Brief Answer:
Persistent pubertal gynecomastia; probably aggravated by excess adipose ts.

Detailed Answer:
Hello. Thank you for writing to us at healthcaremagic

I have gone through your query and I have understood it.

I will keep a likely possibility of Persistent pubertal gynecomastia (PPG). It is one of the common causes of gynecomastia.

During puberty there is a transient relative imbalance between estrogen and testosterone, leading to gynecomastia. Either an increase in estrogen production, a decrease in androgen production, or a combination of these factors increase the size of male breast tissue. The condition often goes away on its own, but may persist in some.

There is a definite hereditary component in persistent pubertal gynecomastia. A family history of gynecomastia is positive in more than half of patients with persistent pubertal gynecomastia.

Besides I also noticed that likely you are overweight (90 kgs for a 25 year old seems a bit too high) and that may be causing increased breast adipose tissue/ pseudogynecomatia and thus further aggravating the problem. I would like to know you height to get a better idea whether you are overweight for your height or not?

Being overweight can be associated with increased peripheral conversion of androgens to estrogens and is associated with a higher prevalence of gynecomastia, as you must have noticed that obese people more often than not have gynecomastia.

You could benefit from change in lifestyle habits besides regular exercise and weight control regime. I strongly urge you to try modified life style, weight managing diet and exercises.

Medical treatment is more effective for recent onset gynecomastia rather than for a long standing problem. Reduction mammoplasty/surgery is an option for long standing gynecomastia. Liposuction would remove excess fat and Excision can be done for excess glandular tissue. However the appropriate line of management will be decided after complete assessment of your history and examination findings. I will urge you to visit a plastic surgeon for this assessment and further action.

In the meanwhile do not forget to try diet / life style changes and exercise. It definitely will benefit you.

Regards

---