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

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.

Treatment

There is no definitive medical treatment. The main answer for Gynecomastia is -SURGERY. It is a daycare procedure in most situations. It is done by a Surgeon, usually, a Plastic surgeon does a better job. 

Anesthesia- Either Local or General anesthesia is given to make it painless. 

Procedure-Through a small incision in the areola, the swelling is removed by both Liposuction of the Fat part and Excision (removal) for Breast gland part. As the incision is through the areola, the final scar is hardly visible. In extensive swellings, skin also needs to be removed, where in a scar around the areola border is visible. 

Recovery- usually can go back to work in 2-3 days time.

Treating Gynecomastia (Enlarged Breasts in Men) With Surgery

It is said that the mind controls the body. If the mind is healthy so will the body be. The condition of the mind is often reflected in bodily symptoms and conditions including illnesses.

The temptation in mostly to treat with heavy drugs that might offer temporary relief but have dangerous side effects and do long term harm.

Homeopathy tackles this issue considering safety and cure in a balanced manner to ensure recovery but without harmful side effects.

The concept of psychosomatic disorders has been in existence since the time of Sigmund Freud. The belief is that with the varied emotions that a person experiences, each disease manifests with a different set of symptoms in each person, implying that each person needs to be treated differently and not given the same disease-specific medication. This is where homeopathy plays a very strong role in psychosomatic disorders as it also believes in treating the person as a whole and not just the symptoms.

In homoeopathy, we base our prescription on what we call constitutional symptoms where we give lot of importance to the mental symptom as well as to the characteristic physical symptom. Hence every prescription from a Homoeopathic physician will surely include an element of psychosomatic angle. It is beyond the scope of this editorial to mention all the remedies of Materia Medica which has the scope for the treatment of psychosomatic disorders.

The homeopath always undertakes a thorough discussion with the patient to understand the accompanying symptoms in detail and then arrive at a customized treatment plan.

Some of the most common psychosomatic disorders include irritable bowel syndrome, migraine, GERD, ulcerative colitis, and allergy disorders.
Specific substances are given to manage anxiety, depression, irritability, insecurity, paranoia, etc. These feelings are considered inducers for the above disorders, and managing them can help bring about a harmony in the patient's overall health.


GERD: Gastro esophageal reflux disease is a disorder that results from stomach acid moving backward from the stomach into the esophagus. GERD usually happens because the lower esophageal sphincter (LES), the muscular valve where the esophagus joins the stomach, opens at the wrong time or does not close properly.

Homeopathy For GERD:
Homeopathic medicine relies not only on identifying the symptoms of the disease, but on a variety of personality traits, the person's mental state and other characteristic symptoms a patient exhibits which correlate to any particular remedy. When choosing a correct remedy for the treatment of heartburn, all aspects of the patient are taken into account.
These are some of the Homoeopathic medicines that may prove beneficial:- Argentum nit, Cal.carb., China, Carbo veg, Lycopodium, Nat. phos, Nux vomica, Phosphorus, Pulsatilla, Robinia, sulphuric acid etc.


Migraine: Migraine is a form of headache. The pain is usually throbbing, pulsating and bursting in character. At times, the pain is one sided or may involve the whole head. Such pain may last for hours or even days. It is often accompanied by other symptoms like nausea or vomiting. At the same time, there is increased sensitivity to light and sound. In some cases, the pain is preceded by some warning symptoms like flashes of light, temporary blindness or tingling sensation in the limbs.

Homeopathy for Migraine:
Belladonna is widely used homeopathy remedy for migraines, where headache is throbbing and violent, occurs suddenly, worsens on touching, and relieves with pressure. Glonoine is useful in congestive headaches with a reddened face that is worsened by sun or heat. Natrum Mur is useful in cases where headache is brought on by grief or stress.

Ulcerative colitis: Ulcerative colitis is a serious chronic inflammatory disease of the large intestine accompanied by ulcerated lesions of the intestinal tissues. It is characterized by episodes of abdominal pain with profuse diarrhea in which large quantities of blood, pus, and mucus are present in the feces. There is an urgency to move the bowels, as many as, three to ten times per day. It may be accompanied with pain, nausea, and vomit. Because of the loss of blood, the patient may become dehydrated and anemic.
Complications of ulcerative colitis includes liver and kidney disease, peritonitis, toxic mega colon, and risk of developing colon cancer.

