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Gynecomastia Surgery: Symptoms, Causes, and Treatment



Gynecomastia Surgery: Symptoms, Causes, and Treatment
Dr Bk Garg : 07 June 2021


Gynecomastia or male boobs refers to an increase of breast glandular tissue in males. The development of breast tissue depends on the balance between the male hormone, testosterone, and the female hormone, estrogen. When the balance between these hormones is disturbed, it can lead to gynecomastia in males. It is estimated that almost 40-60% of the males in India suffer from gynecomastia at some point in their lives.

There is another kind of increased breast size in males that is seen because of the deposition of excess fat in the breasts. This condition is known as pseudo-gynecomastia. This is different from true gynecomastia in the fact that there is no increase in the glandular tissue in pseudo-gynecomastia.

Gynecomastia can be a very embarrassing condition for men and can lead to a decrease in their self-esteem and confidence. But it is also a very easily treatable condition.

In this article, we will discuss gynecomastia symptoms, causes, and the treatment options that are available to the patients. Gynecomastia surgery is a very safe procedure that is usually done for patients having gynecomastia symptoms.

Gynecomastia Symptoms

Because of the development of extra breast tissue or deposition of excess fat in the breast, the patients can observe the following gynecomastia symptoms:

  • Increase in the size of the breasts
  • Swollen breast tissue
  • Breast tenderness

While all these symptoms can be a cause for concern for the patient and should be reported to the doctor, there are some gynecomastia symptoms that, when seen, should be reported immediately to a professional. These include:

  • The very fast increase in the size of the breast tissue
  • Discharge from the nipple
  • Bleeding from the nipple

All these symptoms can point towards a more serious issue and should be checked immediately.

Gynecomastia Causes

Gynecomastia is basically caused by an imbalance between the male and female reproductive hormones. When the testosterone in the body decreases or the estrogen increases, it can lead to increased breast tissue in males.

This hormonal imbalance can occur due to many reasons like:

  • Physiological or normal hormonal changes
  • Medications
  • Some health conditions
  • Substance abuse
  • Use of uncertified herbal products

Physiological or normal hormonal changes

There is a common misconception that the male body does not produce estrogen. But that is not true. Estrogen is also produced in the male body, although in very less amount. Gynecomastia causes are seen frequently in population groups that normally have more estrogen and less testosterone. These include:

  1. Infants
  2. Adolescents
  3. Adults above the age of 50 years

Infants

More than 50% of male babies have enlarged breasts when they are born because of the effects of maternal estrogen on them. This condition normally resolves on its own in 2 to 3 weeks.

Adolescents

Gynecomastia in adolescents is also very common because of the changing and unstable levels of reproductive hormones. This condition normally resolves on its own when these hormones stabilize.

Adults above the age of 50 years

Adults above the age of 50 also have a higher incidence of gynecomastia because of decreased testosterone production with age.

Medications

One of the most common pathological gynecomastia causes is the use of certain medications, with or without a doctor’s prescription. Some of these medications include the following:

  • Anabolic steroids
  • Anti-androgen medications that are used to treat prostate conditions like finasteride, spironolactone, etc.
  • Anti-anxiety medications like diazepam, etc
  • Tricyclic antidepressants
  • Certain antibiotics
  • Anti-HIV drugs like Efavirenz
  • Medications used for heart conditions like digoxin, etc

Some health conditions

Gynecomastia causes also include certain pre-existing medical conditions in males. The most common ones include the following:

  • Under functioning testes or hypogonadism
  • Hyperthyroidism
  • Certain tumors that lead to excess estrogen in the body
  • Chronic kidney diseases
  • Chronic liver conditions
  • Malnutrition and starvation

Substance abuse

Chronic substance abuse is also one of the major gynecomastia causes. Abuse of the following substance is most commonly linked to enlarged breast tissue in males:

  • Alcohol
  • Marijuana
  • Heroin
  • Amphetamines, etc

Use of uncertified herbal products

Many herbal protein powders without proper ingredient information contain anabolic steroids. These can cause gynecomastia in males. Other products like herbal oils have estrogen-increasing properties, which leads to disturbances in reproductive hormones.

Gynecomastia Treatment

When the patient consults with their doctor regarding the symptoms, the doctor will conduct a detailed medical and physical examination for the patient. This will include a detailed medical history about the drugs he is taking, diseases he might be suffering from, etc. the doctor will also do a physical examination of the patient’s chest.

After this, some blood tests and imaging tests will be done for the patient to reach a definite diagnosis. Blood tests are done to check the levels of hormones in the body and X-Ray (mammogram), etc are done to rule out any other abnormality in the breast.

Once the diagnosis of gynecomastia is made, there are many gynecomastia treatment options that are available for the patient.

While most cases of gynecomastia resolve on their own, if it is being caused by some underlying disease, then the disease has to be treated first. Gynecomastia treatment for enlarged breast tissue due to any medication can be treated by discontinuing or adjusting the dose of the medication.

For other cases, the gynecomastia treatment options include:

  • Medications
  • Gynecomastia surgery

Medications

There are some medicines that can be used for some people who are suffering from gynecomastia. Though, this is not a commonly used gynecomastia treatment. These medications include the ones that are used for the treatment of breast cancer, like:

  • Medications
  • Aromatase inhibitors like anastrozole

Gynecomastia surgery

Gynecomastia surgery is the treatment of choice in people who have unresolved gynecomastia, which causes them pain and discomfort. There are two kinds of gynecomastia surgery that are performed on the patients.

  • Liposuction
  • Mastectomy

Liposuction

Liposuction is the surgery of choice in people who suffer from pseudo-gynecomastia. Liposuction can be done to remove the excess adipose tissue or fat cells from the breasts to decrease their size

This surgery is performed under general anesthesia. Thin tubes are inserted into the breast using incisions and the excess fatty tissue is suctioned into these tubes.

Mastectomy

Mastectomy or the removal of breast glandular tissue is usually a less invasive process as compared to liposuction. This is done using small incisions and thus has a slower recovery period.

This is the surgery of choice in people who have true gynecomastia or increased breast glandular tissue.

While both these gynecomastia surgeries are relatively safe, these can have certain side effects and complications. It is extremely important that you get the gynecomastia surgery done only by qualified professionals who have the knowledge and the skill to perform these surgeries. Lack of expertise can lead to various unwanted complications in the patients.

Take Away

This was a brief article on gynecomastia and gynecomastia surgery to help patients understand better about their condition. For further information, contact a qualified professional who will be able to guide you better.

Dr. BK Garg is a very renowned plastic surgeon in Gurgaon. He has his clinic in Gurgaon and he provides a wide range of services to his patients including liposuction, tummy tuck, breast augmentation, rhinoplasty, and gynecomastia surgery in Gurgaon.

With years of experience and knowledge, Dr. BK Garg, along with his skilled team, is the best plastic surgeon in Gurgaon.




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