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

Men also suffer from breast enlargement, medically called gynecomastia. This usually happens when the levels of female sex hormones, in the affected male, overshadow the male sex hormone levels.

Gynecomastia is different from fat accumulation in the male upper chest. It is typically characterised by an increase in the glandular tissue, which can produce milk.

Lots of adolescent boys suffer from male breast enlargement due to the adolescent hormonal surge, though, the condition can present in men at any age. Adolescents lose the breast enlargement typically in periods ranging from 6 months to a year. Beyond this period, a man with enlarged breasts has to seek medical intervention for treatment.

Typically, gynecomastia occurs due to certain medications like for renal failure and hypertension. It can also be caused due to conditions like hyperthyroidism or kidney failure, liver cirrhosis or problems with testes which causes changes in hormones in the male body.

Treatments-

Whatever be the reason, gynecomastia is a deeply distressing condition for men of all ages. Treatments are available, both surgical and medicinal and they help especially surgery.

Male Breast Reduction Surgery- Facts

Surgery for male breast reduction can be performed safely and successfully on teenagers and adult men alike.

In male breast reduction surgery, the surgeon makes an incision around the nipple and removes the excess glandular tissue and fats causing the appearance of the breast. This is the only effective treatment for gynecomastia that has long-lasting, if not permanent, results. Male breasts may also appear due to excess fat in the upper chest. Liposuction is generally very effective in treating this. The surgeon removes fats and some glandular tissue and then sculpts a new chest contour that looks natural for your body.

More severe cases of gynecomastia may require more than this. The surgeon has to then go for something called  surgical tissue excision  to achieve optimal results. Older males with gynecomastia with sagging skin also require tissue excision. This technique allows the surgeon to remove a major chunk of glandular tissue and/or skin that cannot be successfully removed by mere liposuction.

If you are planning to go for breast reduction surgery, find the best cosmetic surgeon. This will go a long way in you getting the best results and minimise scars.

Also be prepared for the after-effects of the surgery. Even though it is typically performed as an outpatient procedure using general anaesthesia or local anaesthesia with sedation, you must be prepared for soreness and swelling. Recovery time is usually a week and a patient is often given a compression garment to wear for the first few weeks after surgery to support the healing breast tissue. Also, be prepared to be off exercise for a month or so after surgery.

Can Surgery Help Reduce Enlarged Breasts In Men?

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

The development of breasts is one of the most prominent physical difference between the structure of a man and a woman. In some cases, hormonal imbalances can cause enlargement of the male breast gland, which is known as gynecomastia.  Apart from being a cause for embarrassment, it is also associated with a number of medical conditions such as kidney failure and liver cirrhosis. However, there is little need to worry if you have been diagnosed with such a condition as it can easily be treated with dietary changes, medication and surgery. Among these, surgery is the only method of treatment that guarantees a permanent and immediate solution to the problem. 

Surgical treatment for gynecomastia is of two types

Liposuction 
Mastectomy
The type of surgery suitable for you will depend on a number of factors including the extent and type of gynecomastia.

Liposuction involves the removal of fat from the breast, but does not touch the breast tissue itself. For this surgery, a surgeon makes a small incision on either side of the chest or along the edge of the areola. Excessive fat is then removed through these incisions and the skin and remaining tissue is then restructured. Liposuction can take anywhere between a week and 3 weeks for complete recovery. In the meanwhile, the patient must wear a compression garment to minimize the swelling and support the chest tissue as it heals. 

A mastectomy on the other hand is used to remove the breast tissue. A mastectomy is performed endoscopically and hence is less invasive. In this case, the incisions are located around the edge of the areola or in the natural crease of the chest. A mastectomy requires a shorter recovery period. In some cases, a combination of the two techniques may also be used. 

The results of both surgical approaches can be seen immediately after the surgery. Slight soreness and pain is a common side effect of this procedure and can be relieved with pain medication. Some men may also experience a temporary loss of sensation over the treated area. 

Though the results of both types of surgeries are permanent, it is important to maintain a healthy lifestyle after the surgery. Unhealthy eating that leads to significant weight gain can make the problem recur. Use of steroids or medication that affects the testosterone levels in the body and certain medical conditions can also lead to recurring gynecomastia.

Enlarged Male Breast Problem - Is Surgery Helpful?

Do you know that enlarged breasts, which are observed in many men are caused because of a health condition? This is known as gynecomastia and involves enlargement of the breast tissues in men. The condition is commonly called man boobs. It is usually not something serious and is not always permanent.

Causes
During the puberty stage, gynecomastia is quite common and normal. It occurs because of natural changes in oestrogen and testosterone, the sex hormones. The condition is also likely in men of old and middle age because of ageing and hormonal shift. Certain medicines such as antibiotics, heart medicines, AIDS medicines, drugs for heartburn and anti-anxiety medicines may also be responsible for this condition. Drinking alcohol in excess and taking marijuana, and other recreational drugs also increase the chances of gynecomastia. Breast size may also get enhanced by the use of herbal products containing lavender oil and tea tree oil.

Symptoms
Men affected by gynecomastia are featured by having a rubbery mass underneath their nipple region. It is less in amount and is usually tender. Fluid discharge is also an indication in some cases.

Diagnosis
For the diagnosis of gynecomastia, you should visit a plastic surgeon, who deals with cases of hormone imbalances. Blood or hormone tests may be required if your physical examination shows that your breasts are larger than usual, the lymph nodes are swollen, or when the lump is sore.

Treatment
Commonly, gynecomastia can not be cured with medicines. Surgery is compulsory. In the case of teenagers, the breasts become of normal shape within two to three years. Surgery is the only option for restoring your chest shape and improving your self-image. In the surgery for treating gynecomastia, a small cut is made on your breasts and extra breast tissues are removed. This makes your breasts smaller and flatter. The nipple may also need to be repositioned. Liposuction is another procedure which is carried out for this purpose, in which extra fat is sucked out from under your skin. Among the different modes of treatment for gynecomastia, surgery is meant for long term results. However, you need to undertake a healthy lifestyle in order to maintain your new chest shape. Gaining weight and taking drugs may cause gynecomastia to reoccur.

Gynecomastia - What You Need To Know About It!

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!

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