Gynecomastia Grading

Simon grade I gynecomastia has become widely known as Puffy Nipples. This occurs when underlying localized breast tissue creates a cone-shaped nipple-areolar complex that projects outward from the surrounding tissue. The underlying gynecomastia can cause pain and discomfort and is frequently sensitive to temperature. Men with puffy nipples often complain that their gynecomastia becomes more apparent with warmer temperatures.

Simon grade II gynecomastia has been colloquially termed “man boobs”. Simon grade IIA describe men with moderate gynecomastia that extends past the nipple-areolar complex, but without skin redundancy.

Simon grade II gynecomastia has been colloquially termed “man boobs”. Simon grade IIb describe men with moderate gynecomastia that extends past the nipple-areolar complex, with skin redundancy. When it’s present, it is often found on the side of the chest. Additionally, skin laxity may cause the nipple areolar 

Simon grade III gynecomastia addresses men whose gynecomastia causes gross feminization of their chest. Feminizing features include breast tissue that extends into the axilla and lateral chest wall and very large nipple areolar complex that sag greater than two centimeters below the inferior border of their pectoralis major muscle. Men with simon grade III gynecomastia may require multiple procedures to address their excess skin and are at higher risk for contour irregularities. 

When being evaluated by your plastic surgeon at HIM Plastic surgery, your plastic surgeon will determine your grade of gynecomastia and determine a specialized surgical plan that addresses your concerns.

**SIMON, BERNARD E., SAUL HOFFMAN, and SIDNEY KAHN. “Classification and surgical correction of gynecomastia.” Plastic and reconstructive surgery 51.1 (1973): 48-52.