Homeopathy for Ulcerative Colitis:
To identify the actual inducing agent, some foods are removed to see if they are inducing attacks. Once identified, that is removed from the patient's diet. In addition, aloe, arsenicum album, carbo vegetabilis, colocynthis, are commonly used remedies for ulcerative colitis. The patient is asked for associated symptoms like bleeding diarrhea, color of the feces, involuntary defecation, abdominal pain, anxiety, cramps, and stress before deciding on a treatment mode.

Irritable Bowel Syndrome: Irritable bowel syndrome, also known as spastic colon is a functional disorder characterized by recurrent abdominal pain, cramping, and bloating. Some people suffer from constipation, which means hard, dry stools, difficult to eliminate, leading to straining without success. Some people experience diarrhea, with frequent loose watery stools.

Homeopathy for Irritable Bowel Syndrome:
Sulphur, Pulsatilla, Phosphorus, Nux Vomica, Lycopodium clavatum, Argentum Nitricum, and Silicea are commonly used homeopathic remedies. Associated symptoms that need to be considered before deciding on a therapy include frequency of stooling, nature of stools, abdominal bloating, restlessness, irritability and nervousness.

Homeopathy is a preferred mode of treatment for psychosomatic disorders as they aim at a holistic treatment of the individual and not just at symptom management.

Allergy: Allergy is an abnormal reaction or increased sensitivity to certain substances. The allergic individual produces symptoms when exposed to these substances, which are harmless to non-allergic people. The main reason for this is that allergic people make a special type of antibody called immunoglobin E (IgE), which can react with environmental substances in harmful way. These substances which lead to secretion of IgE antibodies are called allergens.

Homeopathy for Allergy:
Few important remedies for the homeopathic treatment of allergy are- Histamine, Natrum Mur, Kali Bich, Sepia, Hepar Sulph, , Carbo Veg , Sulphur, Bryonia, Nux Vom, Apis Mel, Ailanthus, and Justicia adhatoda.

Psychosomatic Disorder - Only Homeopathy Cures

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!

The development of a girl s breast at puberty is a major differentiating factor between the silhouette of a boy and a girl. However, sometimes, men too can develop breast tissue. This condition is known as Gynecomastia. While it is not fatal or very harmful to a person s overall health, it can cause emotional distress and affect a person s self-confidence.

Gynecomastia can be triggered by a number of factors including diet, lifestyle, hormonal imbalances etc. One of the most surprising causes of this condition is milk. This is because milk is considered to be rich in oestrogen. When talking of milk, it can be categorised as organic and non-organic milk. In order to increase the amount of milk, a cow can produce they are often injected with hormones. Milk collected from cows who have received such treatment is known as non-organic milk while milk collected from cows who have not received any form of treatment to boost milk production can be termed as organic milk. Non-organic milk may also have a higher than normal IGF-I level. This refers to an insulin-like growth factor that aids in the development of breast tissue.

The main reason milk consumption is encouraged is for its high calcium levels. However, you can get your calcium from other natural sources as well. Green leafy vegetables like spinach, kale and bok-choy are very rich in calcium and the calcium from these vegetables can be very easily absorbed by our bodies. Thus, skipping your glass of milk will not give you weak bones.

Gynecomastia can be treated. Increasing your intake of cruciferous vegetables like broccoli and cauliflower can help absorb and remove oestrogen from the digestive tract before it goes into the blood stream. Spices like turmeric can increase testosterone levels and help balance hormones. Phytoestrogens like flax seeds and soy can also help treat gynecomastia by minimising oestrogen levels and reducing cholesterol.

Two ayurvedic herbs that can increase the production of testosterone and thus, help maintain a balance between oestrogen and testosterone are tribulus terrestris and cordycep. Red clover can also help reduce oestrogen levels. Sarsaparilla is yet another ayurvedic herb that can help treat this condition by strengthening muscles.

In addition to these dietary changes and herbal medicines, one must also exercise to reduce fat tissue in the chest area. Lifting weights or chest bench presses are ideal exercises to strengthen chest muscles and reduce gynecomastia.

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Drinking Milk - Cause Male Breast (Gynecomastia)?

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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