Gynecomastia, colloquially called man-boobs, is an abnormal enlargement of the breasts in men. It is most commonly seen in the teenage years during puberty but resolves in most males by the end of puberty. It can also develop any time thereafter for many reasons such as the result of using anabolic steroids, hormonal imbalances due to a variety of causes, side effects of several medications, marijuana usage, underlying medical problems and aging.
Regardless, many men find this to be quite embarrassing resulting in a loss of self-confidence and worth. Having enlarged breasts, not infrequently feminine in appearance, can be quite demasculinizing and demoralizing, especially for those who are in their teens, twenties and thirties. However, it absolutely bothers men of all ages – even those in their sixties and seventies.
Look! Grandpa has big boobs like grandma.
Not what you would like to hear.
The embarrassing presence of gynecomastia can affect so many aspects of a man’s life – social, dating, intimacy, sports and working out.
These effects are absolutely real.
For many men, this means that their gynecomastia needs to be treated.
Treatment of Gynecomastia
Treatment of gynecomastia depends on what is the underlying cause of the breasts enlargement. There are three possibilities:
- Enlarged glandular (breast) tissue
- Increased fat volume
- Combination of enlarged glandular tissue and fat
The only one above that may respond acceptably to non-operative treatment is gynecomastia (more correctly – pseudogynecomastia) that is caused solely by fat. This is usually related to being overweight.
Obese.
A substantial weight loss can improve the appearance of the chest though it may not necessarily resolve the enlargement enough to be satisfactory in appearance.
Consequently, surgery is generally the definitive treatment for gynecomastia.
Insurance Coverage and Gynecomastia
Virtually all the time, insurance companies consider gynecomastia to be a cosmetic procedure and will not cover it. In fact, many plans specifically state that treatment of enlarged male breasts is an exclusion from coverage.
Of course, these are the same insurance companies that can make it extremely difficult for women with markedly enlarged breasts who have many untoward symptoms as a result, to obtain coverage for their breast reduction surgery.
So, expect little and perhaps be surprised.
Rarely, though.
When Might Insurance Cover Gynecomastia Treatment?
In order to have any chance of obtaining insurance approval for surgery, you have to prove that the procedure is “medically necessary”.
An equivalent of this in our legal system is like proving your innocence when there are no witnesses to support your story yet you do have a strong motive for what happened and surveillance cameras captured you not far from the scene of the crime.
Ok, this may be a little too dramatic but…
You are facing somewhat steep odds to get coverage.
Stating that you are embarrassed, self-conscious or have lost self-esteem won’t do it.
Neither will stating that you are anxious or depressed about your enlarged breasts and that this affects your social life or intimacy.
The following are some examples where you do have a chance of obtaining insurance coverage for treatment of your gynecomastia:
- You are in puberty and your breasts have grown so large that they are the equivalent of a “C” or “D” cup or even larger
- Your breasts have substantially enlarged as a side effect of necessary, therapeutic medication or chemotherapy prescribed by your doctor
- You are experiencing considerable pain associated with noticeably large breasts that may be causing or will lead to some sort of functional or physical impairment
- Rare genetic disorders that can lead to gynecomastia (Klinefelter’s Syndrome)
Documentation Gives You a Chance
Gynecomastia due to you being a dope head, taking anabolic steroids or being substantially overweight is all on you.
As are all the costs to surgically address it.
However, if the reason that you have gynecomastia is similar in nature to the above examples – developing due to no fault of your own then you may have a chance to obtain insurance coverage.
That is, of course, if it is not an absolute exclusion that is clearly stated in you insurance plan.
You will need thorough documentation of your condition in order to buttress your case. This can include letters from one or more of your physicians, relevant blood work and documentation of all relevant issues.
Many insurance companies will list their criteria online that need to be met in order to give you a chance for coverage.
Consultation for Treating Your Gynecomastia
If you have gynecomastia and are strongly contemplating having it surgically treated, please feel free to call the Arizona Center for Aesthetic Plastic Surgery at (480) 451-3000 or contact us by email.
Steven H. Turkeltaub, M.D. P.C.
Scottsdale and Phoenix, Arizona