Gynecomastia isn’t a one-size-fits-all condition, and the treatment shouldn’t be either. While many people refer to gynecomastia as simply “man boobs,” this term doesn’t capture the complexity of what’s happening beneath the skin. True gynecomastia can involve glandular tissue, fatty tissue, skin excess, or any combination of the three. Understanding these elements is key to developing the right surgical approach.
As a board-certified plastic surgeon with over 5,000 gynecomastia surgeries performed, Dr. Joseph T. Cruise has spent decades refining the process of diagnosis and treatment. Through this experience, he developed the Cruise Classification System, which outlines six distinct types of gynecomastia based on physical presentation, patient history, and treatment needs. This system is central to his diagnostic process and allows for highly customized, consistently reliable outcomes.
Learn more about the types of gynecomastia below, or schedule your consultation with Dr. Cruise today to discover treatment options tailored to your unique needs.
Diagnosing your type of gynecomastia begins with a comprehensive physical exam. Dr. Cruise evaluates the type, amount, and location of tissue involved. He also considers your skin quality, nipple position, and whether any sagging tissue or breast roll is present.
In some cases, you may be asked to have hormone levels checked or undergo imaging studies to rule out other medical conditions that could be causing enlarged male breast tissue. From there, Dr. Cruise will classify your gynecomastia into one of six types. This classification not only helps patients understand what’s going on—it’s also the foundation for choosing the right surgical plan. Treating Type 1 puffiness the same way as a full chest roll simply doesn’t work. Precision diagnosis leads to precision treatment.
Dr. Cruise's classification system divides gynecomastia into six distinct types based on physical appearance, degree of skin laxity, and how far the tissue extends. Here’s how each type is defined and treated:
Gynecomastia surgery isn’t just about removing tissue—it’s about understanding what kind of tissue is present, how much skin is involved, and how your anatomy will respond after surgery. A missed diagnosis or a “one-size-fits-all” approach often results in contour irregularities, persistent puffiness, or even the need for revision surgery.
Dr. Cruise’s diagnostic process is rooted in anatomical precision and surgical planning. By identifying the correct type of gynecomastia, he’s able to recommend a treatment strategy that delivers natural-looking, masculine results—the first time.
If you suspect you have gynecomastia—or if you’ve had previous surgery without the results you hoped for—Dr. Cruise can help.
His experience in diagnosis, classification, and advanced male chest surgery makes him one of the most trusted names in gynecomastia treatment.
Schedule a private consultation at our Newport Beach office by calling 949-644-4808 or using our secure online form.
In most cases, a clinical evaluation is sufficient. However, if there are concerns about underlying medical conditions (such as hormonal imbalances or breast tumors), Dr. Cruise may recommend lab tests or imaging like an ultrasound or mammogram in coordination with your primary care provider or endocrinologist.
Knowing your gynecomastia type ensures that your surgical treatment plan is customized for your anatomy. Each type requires a different approach—from minor gland excision for puffy nipples to more extensive surgery involving skin removal and nipple repositioning for severe cases.
Gynecomastia involves the growth of actual glandular breast tissue, while pseudogynecomastia is caused by excess fat without glandular enlargement. Dr. Cruise carefully distinguishes between the two, as pseudogynecomastia often responds to weight loss alone, while true gynecomastia typically requires surgery.
Mild cases during puberty often resolve without treatment within 1–2 years. However, if breast tissue persists beyond this timeframe or worsens, surgical treatment may be necessary. Adult gynecomastia rarely improves on its own.
Type 1 gynecomastia is limited to puffy nipples with tight surrounding skin. If your chest has a rounded appearance, sagging, or fullness extending beyond the areola, you may have a more advanced type. Dr. Cruise will determine your classification during your consultation.
Yes. Less severe types (like Type 1 and 2) may be treated under local anesthesia in-office, while more extensive cases (Types 4–6) typically require general anesthesia in a surgical center. Your classification helps determine the safest and most efficient surgical setting.
Dr. Cruise frequently sees patients with residual or recurrent gynecomastia due to incomplete diagnosis or treatment. An accurate reclassification and treatment plan can help resolve lingering issues and restore a more masculine chest contour.
The cost of surgery depends on the type of gynecomastia and surgical techniques used. Visit our pricing page to learn about the typical price range for gynecomastia procedures. We accept several types of financing to help make gynecomastia treatment accessible.
