For some women, when it comes to attracting men, breast size can be a major source of physical insecurity.

It is not uncommon for less-endowed women to rely on cleavage maximising push-up bras, 'bust-enhancing' massages or even surgery in order to make up for their perceived inadequacy there.

But there are men who dislike conspicuous mammaries - when they are the ones who have them.

'Gynaecomastia is the development of abnormally large mammary glands or breast tissues in males, resulting in breast enlargement,' said Dr Jane Lim, senior consultant, division of plastic, reconstructive and aesthetic surgery, National University Hospital.

It can affect males at different stages of life, from 'neonates (infants under one month old) to adolescents, adults and the elderly,' she said.

The result, she added, is that usually a man is 'embarrassed by the situation when he is required to strip in the company of his peers, like at the swimming club or in the army'. Enlarged breasts on a male could then lead to lowered self-esteem. The appearance of his chest may even invite questions or inquisitive stares.

While the condition is often easily identifiable, it is difficult to pin down what exactly causes it.

Generally, it has been attributed to an imbalance of sex hormones or the tissue responsiveness to them, said Dr Lim.

It could also be the result of external factors, such as medication that includes hormones and conditions like chronic kidney disease and chronic liver disease. However, in a number of cases, the causes of breast enlargement are unknown.

While some cases, such as those that occur during puberty, may eventually resolve themselves or improve when the oestrogen level falls, others are permanent.

The treatment would then depend on the root cause of the condition.

'In the early stages of the condition, a consultation with an endocrinologist (specialist in hormones) may be helpful in establishing the cause of gynaecomastia, as well as in obtaining advice on medication or a change of medication that may lead to the improvement of the condition,' said Dr Lim.

However, what can be done if the condition of the patient does not improve with time or after numerous consultations?

'Medication that can counter its effects are not often used as they may have side-effects. Gynaecomastia is not usually a life-threatening condition,' said Dr Lim.

If the individual has had the problem for a long time and wants something to be done, surgery may be the only option.

'Surgery can be in the form of excision, liposuction or reduction mammoplasty or a combination of techniques,' said Dr Lim.

She advises patients not to take surgery lightly as it carries risks similar to that of any other surgery needing general anaesthesia.

This article was first published in Mind Your Body, The Straits Times on May 21, 2008.