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

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?

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?

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?

Gynecomastia is basically swelling of the breast tissues in boys and men. This is usually caused due to an imbalance of the hormones, estrogen, and testosterone. Gynecomastia can affect either one or both the breasts, sometimes in an uneven manner. Newborn babies, boys who go through puberty along with older men might develop this condition as a result of normal changes in the levels of the hormone.
It is not necessarily a serious problem but men might find it difficult to cope with this condition. This condition can go away on its own. In case, it persists, consultations with a cosmetic/plastic surgeon can be of great help.
Before looking at the tips from a cosmetic/plastic surgeon to come out of this problem, let us briefly talk about the symptoms and causes related to Gynecomastia.

Symptoms- 
There are certain signs and symptoms, which suggest that men could well be suffering from gynecomastia. They include the likes of:

Swelling of the breast gland tissue
Pain
Tenderness
Nipple getting discharged in either one or both the breasts
Causes -
Gynecomastia is usually triggered by a decrease in the amount of the hormone testosterone compared with estrogen. Different things can alter the hormonal balance like:

1. Natural hormonal changes

2. Several medicines including:

Anti-androgens used for treating enlarged prostate, prostate cancer
Anabolic steroids
Medicines for AIDS
Anti-anxiety medicines
Tricyclic antidepressants
Antibiotics
3. Consumption of alcohol
4. Heroin and other such drugs
5. Several health conditions like Hypogonadism, Hyperthyroidism, Kidney failure, Live cirrhosis, etc.

Tips From Cosmetic/Plastic Surgeon-
Consultation with Cosmetic/Plastic Surgeon can let men have useful tips as to the treatment as well as prevention of Gynecomastia. They include the following:

Liposuction Treatment can be an ideal way to get rid of this problem. It removes fat from the breast but leaves behind the breast gland tissue in its place. The treatment involves making two or more small incisions through narrow tubes get inserted into the chest region. The tube gets moved around gently to loosen up the excess fat tissue, which is then sucked out. The treatment involves less amount of scar.
Cosmetic/Plastic Surgeon can advise patients that there are iatrogenic causes behind this problem like side-effects from any medicine or health issues like an overactive thyroid or tumor.
Mastectomy can be another effective method of treatment. It is performed endoscopically and thus has a quicker recovery time. A patient can stay at the hospital for a few hours and go back. This involves less amount of scarring.
Cosmetic/Plastic Surgeons can also go for another extremely effective method in their hands to take care of this problem of Gynecomastia. It is the Excision Technique. This is recommended where glandular breast tissue or excess skin must be removed to cure this. The patterns of incision would vary depending on the specific conditions and patients  surgical preference.


All You Must Know About Gynecomastia!

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)?

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