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 hormonal condition that causes swelling of the breast tissues in men and boys. This condition usually arises as a result of hormonal imbalance. Breasts do not form in the same pattern in males as they do in females but all males are naturally born with tiny quantities of the breast tissues. The male body produces the testosterone hormone, which plays an important role for growth during the stage of puberty. However, they also make the hormone estrogen that is instrumental for developing sexual growth in females.

When a male passing through the stage of puberty makes lesser amounts of testosterone then there is an imbalance of the hormones. As a result of the higher amount of estrogen present in men leads to swelling of the breast tissues.

Cause of imbalance-

Aside from the common reason which is the lesser production of testosterone, there are a few other reasons that can put into effect this imbalance. They are-

  Injury to the testicles that are responsible for producing testosterone
  Obesity which leads to greater production of estrogen
  Taking illegal drugs
  Liver disorder
  Failure of the kidney
  Thyroid problems that result in throwing off your hormonal balance
  Medications that you might be taking for illnesses such as cancer, depression, heart disorders and ulcers

Treatment of Gynecomastia

The treatment of gynecomastia involves a general surgery which reduces the size of breasts by flattening and enhancing the contours of the chest. If in very severe cases the weight of the breast tissue has sagged and stretched the areola region, then the areola size can be improved surgically by reducing the excess skin.

  Mammaplasty

Plastic surgery, known as Mammaplasty, is also sometimes put into effect in order to treat the condition of gynecomastia.

  Liposuction

In the case of liposuction, the procedure of the treatment first starts with a set of medications that need to be consumed. These medications help to reduce pain during the surgery. There are two ways of taking this medication, either through intravenous sedation or via general anaesthesia. The liposuction technique involves the insertion of a hollow tube with the help of several incisions. Liposuction technique is generally prescribed if the cause of gynecomastia is excess of fatty tissues. During the procedure, the cannula or the tube will be moved back and forth in order to loosen up the excess fat. This fat is then removed via vacuum suction.

  Excision Technique

The excision technique is prescribed when the glandular breast tissue needs to be removed in order to rectify gynecomastia. In this procedure, the nipple will either be repositioned to a manlier contour or the areola size will either be lessened. In some other cases, the general surgery of gynecomastia can also involve a combination of both the excision technique as well as the liposuction technique.

Gynecomastia is a condition that can severely damage the emotional balance of a man and lessen their self-confidence. It has been also seen that many men suffering from this condition tend to avoid physical intimacy or sexual activities as a result of body-image issues. Therefore, treatment is highly recommended for those suffering from gynecomastia.

Gynecomastia - Knowing The Causes & Treatment Of It!

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

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

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

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