Growth of the breast tissue in men is common and is called gynecomastia. This condition often occurs during puberty and in many occasions resolves spontaneously. It can also occur in old age in which case it is unlikely to resolve but rarely requires treatment.
In people under the age of 20 treatment is rarely performed as the condition is likely to improve. In most cases the cause for the condition remains uncertain (idiopathic gynecomastia) and is has generally been attributed to an inbalance in sex hormones or the tissue unresponsiveness to them
However there are a number of factors that can produce the condition which need to be excluded. These include generalised weight gain. This is known as pseudogynecomastia and is best treated by judicious weight loss. Other causes include:
Medication- the following drugs are believed to cause gynecomastia:
Cimetidine, Omeprazole, Spirinolacte and Cannabis
Increase in the production of the female hormone estrogen
This occurs in certain testicular tumours and in patients with hyperthyroidism
Decrease in the production of the male hormone testosterone
This can be caused by genetic conditions such as Klinefelter syndrome. Diseases of the hypothalamus or pituitary can also lead to low testosterone levels. Abuse of anabolic steroids has a similar effect.
It is important to remember that in the vast majority of cases no cause is found for the condition. In many cases other male members of the family have the condition and it can be considered hereditary.
Treatment
If you are overweight it is sensible to try and loose weight as this will reduce the fatty content of the breast tissue. In some cases this will not reduce the fullness in the area as it is composed of breast tissue rather than fatty tissue.
Exercising and building up the pectoralis muscled under the breast may make the condition worse. This is because it makes the muscle bigger and thicker but has little effect on the overlying breast tissue.
There a number of medications that are reported to reduce gynecomastia. There is little evidence that they are effective but they may be worth trying in the first instance as they are unlikely to cause any harm.
Surgical reduction of gynecomastia is possible and is either performed by fat reducing or excisional techniques. Liposuction is the main fat reducing technique and is works best on people with generalised prominence in the area without excessive skin laxity. Advantages of liposuction include minimal downtime and very little scarring. The scarring is limited to 2-3 short incisions approximately 5mm in length located at the edges of the breast tissue.
In excisional techniques skin is removed along with breast tissue. This technique is best reserved for people with significant skin looseness as it will reduce this. On the downside it does involve more scarring than liposuction. This is usually located around the nipple but can extend down the fold under the breast.
After Your Surgery
Whether you’ve had excision with a scalpel or liposuction, you will feel some discomfort for a few days after surgery. However, discomfort can be controlled with medications prescribed by your surgeon. In any case, you should arrange to have someone drive you home after surgery and to help you out for a day or two if needed.
You’ll be swollen and bruised for awhile–in fact, you may wonder if there’s been any improvement at all. To help reduce swelling, you’ll probably be instructed to wear an elastic pressure garment continuously for a week or two, and for a few weeks longer at night. Although the worst of your swelling will dissipate in the first few weeks, it may be three months or more before the final results of your surgery are apparent.
In the meantime, it is important to begin getting back to normal. You’ll be encouraged to begin walking around on the day of surgery, and can return to work when you feel well enough–which could be as early as a day or two after surgery. Any stitches will generally be removed about 1 to 2 weeks following the procedure.
Your surgeon may advise you to avoid sexual activity for a week or two, and heavy exercise for about three weeks. You’ll be told to stay away from any sport or job that risks a blow to the chest area for at least four weeks. In general, it will take about a month before you’re back to all of your normal activities.
You should also avoid exposing the resulting scars to the sun for at least six months. Sunlight can permanently affect the skin’s pigmentation, causing the scar to turn dark. If sun exposure is unavoidable, use a strong sunblock.
Your New Look
Gynecomastia surgery can enhance your appearance and self-confidence, but it won’t necessarily change your looks to match your ideal. Before you decide to have surgery, think carefully about your expectations and discuss them frankly with your plastic surgeon.
The results of the procedure are significant and permanent. If your expectations are realistic, chances are good that you’ll be very satisfied with your new look.
To find out if you would be suitable for surgical treatment of gynecomastia it is best to see a specialist to discuss your options. At the Gatehouse Clinic a number of our surgeons have a special interest in gynecomastia surgery and would be more than happy to see you for a consultation in which the condition would be discussed and any of your questions answered. If you would like to arrange a consultation please contact us at the Gatehouse Clinic where your enquiry will be handled with the strictest confidence.
Gynecomastia is a common condition producing generalized enlargement of the male breast tissue.
It can be treated by Excisional techniques which involve an incision around the nipple allowing access to the enlarged tissue which is removed.
Liposuction techniques involve reducing the amount of breast tissue by suctioning it out via small incisions around the breast.