Introduction 

The common male problem in an Aesthetic clinic, Gyanecomastia, is truly Pseudogynaecomastia with only fatty tissue and minimal glandular tissue. The condition is a part of the co existing Obesity disorder and is rarely, a standalone entity. The treatment options shall include an approach to answer the issue of obesity as a whole, not rest contented with surgical removal of the enlarged breasts alone. What is seen and what is treated is just a tip of the iceberg. 

Gynaecomastia, an innocuous condition, that affects 35-70% of male population immediately after birth, during adolescence and old age is rarely brought to notice as the sufferer makes all attempts to hide it as the condition brings with it a sense of shame and pain in public places and mental suffering. Herein starts the search for the treatment. Medical and multifaceted surgical options evolved over centuries with the current opinion being fat removal by anyone form of liposuction and the gland removal by direct excision. Gynaecomastia, is increased breast tissue in males composed of glandular and fatty tissue. 

Physiological gynaecomastia of puberty that normally regresses with age tend to stay back being sustained by the modern lifestyle changes. Processed foods and environmental pollution of air and water, the cosmetics used on the body like deo odorants, perfumes and toiletries, synthetics and chemicals have contributed to explosions of generalised obesity. With this generalised obesity, the tendency to hold back excess fat in the breast developed. This clearly shows the reason for higher incidence of (pseudo) Gynaecomastia of late. Hormonal imbalance due to reasons stated above, aggravate the situation. Gynaecomastia is part of the generalised obesity and it is more fat and little gland. 
However, this condition does not have any harmful effect on the body, but it can cause distress emotionally. Men may lose their self-confidence and they can be psychologically affected by this.

What Causes Gynaecomastia?

It is a type of hormonal imbalance that results in the growth of the male breast tissues. The ratio of oestrogen v/s androgens gets altered and causes the enlargement of the breasts. For this condition to occur, the amount of oestrogen increase in the body, or the amount of testosterone drops. Sometimes it can be the combination of both.

There are certain diseases that may contribute to gynaecomastia and they are as follows:

Kidney diseases

Liver disease

Drop in testosterone levels

Certain medications such as methadone, medications for HIV or treating prostate cancer

Certain tumours caused in male sex organs such as cancer of the Leydig cells or the Sertoli cells resulting in deprivation of androgen levels

Conclusion: 
True Gynaecomastia that requires surgical treatment is not so uncommon. What is commonly believed to be gynaecomastia is truly Pseudo gynaecomastia with a co exiting clinical picture of obesity, high BMI, sedentary life and wrong lifestyle. Surgical treatment by laser liposuction under Tumescent Anaesthesia gives very good results with high patient satisfaction and negligible post operative complications. Gland fragmented with laser can be extricated thro  same entry point without sub areolar incision.

Gynaecomastia (Enlarged Breasts In Men): Causes and Treatments

While some people look forward to spring and the beautiful flowers that bloom, for others this is a time of extreme discomfort triggered by pollen allergies. Pollen is probably one of the most difficult allergies to fight as it is invisible and is literally present everywhere. Sneezing, coughing, a runny nose, congestion and watery eyes are the most common symptoms of a pollen allergy. However, you can minimise your troubles by following a few simple steps.

Keep an eye on the pollen count: Not every day has the same amount of pollen in the air. Pollen density is also affected by the time of the day. Pollen count refers to the amount of pollen present in the air during a specific time period. You can find out the pollen count of your area online or through a number of apps. Once you know the pollen count. You can plan your day accordingly and step out or stay in.
Plan your time spent outdoors wisely: It isn t always possible to stay indoors even if you know the pollen count is high. However, you can still plan your time so as to not be outdoors at peak pollen times. 5am to 9am are the worst times to step out as this is when most plants pollinate. Hence avoid stepping out during this time. Windy days can also worsen the situation by spreading pollen around. If you must go for a jog early morning, avoid thoroughfares and gardens and instead pick a route around residential streets.
Protect yourself: Face masks may not look very good but can help reduce the amount of pollen being inhaled. If you find yourself sneezing a lot during pollen season, consider investing in a painter s mask that can filter the air being inhaled and exhaled. If you are stepping out to do yard work or know that you re going to spend a lot of time in heavy traffic areas, take your antiallergenic medication before you step out instead of waiting for an allergic reaction to begin.
Have plenty of showers: Try making it a habit to have a shower and changing your clothes as soon as you come home. This prevents the outdoor pollen from circulating in your home. Follow this routine even if you ve simply been gardening outdoors. While showering, do not forget your hair. If you do not want to shampoo it every day, simply rinse it out to get rid of all the pollen.

