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.

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!

Your child is fond of nuts and has eaten a chocolate with nuts but shortly after that develops a skin rash and starts to itch. The rash may even spread to the surrounding area. This is an indication of food allergy to nuts.

What happens is simple - the body's immune system recognizes specific proteins in the food as harmful (antigens) and produces antibodies which can combat them. This leads to an allergic reaction which can vary from something as simple as a skin rash to severe breathing issues.
Though any child can develop food allergies, in most cases, there is a strong hereditary linkage. If parents have had a history of allergy to certain foods, then there is a strong likelihood that the child could have that food allergy too.

Some of the common foods that can cause allergies are as follows:
1. Cow's milk
2. Eggs
3. Nuts (peanuts, walnuts, pecans, cashews or hazelnuts)
4. Soy
5. Wheat
6. Fish (salmon, cod and others)
7. Shellfish (lobsters, shrimps and others)
Of these, peanuts, seafood, and milk are the most common food stuffs that lead to allergies.

Because the child is yet to realize that he has eaten something that his system will not readily accept, the allergic reaction can be described in various ways, as below:
1. Scratching or itching on the tongue
2. Change in the voice - can become husky or hoarse
3. Burning of the tongue
4 tingling of the tongue
5. Funny feeling in the mouth
6. Feeling of something stuck in the throat
7. Itchy feeling or bugs in the ears
8. Throat going thick
9. Bump on the back of the tongue

These are some ways that a child can describe his allergic reaction. Some of the mild symptoms of a food allergy are as follows:
1. Hives (red, swollen, itchy areas on the skin)
2. Eczema of the skin (dry, itchy rash)
3. Nasal congestion
4. Sneezing
5. Itching of the tongue and the mouth
6. Nausea or vomiting
7. Stomach pain

Severe symptoms include:
1. Severe swelling of the lips and tongue that can block breathing
2. Inability to swallow
3. Difficulty breathing
4. Turning blue
5. Dropping of pulse
6. Drowsiness

As the parent identifies a similar reaction when eating the same food item, they can suspect allergic reactions and immediately reach out to the doctor. A detailed discussion will help establish the causative agent. Once that is known, then avoiding food allergies is quite easy. In fact, a well-informed child will know that avoiding certain foods is very beneficial. This will improve the quality of life of the child, help avoid missing school due to allergic reactions, and help avoid the child (and the parent) suffering.

How to Know if Your Child Suffers From Food Allergy

Gynecomastia is a condition characterized by enlargement of the breast tissue in men. It occurs when there is an imbalance of the testosterone (male sex hormone) and estrogen (female sex hormone) in the body. It may a cause of embarrassment in men.
Causes:
The primary cause for this condition is increase in the level of estrogen in comparison with testosterone in the male body. Testosterone controls male characteristics such as body hair and muscle mass. Estrogen is responsible for controlling female characteristics such as breast enlargement. 
Men usually produce small quantities of estrogen in their body to maintain certain sexual functions. Complications occur when estrogen levels in the male body increase too much in proportion to testosterone.
The condition can be classified as follows:
1. Gynecomastia in infants:  Half of the infants are usually born with large breasts due to their mother's estrogen. The effect tends to wear of in a few weeks.
2. Gynecomastia during puberty: Gynecomastia occurs during puberty due to changes in hormones. The condition goes away without any treatment in six months to 1 year.
3. Gynecomastia in men: This condition may peak in men during the age of 50-80. Statistics show that at least 1 out of 4 men in this age group have this condition.

Some other causes for this condition in middle aged men are as follows:
1. Heart medications
2. Anti-anxiety drugs
3. Antibiotics
4. Chemotherapy
5. Medications that are used to treat heartburn
6. Smoking marijuana and drinking alcohol 

Treatments:
1.        If the cause of the condition is medications, then discontinuing the medicines should stop the effects. It can also be treated by taking medicines to reduce estrogen levels in the body. 
2.        Surgery is another option where an incision is made in the chest area and the extra breast tissues are removed from the area. This also requires repositioning of the nipple in the chest. 
3.        Post-surgery, you should stick to a proper and healthy lifestyle to retain the new shape of the chest area. Weight gain or taking steroids can cause the symptoms of this condition to reappear.


Causes and Treatment of Gynecomastia

Nuts are a rich source of energy but are also one of the most common food allergens. Both children and adults can suffer from nut allergies. While some children may outgrow the allergy, for others this is a lifelong condition. When it comes to children, the sibling of a child who is allergic to nuts also has a high risk of being allergic to them as well.

Nut allergies can be categorized as an allergy to peanuts or an allergy to tree nuts. Tree nuts are nuts that grow on trees such as walnuts, cashew nuts and almonds. Peanuts are not considered tree nuts as they grow underground in the form of legumes. A person can be allergic to both types of nuts but it is not necessary that if you are allergic to peanuts, you should avoid almonds as well and vice versa.

There are laboratory tests to determine the types of food you can be allergic to but in most cases, you realize you are allergic to something only after consuming it. Some of the symptoms of nut allergies include:

Redness
Rashes
Tenderness of the skin
Hives
Swelling of the hands and feet
Sneezing
Runny nose
Sore throat
Watery eyes
Nausea
Vomiting
Stomach cramps
Diarrhea
Shortness of breath
Most of the symptoms that affect the skin and respiratory system can be relieved with the help of antihistamines. Cold compresses can also help relieve itchiness caused by nut allergies.
One of the most severe forms of nut allergies can result in Anaphylaxis. This can be described as the swelling of the throat so much so that the airways are blocked and it becomes difficult to breathe. It is often accompanied by swelling of the facial features and itchiness. The only way to relieve this swelling is with an adrenaline injection. This reduces the swelling and reopens the airways. The most common type of adrenaline injection is known as an epi pen.

Some types of foods that commonly contain nuts and should be avoided include baked goods, pesto, nougat, marzipan, soups, multigrain bread, honey, granola, sauces such as hot sauce and barbeque sauce, salad dressings and veggie burgers. Nuts are often also used as thickening agents and hence if you know you are allergic to nuts, pay attention to food labels before you buy any product and make it a habit to tell your server in a restaurant that you are allergic to nuts.

Nuts - How To Know If You Are Allergic To Them?

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

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