Gynecomastia

What is Gynecomastia?

Gynecomastia is the non-cancerous enlargement of breast tissue in males. This can occur in boys during puberty or in men of any age. There are two main types:

1. Physiological gynecomastia

This is a temporary condition that occurs due to hormonal changes. It is most common in newborn babies (due to maternal hormones), boys going through puberty (increased estrogen compared to testosterone), and older men (due to decreasing testosterone levels). In most cases, physiological gynecomastia resolves on its own within a few months to a year without treatment.

2. Pathological gynecomastia

This is a less common type caused by an underlying medical condition, medication, or substance use. Examples include liver disease, Klinefelter syndrome, certain medications (antidepressants, steroids), and marijuana use. Pathological gynecomastia usually requires medical evaluation and treatment to address the underlying cause.

What causes gynecomastia?

Hormonal Imbalances:

• Decreased testosterone: This is the most common cause, especially in older men. Testosterone is the primary male hormone responsible for male characteristics like muscle mass and facial hair. When testosterone levels decline, the ratio of estrogen to testosterone increases, leading to breast tissue growth.
• Increased estrogen: Certain medical conditions, such as Klinefelter syndrome (extra X chromosome in males) or tumors, can cause overproduction of estrogen, triggering gynecomastia.
• Puberty: Fluctuations in testosterone and estrogen during puberty can cause temporary breast enlargement in boys, usually resolving on its own.
• Newborn babies: Due to maternal hormones, newborns may experience temporary breast enlargement, which fades within a few weeks.

Medications and Substances:

• Certain medications: Antidepressants, antibiotics, steroids, heart medications, and ulcer medications can have side effects that include gynecomastia.
• Illegal drugs: Marijuana, heroin, and anabolic steroids can disrupt hormone balance and lead to breast enlargement.

Medical Conditions:

• Liver disease: Impaired liver function can affect hormone processing and contribute to gynecomastia.
• Kidney failure: Similar to liver disease, kidney problems can disrupt hormone balance and cause breast enlargement.
• Thyroid disorders: Overactive or underactive thyroid glands can disrupt hormone levels and potentially lead to gynecomastia.

Other Causes:

• Obesity: Excess body fat can convert some testosterone into estrogen, increasing the risk of gynecomastia.
• Aging: Testosterone levels naturally decline with age, increasing the risk of gynecomastia in older men.

How is gynecomastia treated?

he treatment for gynecomastia depends on its cause and severity. Here’s a breakdown of the main approaches:

Non-surgical options:

• Observation: For physiological gynecomastia, particularly in newborns and adolescents, doctors often recommend observation without treatment. The hormonal fluctuations usually resolve on their own within a year.
• Addressing the underlying cause: If gynecomastia results from a medical condition or medication, treating the underlying issue is crucial. For example, discontinuing certain medications or managing thyroid disorders can help address the hormonal imbalance.
• Lifestyle changes: Maintaining a healthy weight through diet and exercise can regulate hormone levels and potentially improve gynecomastia symptoms in some cases.

Medical treatment:

• Hormonal therapy: In specific cases, medications like testosterone or anti-estrogens may be prescribed to balance hormone levels and reduce breast tissue growth. However, this approach has limitations and may not be suitable for everyone.

Surgical intervention:

• Liposuction: For primarily fatty tissue enlargement, liposuction can effectively remove excess fat from the breasts.
• Glandular tissue excision: When the issue involves glandular tissue, surgical excision is necessary to remove the excess tissue directly.
• Combination approach: Sometimes, both liposuction and excision are combined for optimal results.

How is gynecomastia surgery performed?

The specific technique used for gynecomastia surgery depends on the severity and composition of the breast tissue enlargement. Here’s a breakdown of the two main approaches:

1. Liposuction:

• This technique is preferred when the enlargement primarily involves excess fat tissue.
• Surgeons make tiny incisions around the chest or near the nipple.
• A thin tube called a cannula is inserted and moved back and forth to loosen the fat.
• A vacuum then suctions out the loosened fat through the cannula.
• Liposuction typically takes 1-2 hours under general anesthesia.

2. Glandular tissue excision:

• This approach is necessary when the enlargement involves significant glandular tissue.
• Depending on the extent of tissue, different incision patterns are used:
  • Periareolar incision: Small incision around the nipple to remove smaller amounts of tissue.
  • Lipo-subcutaneous mastectomy: Larger incision along the lower chest crease to remove more tissue.
  • Full mastectomy: Rarely used for extensive gynecomastia.
• In some cases, liposuction might be combined with excision for a more comprehensive approach.
• Glandular tissue excision typically takes longer than liposuction, around 2-3 hours under general anesthesia.

Will I have scars after gynecomastia surgery?

Unfortunately, it’s very likely you will have scars after gynecomastia surgery. Even with the most skilled surgeon, incisions are necessary to access and remove the excess breast tissue.

What is the recovery time?

1-3 days after surgery:

• You’ll likely stay in the hospital for monitoring and pain management.
• Expect swelling, bruising, and discomfort around the chest.
• You’ll wear a compression garment to support healing and reduce swelling.

1-2 weeks after surgery:

• Most pain subsides, and swelling gradually decreases.
• You can resume light activities like walking and gentle stretching.
• Avoid strenuous activities, lifting heavy objects, and driving.

2-4 weeks after surgery:

• You can gradually return to most normal activities.
• Discomfort should be minimal, but some swelling might persist.
• Continue wearing the compression garment as instructed.

4-6 weeks after surgery:

• Most swelling should be gone, and you can resume all activities, including exercise.
• Scars may still be red and raised, but they’ll gradually fade over time.

Are the results of gynecomastia surgery permanent?

Overall, with appropriate management of the underlying cause (if applicable) and maintaining a healthy lifestyle, the results of gynecomastia surgery can be considered long-lasting, if not entirely permanent.

It’s crucial to discuss your specific case and expectations with a qualified healthcare professional for accurate information and personalized guidance. They can assess your individual factors and provide realistic expectations about the permanency of results in your situation.

Conclusion

Estevien Clinic is equipped with state-of-the-art facilities, creating a safe and comfortable environment for patients undergoing Gynecomastia surgery. The clinic adheres to strict safety protocols and utilizes advanced medical technologies, ensuring optimal results and minimizing potential risks associated with the procedure.

Moreover, the personalized approach of Estevien Clinic sets it apart. The medical staff takes the time to understand each patient’s unique needs and concerns, tailoring treatment plans to achieve the best possible outcomes.