Pollen Allergy - 4 Tips To Keep Yourself Safe!

Swollen breast tissues in men or boys caused by hormonal (testosterone and estrogen) imbalances is called gynecomastia. Both breasts or one breast, can be affected by gynecomastia. At any point in life, from birth to puberty, even in adulthood, you might develop gynecomastia. Most of the times, gynecomastia is caused by hormonal imbalances, but there might be some underlying causes as well.
Gynecomastia is normally not a serious condition, but it can be difficult to deal with the pain and embarrassment.
It can be cured with surgery or medication, if it doesn't go away on its own.

Symptoms and signs of gynecomastia include
a) Enlarged glands in the breast tissue
b) Tenderness in the breast

The causes that trigger gynecomastia include
1. Hormonal changes: Testosterone and estrogen control the sexual development in men and women respectively. Estrogen is not a hormone that only women produce; men produce it too. When the production of testosterone and estrogen are thrown out of balance, gynecomastia occurs.
2. Medication: Certain medications such as anabolic steroids, androgens, HIV/AIDS medicines, antibiotics and chemotherapy can cause gynecomastia.
3. Drugs and alcohol: Substances such as alcohol, marijuana, amphetamines, heroin and methadone cause gynecomastia.
4. Health condition: Certain factors, such as aging, hypogonadism (hormonal disorder), hyperthyroidism (overactive thyroid gland), tumors, kidney failure, cirrhosis, liver failure, malnutrition and starvation can lead to gynecomastia.
5. Herbal products: Essential oils derived from plants such as lavender or tea tree, used in lotions or shampoos, have weak estrogenic actives. They have been said to cause gynecomastia.

Gynecomastia can be cured either with medication or surgery. Surgical options for gynecomastia are, however, limited. The two surgical options for gynecomastia include:
a) Liposuction: Liposuction only removes the fat from the breast, not the breast gland tissue. It has fewer complications, there is limited or zero blood loss and there is less distortion of the nipple.
b) Mastectomy: Mastectomy removes the gland tissues in the breast. The surgery uses minimal incisions to remove the gland tissue. Also, it involves less time to recover.

Treating Gynecomastia With Surgery

While women strive to enhance the way their breasts look, the development of breast tissue in men can be embarrassing. This condition is known as Gynecomastia. It can affect one or both breasts in a symmetric or asymmetric manner and is caused by an imbalance of estrogen and testosterone hormones. It can also be caused due to a side effect of medication or because of other health problems such as an overactive thyroid or tumor. In some cases, this condition can get resolved on its own while in other cases, medication and surgery may be recommended.

Medications

Before undergoing treatment for Gynecomastia, it is essential to ascertain that you are in fact suffering from this condition. This is because gynecomastia and the buildup of fat tissue in the chest can look similar, but are treated differently. When treating this condition, medication needs to be supplemented with controlled calorie intake and physical exercise. It is also cheaper than surgical treatment.

Surgical Treatment

Surgery is often the preferred mode of treatment for significantly enlarged male breasts. Surgical treatment for gynecomastia is of two types:

    Liposuction: This removes fat from the breast, but leaves the breast gland tissue in place. Liposuction can be performed in a number of ways. It involves making two or more incisions through which narrow tubes are inserted into the chest area. This tube is gently moved around to loosen the excess fat tissue that is then sucked out.
    Mastectomy: This procedure removes the breast gland tissue itself. It is performed endoscopically and hence has a quicker recovery time and involves less scarring.

You may feel a slight discomfort after the surgery for a few days. You will also be advised to wear a chest support brace for a few days to allow your body to heal without putting any pressure on the site of the surgery. Normal activities can be resumed within 2 to 3 days but avoid strenuous activities of heavy lifting for a month after the surgery.

As long as you follow a healthy lifestyle and have a balanced diet, either of the above surgical procedures should have a lasting effect. This makes surgery a more preferred form of treatment than medication.

Apart from this, certain exercises can also help tone chest muscles and reduce fat tissue. This includes inclines dumbbell presses, push-ups and exercises that focus on pectoral muscles. However, this is a very gradual process and hence suitable only for mild cases of gynecomastia.

Gynecomastia Treatment

Every year, the emergency rooms at hospitals get flooded by cases of allergic reactions from food. According to a census, about 15 million Indians suffer from some kind of food allergy. The symptoms of food allergy may vary from itchy mouth to potentially fatal conditions like anaphylactic shock. Other symptoms of an allergic reaction can present themselves as difficulty in breathing, swelling of the tongue, rashes and intestinal discomfort.

