Gynecomastia: Causes and Treatment

Gynecomastia is the enlargement of male breast tissue and is a common condition that can occur at any age. It is often due to an imbalance between estrogen and testosterone hormones. Gynecomastia is not a fatal condition but one may be motivated to seek proper treatment due to self-consciousness and a lack of confidence.?

Causes of Gynecomastia

Gynecomastia is caused by a hormonal imbalance between estrogen and testosterone. These hormones are particularly involved in breast development. Too much production of estrogen or too little testosterone can increase breast mass, giving them a feminine appearance. This hormonal imbalance can be caused by a variety of factors including,

• Obesity: Fat deposits under the breast can also enlarge breast known as pseudo gynecomastia
• Alcoholism
• Klinefelter syndrome (A genetic condition)
• Liver or adrenal disease
• Certain drugs like anabolic steroids, antidepressants, antihypertensives, or exogenous hormones for hormone replacement therapy.

The Severity-Based Types of Gynecomastia

Gynecomastia is a clinical condition and for the sake of better understanding and treatment, it is divided into different stages according to its severity. All of these stages require different interventions and different surgical techniques.

• Stage 1: Minor breast enlargement with no skin involvement
• Stage 2a: Moderate or visible breast enlargement with no skin involvement.
• Stage 2b: Moderate or visible breast enlargement with skin involvement.
• Stage 3: Excessive breast enlargement with skin involvement.

Stages 1 and 2 do not require extensive surgery and skin can be spared during breast reduction. Other stages will require the removal of excess skin for a better cosmetic appearance.?

How to Treat Gynecomastia

Gynecomastia is a harmless condition that doesn't usually require any medical assistance. Most cases of gynecomastia are resolved on their own with time once the underlying causes are treated. Sometimes social distress or pain in the enlarged breast may cause patients to seek medical help. The primary surgical option for breast enlargement in males is breast reduction.?

There are two surgical options for breast reduction for the treatment of breast enlargement in males. These are,?

• Liposuction: Removal of extra fat tissue from the breast to reduce it to its normal size.
• Mastectomy: Removal of whole breast tissue along with gland and stroma.?

Gynecomastia Surgery

Gynecomastia surgery is also known as male breast reduction surgery. Its main aim is to reduce the size of the breast and restore its contour to masculine form to spare the patient from feeling self-conscious. It is a perfectly safe surgery and has an incredibly smooth recovery rate. Although many surgeons prefer to do gynecomastia surgery under general anesthesia using local anesthesia is perfectly suitable for this type of surgery. Some surgeons prefer the use of drains to drain the wound and compression vests to help with pain and inflammation after the surgical procedure.

Pre-Op Precautions

Before undergoing gynecomastia surgery, it is important to take good care of your health. Surgeons will make sure to treat any underlying cause of gynecomastia before surgery to prevent relapses. They will also do a thorough physical examination to assess your anesthesia status. It is considered a major surgical procedure and is performed under general anesthesia most of the time. It is important to be in good shape physically before surgery.

• Eat healthy foods to prepare your body for surgery
• Stop smoking at least 3 weeks before surgery as smoking can delay the recovery process.
• Stop taking anticoagulants such as aspirin before surgery as they can increase the risk of bleeding. Consult your doctor regarding any medication you are taking.
• Fill up your pain prescription beforehand as the first few days after surgery can be painful. You may need analgesics to help minimize and manage the pain.?

The Risk of Gynecomastia Surgery

Gynecomastia surgery like every other surgery is not without risks and complications. Some of the risks for male breast enlargement surgery include:

• Bruising
• Bleeding
• Hematoma
• Visible scarring
• Marked inflammation
• Asymmetrical breasts
• Numbness of overlying skin and nipple
• Irregular contour
• Infection due to drain placement
• Loose overlying skin

These complications are common and can occur despite great pre-op and post-op precautions. Attention to surgical technique, a healthy body, and impeccable pre/post-op management is necessary to reduce the incidence of these complications.

Expected Result

Gynecomastia surgery results are immediately visible. You don't have to wait for days or weeks to see significant improvement but final results may take up to 3-6 months. It can be attributed to the body's own process of healing and adjusting to the lost tissue. In 2-3 weeks, swelling from the wound will subside completely and you will be able to appreciate the new contour of the breast. However, The surgical scars from the gynecomastia surgery are permanent and will remain visible for a long time. The place of incision is a very important decision to discuss with your surgeon.?

Final Thoughts

Gynecomastia surgery is a safe surgical procedure with minimum risk of complications. It can greatly increase the self-esteem and confidence of people suffering from gynecomastia.?If you think you are a candidate for this surgery, consult a professional surgeon for a better understanding.