Gynecomastia | Plastic Surgery - Thumbay University Hospital

Gynecomastia

Gynecomastia is the growth of abnormally large breasts in males. It is due to the excess growth of breast tissue, not excess fat tissue.

Considerations
The condition may occur in one or both breasts and begins as a small lump beneath the nipple, which may be tender. The breasts often enlarge unevenly. Gynecomastia during puberty is not uncommon and usually goes away over a period of months.

In newborns, breast development may be associated with milk flow (galactorrhea). This condition usually lasts for a couple of weeks, but in rare cases may last until the child is 2 years old.

Causes
Androgens are hormones that create male characteristics, such as hair growth, muscle size, and a deep voice. Estrogens are hormones that create female characteristics. All men have both androgens and estrogens.

Changes in the levels of these hormones, or in how the body uses or responds to these hormones can cause enlarged breasts in men.

More than half of boys develop gynecomastia during puberty.

Other causes include:

Aging
Cancer chemotherapy
Chronic liver disease
Exposure to anabolic steroid hormones
Exposure to estrogen hormone
Kidney failure and dialysis
Lack (deficiency) of testosterone (male hormone)
Marijuana use
Hormone treatment for prostate cancer
Radiation treatment of the testicles
Side effects of some medications (ketoconazole, spironolactone, metronidazole, cimetidine (Tagamet))
Rare causes include:

Genetic defects
Overactive thyroid
Tumors
Breast cancer in men is rare. Signs that may suggest breast cancer include:

One-sided breast growth
Firm or hard breast lump that feels like it is attached to the tissue
Skin sore over the breast
Bloody discharge from the nipple

Home Care
Apply cold compresses and use pain relievers ( analgesics) as your health care provider recommends if swollen breasts are also tender.

Other tips include:

Stop taking all recreational drugs, such as marijuana
Stop taking all nutritional supplements or any drugs you are taking for bodybuilding
When to Contact a Medical Professional
Call your health care provider if:

You have recent swelling, pain, or enlargement in one or both breasts
There is dark or bloody discharge from the nipples
There is a skin sore or ulcer over the breast
A breast lump feels hard or firm
Note: Gynecomastia in children who have not yet reached puberty should always be checked by a health care provider.

What to Expect at Your Office Visit
Your health care provider will take a medical history and perform a physical examination.

Medical history questions may include:

Is one or both breasts involved?
What is the age and gender of the patient?
What medications is the person taking?
How long has gynecomastia been present?
Is the gynecomastia staying the same, getting better, or getting worse?
What other symptoms are present?
Testing may not be necessary, but the following tests may be done to rule out certain diseases:

Blood hormone level tests
Breast ultrasound
Liver and kidney function studies
Mammogram
Intervention:

If an underlying condition is found, it is treated. Your physician should consider all medications that may be causing the problem. Gynecomastia during puberty usually goes away on its own.

Breast enlargement that is extreme, uneven, or does not go away may be embarrassing for an adolescent boy. Treatments that may be used in rare situations are:

Hormone treatment that blocks the effects of estrogens
Breast reduction surgery

Male breast reduction procedure steps

What happens during gynecomastia correction surgery?
Plastic surgery to correct gynecomastia is technically called reduction mammaplasty, and reduces breast size, flattening and enhancing the chest contours.
In severe cases of gynecomastia, the weight of excess breast tissue may cause the breasts to sag and stretch the areola (the dark skin surrounding the nipple). In these cases the position and size of the areola can be surgically improved and excess skin may be reduced.
Anesthesia
Medications are administered for your comfort during the surgical procedure. The choices include intravenous sedation and general anesthesia. Your doctor will recommend the best choice for you.
Liposuction
In cases where gynecomastia is primarily the result of excess fatty tissue, liposuction techniques alone may be used.
This requires insertion of a cannula, a thin hollow tube, through several small incisions. The cannula is moved back and forth in a controlled motion to loosen the excess fat, which is then removed from the body by vacuum suction.
There are various liposuction techniques that may be used; the technique most appropriate in your case will be defined prior to your procedure.

Excision
Excision techniques are recommended where glandular breast tissue or excess skin must be removed to correct gynecomastia.
Excision also is necessary if the areola will be reduced, or the nipple repositioned to a more natural male contour. Incision patterns vary depending on the specific conditions and surgical preference.

Sometimes gynecomastia is treated with both liposuction and excision.

Will there be scars?
Any surgical treatment to correct gynecomastia will require incisions. While most incision lines are concealed within natural contours, some may be visible and are a necessary result of breast reduction surgery.