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

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

Gynecomastia is a condition where the tissues of the breasts swell in a boy or men. This is caused by the imbalance of testosterone and oestrogen. It might affect one or both the breasts depending on the level of hormonal imbalance. Although not considered as a serious condition, Gynecomastia can be a difficult condition to cope up with. There are multiple treatment options and surgery is one of them. In many cases, this condition goes as abruptly as it appeared. For cases that are complicated and difficult to get rid of, doctors suggest a medical procedure get rid of the condition.


Symptoms of Gynecomastia:
Some common symptoms of Gynecomastia include tenderness of breasts, swollen breast gland, pain in the breasts, discharge from the nipple etc.


Causes of Gynecomastia:
There could be many causes of this disease. If the condition is witnessed in babies, it could well come from the mother due to an overdose of oestrogen. Gynecomastia also appears during puberty resulting in the breast to swell up. The condition can again crop up after the age of 50 due to hormonal changes.
Certain medications can be a reason of Gynecomastia. Some of the common medications include certain antibiotics, anti-anxiety related medications, chemotherapy shots, HIV patients receiving HAART, cardiovascular medications such as Lanoxin, anabolic steroids etc.
Certain drugs such as heroin, alcohol, methadone, marijuana, Amphetamines etc.
Certain health conditions such as hypogonadism, hyperthyroidism, liver cirrhosis, ageing, certain tumours, failure of the kidney malnutrition etc.


Risk Factors Of Gynecomastia-
Certain risk factors of gynecomastia include older age, use of certain steroids, adolescence and other medical conditions such as Klinefelter's syndrome, tumour related to hormonal fluctuation and disease related to thyroid.
Diagnosis:
A doctor typically checks the history of drugs along with the health condition of the patient. He might also take a look at the health of the extended family. A careful tissue evaluation of the genitals, breast and abdomen are done. This is followed by a physical exam followed by prescribing certain tests such as mammograms, complete blood work, CT scan, biopsy of the tissue, MRI scan etc.


Treatment:
Most people suffering from Gynecomastia see a significant regression with periodic treatment. If however the condition arises from an underlying cause such as cirrhosis and malnutrition, a doctor suggests 2 option- medications and surgery:


Medications: Certain medications that are known to be helpful for breast related cancers are known to be effective in this condition. Some common examples of these drugs include evista, arimidex and soltamox.
Surgery: Only after exploring all medical options a doctor suggests surgery. There are 2 procedures namely mastectomy and liposuction. The latter removes the fat cells of the breast and the former removes the breast gland tissue.     


Gynecomastia - Is Surgery The Best Option?

A change in weather bring about changes in the composition of dust and pollen and induce seasonal allergies, which a huge number of people fear. The good news is that there are a number of common food substances which can help control these seasonal allergies. There are specific ingredients in these foods which improve immunity and provide antihistamine-like effects (which is what most anti-allergic drugs do). Some of these foods are mentioned below:

Green tea: With its natural dose of antihistamines, it prevents you from developing allergies. A hot cup in the morning acts as a good shield against sneezing, which is common with pollen and dust allergies.
Oranges and strawberries: Vitamin C is essential for controlling allergies and it is always recommended to reach for a couple of fresh oranges or strawberries than popping a vitamin pill. They also contain other substances like traces of Omega-3 fatty acids and Quercetin.
Garlic: This blocks the production of chemicals that can cause allergies. Eating a couple of cloves in the morning daily will do wonders for the allergy prone people.
Turmeric: This miraculous Indian spice has strong anti-inflammatory properties and helps prevent all kind of allergies.
Nuts and seeds: For the vegetarians, eating walnuts and flax seed is a good alternative. A handful of walnut is equal to 3 ounces of salmon. Flax seed also contains selenium which has anti-allergic properties.
Cabbage and broccoli: The flavonoid called quercetin helps by reducing inflammation that is usually associated with allergies. Other sources include apples, onions, berries, and cauliflower.
Fatty fish: These contain a good amount of omega 3 fatty acids, and work better than the supplements any day. Take your pick from mackerel, sardines, salmon, tuna, trout, bluefish or herring. These have two types of Omega-3 fatty acids (DHA and EPA) which are known to prevent people developing allergic symptoms. This anti-allergic property provides great relief in people who see seasonal allergic changes.
Local honey: For those who suffer from pollen allergy, a morning dose of honey helps build tolerance to this kind of allergy.
Wasabi: This pungent green paste helps breathing by opening up the airways and is very good for blocked nasal passages. It also is rich in antihistamines and helps prevent you from developing allergies.
Yoghurt and Kefir: These and other dairy products are rich in probiotics which contain a lot of friendly bacteria like Lactobacillus and Bifidobacterium, which are generally found in the intestines. They also help build immunity and increase bodys ability to fight allergens better.
So, for those prone to seasonal allergies, there are few things that are easy to find and well within the reach of regular kitchen and can shield against allergies.

10 Foods That Help You Fight Allergies

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:

Enlarged glands in the breast tissue
Tenderness in the breast
The causes that trigger gynecomastia include:

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.
Medication: Certain medications such as anabolic steroids, androgens, HIV/AIDS medicines, antibiotics and chemotherapy can cause gynecomastia.
Drugs and alcohol: Substances such as alcohol, marijuana, amphetamines, heroin and methadone cause gynecomastia.
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.
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:

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.
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. 

Gynecomastia (Enlarged Breast In Men) - Know The Treatments!

One of the most common cosmetic procedures performed in the world today is that of breast augmentation or reduction. This is a fairly common surgery wherein depending on the requirement of the patients; the breasts are either made bigger with the help of implants or reduced in size by excising fat and tissue. Although a majority of these patients are female, there are an increasing number of male patients, who opt for male breast surgery as well.
The need for male breast surgery-
The requirement for male breast surgery arises due to the occurrence of Gynecomastia or the development of male breasts. In this condition, fat and glandular tissues are stored within the male chest in the pattern of female breasts, thus giving it a feminine look. This is a common occurrence among men and can be a cause of social embarrassment for the man as well as affecting his self esteem. Some of the causes for gynecomastia or male breasts would be  
Excessive Weight Gain.
Hormonal changes within the body where testosterone levels drop due to conditions such as  Hypogonadism  (in men, the inability of the testicle s to function correctly) and estrogen levels increase.
Medications used to treat other disorders such as certain anti -depressants, cancer medication, and anti-anxiety medications among others.
Excess consumption of alcohol and certain drugs.
Hyperthyroidism (excess thyroid secretion by the thyroid gland).
It isn t always just fat!
While many people tend to blame male breasts due to the accumulation of fat, this may not be the case always. Even skinny or people with an athletic build may notice misshapen chest that has more of a feminine appearance and thus would like to correct that. This is obviously caused by hormonal factors and genetics of body shape as well rather than just being obese or overweight.
Types of Male Breast Surgery-
Male breast surgery revolves around breast reduction and contouring to give it a more flat and toned look. This can be achieved in either of these ways:
Liposuction   This is a fairly common procedure and is minimally invasive; meant to suck out the fat through a small opening on the skin. With the help of liposuction, doctors can easily contour your chest to have a more masculine look by removing the excess fat. This procedure is a very popular one as it takes less time to recover and also isn t invasive. However, this is used as an option for male breast surgery when the problem isn t acute.
Surgery to remove excess tissues and fat   If the male breasts have excessive glandular tissue and the problem is acute, a more extensive form of surgery wherein the glandular tissue is excised may be required. However, this is also not very invasive and you can get back to your regular routine within a few days after surgery.


Male Breast Surgery

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