According to specialists, allergies to food can develop at any age, at any time. Hence, if you suspect a sudden allergic reaction to a food that you have consumed before without any problem, it is advised to consult your doctor.

Here is a list of the most common food allergies that people suffer from frequently-

MILK: Milk is the most common food that children and infants are allergic to. Milk allergy must not be confused with lactose intolerance wherein a person faces many difficulties in digesting the sugar present in milk. The two conditions are not related. Milk allergy is the hypersensitivity reaction that happens in response to certain proteins present in milk and can be potentially deadly. Most children are seen to outgrow their allergy to milk.
WHEAT: It is a common misconception to confuse Celiac's disease with a wheat allergy. Wheat allergy exclusively occurs due to the hypersensitivity to the protein present in wheat alone. In Celiac's disease, it is the gluten in the food they are hypersensitive to, which is also present in rye, barley and oats.
SOY: Soy is a very common allergic food and most children seem to outgrow it by the age of 10. Most of the time, soy allergy is not too severe and the symptoms presented are mostly mild. Although, cases of anaphylaxis in reaction to soy have been reported. Soy and soy protein are very common ingredients found in food, hence it is advised to check the ingredients present before consuming it.
SHELLFISH: This allergy usually does not go away and you are most likely to deal with all your life. Most people who experience allergies from shellfish are most likely to be hypersensitive to both crustaceans (lobsters, shrimps and crabs) and mollusks (mussels, oysters, scallops and clams). This type of allergy can become very intense and you must even avoid the steam produced from cooking shellfish. For some people, the mere contact with shellfish can trigger an allergic reaction.

4 Most Common Food Allergies

Food allergy is actually an abnormal response triggered by the immune system to food as if it is threatening. Food intolerance looks similar to food allergies. However, the difference lies in how each one of them affects an individual. Food allergy is extremely intrinsic and to an extent, affects the internal organs. 

On the other hand, food intolerance is less severe, mostly just affects the digestive system due to the inability to digest that particular food properly, leading to an upset stomach. Most of the people suffer from food intolerance only, but they confuse it with food allergy.

About ninety percent of all cases of food allergy are related to only eight types of food as per research statistics. These are milk, tree nuts, egg, peanut, soy, wheat, shellfish, and fish.

The Reaction:\

In order to understand how symptoms manifest, it is of utmost importance, in this case, to understand how an allergic reaction to food occurs. An allergic reaction is a bi-step process as discussed further.

Step1: On exposure to the food allergen for the first time, the body reacts abnormally and produces IgE antibodies against the perceived allergen. These circulate throughout the entire body with blood and attach themselves to basophils (found in blood) and mast cells (found in sites like the nose, lungs, throat, gastrointestinal tract, skin, etc.).

Step 2: The next time the body is exposed to a particular food allergen, it gets alert and alarms the tissue that releases histamine in large quantity. Depending on the site of release, allergy symptoms are caused, ranging from mild to severe to potentially life-threatening (for example, in anaphylaxis).

The time span for an allergic reaction manifesting into symptoms can vary between a few minutes to several hours post exposure to the food allergen. The site of mast cells for release of histamine greatly affects the location and timing of the reaction.

Who is at Higher Risk?

If a person has a family history of developing a food allergy, it creates even greater chances for him/ her to have the same or similar reactions. If both the parents have some kind of allergic reaction to food, it is very likely that the child would have that too.

Symptoms:

Symptoms of food allergies largely depend on the sites of mast cells that release histamines. It is possible that these sites are located in nose, ears, or throat leading to itching in mouth, having a trouble in swallowing and breathing, and swelling of lips and tongue. If the location is in the gastrointestinal tract, it may lead to vomiting, diarrhoea, and abdominal pain. If it is in the skin, it might lead to hives, itching, decolourization, pigmentation, worsened eczema, etc.

Cross Reactivity:

If a person has an allergy to a particular food, it is advisable to abstain from similar types of food. For example, if somebody is allergic to crab, he/ she should abstain from shrimp, crayfish, lobster, etc. too as they might also trigger the reaction. This is called cross reactivity.

Treatment:

It is always advisable to abstain from foods which cause an allergic reaction in an individual. However, in case it has already occurred, there are two major types of medication which help in relieving the symptoms. Antihistamines are used for treating mild to chronic reaction, whereas adrenalines are used for severe reaction like in anaphylaxis.

Take Away:

Food allergy is usually a condition for life and cannot be permanently treated. However, symptoms can be relieved. Therefore, it is advisable to avoid the allergy, causing group of food.

Food Allergy - Everything About It!

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