often marketed to boost performance or muscle growth but can have powerful hormonal effects, especially in young males who are still going through puberty.
His case was emotionally difficult. Like many teenage boys, he wanted to improve his body, feel stronger, and look more defined. Instead, he was left with puffy, sensitive nipples and visible breast tissue, which was something he didn’t expect and didn’t know how to reverse.
Understanding Hormone-Driven Gynecomastia
During the evaluation, we found classic signs of gynecomastia triggered by synthetic hormonal ingredients. Prohormones and anabolic-like supplements can mimic or disrupt the body’s natural testosterone-estrogen balance, especially in younger users whose hormone levels are still stabilizing.
Contributing Factors in This Case
- Prohormone exposure: The gym supplements he had been using contained hormone-like compounds that triggered breast tissue growth.
- Pubertal timing: At 17, his body was still maturing. This made him more vulnerable to hormonal disruption and tissue overgrowth.
- Tissue herniation: On the right side, the gland had pushed forward through the areola zone, creating the classic “puffy nipple” appearance.
This combination of age, supplement use, and tissue behavior led to a fairly aggressive presentation in someone who otherwise had low body fat and good muscle tone.
These hormone-sensitive cases often progress quickly, and early treatment can prevent long-term psychological and physical effects.
Surgical Plan and Key Differences Between Sides
Although both sides of the chest showed visible swelling, there was a significant difference in the volume and depth of tissue between them. We tailored our approach to match the asymmetry.
Glandular Removal Summary
- Right side: We removed 31 grams of dense, fibrous breast tissue. This side was more prominent, herniated, and required delicate dissection beneath the areola.
- Left side: A smaller 7-gram gland was excised, allowing us to achieve symmetry without overcorrecting or disrupting natural chest contour.
The goal was not only to remove the mass but also to allow the underlying muscle to reappear and the chest to return to a flat, defined shape.
Despite the difference in volume, both sides were balanced perfectly after the procedure, thanks to careful sculpting.
What Happens to the Skin Afterward?
This patient’s skin was still young and healthy, with excellent elasticity. In cases like his, where the gland has pushed outward and stretched the areola, the question is whether the skin will snap back once the tissue is removed.
Post-Surgical Skin Behavior
- Elastic rebound: After surgery, the relaxed skin begins to contract naturally. This is especially true for younger patients who haven’t had prolonged tissue pressure.
- Improved areola shape: As the puffy gland is removed and no longer stretching the skin outward, the areola flattens back to its natural, tight form.
- No need for skin removal: Due to his age and skin quality, there was no need for excision or lifting of the areola or surrounding tissue.
This is one of the biggest advantages of treating gynecomastia early. The body has the ability to heal in a way that leaves behind little to no evidence of surgery.
Final Results and Takeaway
At follow-up, this 17-year-old’s chest was completely flat, and the puffy nipple appearance was gone. The difference was not only visible but also deeply impactful for his confidence. He could wear fitted shirts, go to the gym, and return to social activities without worrying about how his chest looked.
This case also serves as a reminder to teens and parents alike that supplement use, even when marketed as “safe” or “natural,” can carry real risks. Hormonal manipulation in a developing body can have unintended consequences, and gynecomastia is one of the most common.
At the Charlotte Gynecomastia Center, we’re here to support young men facing this unexpected challenge and help them return to feeling comfortable in their own skin.
If you are experiencing similar symptoms, reach out to our gynecomastia center to schedule a consultation.
