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

Most men, about 60%, see some development of breast tissue in their lifetime. This growth could be round, symmetrical and occurs bilaterally. This growth of breast tissue in males is medically known as gynecomastia.

Causes:

The most common cause is an imbalance between the oestrogen and androgens, with excessive oestrogens leading to the growth of breast tissue.
Excessive use of anabolic steroids
Obesity
Unknown reasons
It can affect men of all ages, and if this presents as a serious problem, then surgery is the most definitive form of treatment.

Surgical options: There are two major options available for correcting gynecomastia   liposuction and excisive surgery.

Liposuction:

Done either under local sedation or under general anaesthesia depending on the extent of the tissue proliferation
A small incision is made either in the armpit or around the areola
Excessive fat tissue and breast gland tissue are suctioned out
The chest contour also is altered at the same time, if desirable
Post-surgery, the person is made to wear a compression garment for the first few days
This helps in keeping the tissue in place and also helps reduce swelling
Healing takes about a couple of weeks  time, depending on the person s overall health status and the extent of surgery.
Excisive surgery:

This is done when the extent of gynecomastia is more severe
These people would have sagging, stretched skin around the breast area
More amount of fat and glandular tissue can be removed through excision
This is more often done under general anaesthesia
The incision is often done around the areala (dark portion around the nipple) so it is concealed or along the natural creases which are formed due to excessive breast tissue
Excessive breast tissue is removed and the incisions are closed
There could be swelling, pain, bruising, and higher chances of post-surgical infections
Recovery will take about ten days to two weeks
Refraining from exercise is often advised for up to 2 weeks
Benefits:

Restore a masculine appearance
Shorter surgery
Faster recovery
Minimal or invisible scars
Almost immediate results that can be dramatic
Improved confidence and self-image
After the surgery:

Surgery is definitely a sure way to remove the male breast tissue, it is almost a permanent treatment for this condition.
It is very important to get a trained, experienced surgeon for the procedure
It is important to follow post-op instructions including pain management, infection control, and recovery
If it was caused by use of steroids or obesity, lifestyle modification is essential to prevent recurrence

Enlarged Breasts In Men - Surgery At Your Rescue!

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!

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

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

Food is a very important part of your life as it provides all the necessary nutrients required by your body and is essentially, the fuel for all things to function within. However, many people may have aversion to certain kinds of food as it causes adverse reactions within their body. Let s look at some of the common food allergies that people commonly report and how to identify them.

Allergies v/s Intolerances: It is important to note here that there is a significant difference between food sensitivities or intolerances and allergies. Sensitivities or intolerances cause adverse effects on your body inevitably when you consume certain types of foods. One such example is diarrhea, caused by ingesting cheese or milk by lactose intolerant people. However, allergies are caused when the immune system within your body mistakes harmless food as something that might harm you and thus tries to protect you from its effects. This results in reactions within your body which may be very painful and problematic.

Common foods that trigger allergies
Some of the common foods that trigger allergies are:
1. Peanuts
2. Shellfish
3. Other forms of tree nuts such as almonds, walnuts etc.
4. Gluten rich grains such as wheat, rye barley, oats
5. Certain types of fish
6. Eggs
7. Soy products
8. Milk (allergic reactions mostly occur within children)

Some other foods which have been known to cause allergies in rare cases are:
1. Meats such as pork, chicken, beef, mutton
2. Corn and corn products
3. Gelatin
4. Certain spices such as mustard, garlic and coriander among others
5. Certain seeds such as poppy, sunflower, or sesame

Symptoms of allergies
In certain cases, the allergies might manifest immediately, almost in a matter of minutes, within the body. However, in many cases, it may take a few hours for it to show up. The symptoms may range from mild to quite severe. Mild symptoms will make it quite hard to actually diagnose it as a food allergy.

Some of the milder symptoms could be:
1. Hives or eczema could form on your skin which may be very itchy. These would look like raised swollen areas that could be red, inflamed, and dry.
2. The inside of your mouth and ears may become itchy
3. You could suddenly develop a runny or a blocked nose and start sneezing or coughing.
4. Your eyes may become watery, red and itchy
5. You may develop a funny taste in your mouth
6. Others symptoms may include throwing up and even loose motions

Other severe forms of allergies can be caused mostly by shellfish and peanuts and other forms of nuts and fish. Symptoms in such cases would look like:
1. Uneven heartbeat
2. Difficulty in swallowing and breathing
3. Feeling of extreme weakness, confusion
4. Passing out or feeling light headed
5. The tongue, throat or lips may swell up
6. Chest pain

Common Foods that Can Trigger Allergy

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