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

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!

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?

It is said that the mind controls the body. If the mind is healthy so will the body be. The condition of the mind is often reflected in bodily symptoms and conditions including illnesses.

The temptation in mostly to treat with heavy drugs that might offer temporary relief but have dangerous side effects and do long term harm.

Homeopathy tackles this issue considering safety and cure in a balanced manner to ensure recovery but without harmful side effects.

The concept of psychosomatic disorders has been in existence since the time of Sigmund Freud. The belief is that with the varied emotions that a person experiences, each disease manifests with a different set of symptoms in each person, implying that each person needs to be treated differently and not given the same disease-specific medication. This is where homeopathy plays a very strong role in psychosomatic disorders as it also believes in treating the person as a whole and not just the symptoms.

In homoeopathy, we base our prescription on what we call constitutional symptoms where we give lot of importance to the mental symptom as well as to the characteristic physical symptom. Hence every prescription from a Homoeopathic physician will surely include an element of psychosomatic angle. It is beyond the scope of this editorial to mention all the remedies of Materia Medica which has the scope for the treatment of psychosomatic disorders.

The homeopath always undertakes a thorough discussion with the patient to understand the accompanying symptoms in detail and then arrive at a customized treatment plan.

Some of the most common psychosomatic disorders include irritable bowel syndrome, migraine, GERD, ulcerative colitis, and allergy disorders.
Specific substances are given to manage anxiety, depression, irritability, insecurity, paranoia, etc. These feelings are considered inducers for the above disorders, and managing them can help bring about a harmony in the patient's overall health.


GERD: Gastro esophageal reflux disease is a disorder that results from stomach acid moving backward from the stomach into the esophagus. GERD usually happens because the lower esophageal sphincter (LES), the muscular valve where the esophagus joins the stomach, opens at the wrong time or does not close properly.

Homeopathy For GERD:
Homeopathic medicine relies not only on identifying the symptoms of the disease, but on a variety of personality traits, the person's mental state and other characteristic symptoms a patient exhibits which correlate to any particular remedy. When choosing a correct remedy for the treatment of heartburn, all aspects of the patient are taken into account.
These are some of the Homoeopathic medicines that may prove beneficial:- Argentum nit, Cal.carb., China, Carbo veg, Lycopodium, Nat. phos, Nux vomica, Phosphorus, Pulsatilla, Robinia, sulphuric acid etc.


Migraine: Migraine is a form of headache. The pain is usually throbbing, pulsating and bursting in character. At times, the pain is one sided or may involve the whole head. Such pain may last for hours or even days. It is often accompanied by other symptoms like nausea or vomiting. At the same time, there is increased sensitivity to light and sound. In some cases, the pain is preceded by some warning symptoms like flashes of light, temporary blindness or tingling sensation in the limbs.

Homeopathy for Migraine:
Belladonna is widely used homeopathy remedy for migraines, where headache is throbbing and violent, occurs suddenly, worsens on touching, and relieves with pressure. Glonoine is useful in congestive headaches with a reddened face that is worsened by sun or heat. Natrum Mur is useful in cases where headache is brought on by grief or stress.

Ulcerative colitis: Ulcerative colitis is a serious chronic inflammatory disease of the large intestine accompanied by ulcerated lesions of the intestinal tissues. It is characterized by episodes of abdominal pain with profuse diarrhea in which large quantities of blood, pus, and mucus are present in the feces. There is an urgency to move the bowels, as many as, three to ten times per day. It may be accompanied with pain, nausea, and vomit. Because of the loss of blood, the patient may become dehydrated and anemic.
Complications of ulcerative colitis includes liver and kidney disease, peritonitis, toxic mega colon, and risk of developing colon cancer.

Homeopathy for Ulcerative Colitis:
To identify the actual inducing agent, some foods are removed to see if they are inducing attacks. Once identified, that is removed from the patient's diet. In addition, aloe, arsenicum album, carbo vegetabilis, colocynthis, are commonly used remedies for ulcerative colitis. The patient is asked for associated symptoms like bleeding diarrhea, color of the feces, involuntary defecation, abdominal pain, anxiety, cramps, and stress before deciding on a treatment mode.

Irritable Bowel Syndrome: Irritable bowel syndrome, also known as spastic colon is a functional disorder characterized by recurrent abdominal pain, cramping, and bloating. Some people suffer from constipation, which means hard, dry stools, difficult to eliminate, leading to straining without success. Some people experience diarrhea, with frequent loose watery stools.

Homeopathy for Irritable Bowel Syndrome:
Sulphur, Pulsatilla, Phosphorus, Nux Vomica, Lycopodium clavatum, Argentum Nitricum, and Silicea are commonly used homeopathic remedies. Associated symptoms that need to be considered before deciding on a therapy include frequency of stooling, nature of stools, abdominal bloating, restlessness, irritability and nervousness.

Homeopathy is a preferred mode of treatment for psychosomatic disorders as they aim at a holistic treatment of the individual and not just at symptom management.

Allergy: Allergy is an abnormal reaction or increased sensitivity to certain substances. The allergic individual produces symptoms when exposed to these substances, which are harmless to non-allergic people. The main reason for this is that allergic people make a special type of antibody called immunoglobin E (IgE), which can react with environmental substances in harmful way. These substances which lead to secretion of IgE antibodies are called allergens.

Homeopathy for Allergy:
Few important remedies for the homeopathic treatment of allergy are- Histamine, Natrum Mur, Kali Bich, Sepia, Hepar Sulph, , Carbo Veg , Sulphur, Bryonia, Nux Vom, Apis Mel, Ailanthus, and Justicia adhatoda.

Psychosomatic Disorder - Only Homeopathy Cures

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?

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

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