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

While women strive to enhance the way their breasts look, the development of breast tissue in men can be embarrassing. This condition is known as Gynecomastia. It can affect one or both breasts in a symmetric or asymmetric manner and is caused by an imbalance of estrogen and testosterone hormones. It can also be caused due to a side effect of medication or because of other health problems such as an overactive thyroid or tumor. In some cases, this condition can get resolved on its own while in other cases, medication and surgery may be recommended.

Medications

Before undergoing treatment for Gynecomastia, it is essential to ascertain that you are in fact suffering from this condition. This is because gynecomastia and the buildup of fat tissue in the chest can look similar, but are treated differently. When treating this condition, medication needs to be supplemented with controlled calorie intake and physical exercise. It is also cheaper than surgical treatment.

Surgical Treatment

Surgery is often the preferred mode of treatment for significantly enlarged male breasts. Surgical treatment for gynecomastia is of two types:

    Liposuction: This removes fat from the breast, but leaves the breast gland tissue in place. Liposuction can be performed in a number of ways. It involves making two or more incisions through which narrow tubes are inserted into the chest area. This tube is gently moved around to loosen the excess fat tissue that is then sucked out.
    Mastectomy: This procedure removes the breast gland tissue itself. It is performed endoscopically and hence has a quicker recovery time and involves less scarring.

You may feel a slight discomfort after the surgery for a few days. You will also be advised to wear a chest support brace for a few days to allow your body to heal without putting any pressure on the site of the surgery. Normal activities can be resumed within 2 to 3 days but avoid strenuous activities of heavy lifting for a month after the surgery.

As long as you follow a healthy lifestyle and have a balanced diet, either of the above surgical procedures should have a lasting effect. This makes surgery a more preferred form of treatment than medication.

Apart from this, certain exercises can also help tone chest muscles and reduce fat tissue. This includes inclines dumbbell presses, push-ups and exercises that focus on pectoral muscles. However, this is a very gradual process and hence suitable only for mild cases of gynecomastia.

Gynecomastia Treatment

What is allergic rhinitis?

Allergic rhinitis is defined as allergic symptoms in the nasal passage. Allergic rhinitis can be seasonal (occurring during specific seasons) or perennial (occurring year round). The allergens that most commonly cause seasonal allergic rhinitis include pollens from trees,grasses and weeds, as well as spores from fungi and moulds. The allergens that most commonly cause perennial allergic rhinitis are house dust mites, cockroaches,animal dander,and fungi or moulds. Perennial allergic rhinitis tends to be more difficult to treat.

How does allergic rhinitis occur ?

This condition occurs when allergens (allergy- causing substances) come into contact with the nose, and usually also the ears, sinuses, and the throat. When allergens come in contact with the lining of the nose and sinuses, they trigger the cells to release the chemical histamine, which causes the allergy symptoms described below.

What are the symptoms ?

Nasal congestion 
Sneezing 
Watery " runny nose" 
Itchy eyes,nose,or throat 
Puffy eyes or 'allergic shiners'
Post nasal drip 
Tears 
These symptoms may occur during a certain season or year long. They can occur at any age. 

What is the treatment for allergic rhinitis ? 

A number of medications ,including antihistamines, intranasal corticosteroids, and decongestants are available to control symptoms. Allergen immunotherapy could provide long lasting benefit. You can "train" your immune system not to react exaggerated to an allergen anymore.

Allergic Rhinitis - Signs That You are Suffering from it?

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)?

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?

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

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