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 is a very important part of your life as it provides all the necessary nutrients required by your body and is essentially, the fuel for all things to function within. However, many people may have aversion to certain kinds of food as it causes adverse reactions within their body. Let s look at some of the common food allergies that people commonly report and how to identify them.

Allergies v/s Intolerances: It is important to note here that there is a significant difference between food sensitivities or intolerances and allergies. Sensitivities or intolerances cause adverse effects on your body inevitably when you consume certain types of foods. One such example is diarrhea, caused by ingesting cheese or milk by lactose intolerant people. However, allergies are caused when the immune system within your body mistakes harmless food as something that might harm you and thus tries to protect you from its effects. This results in reactions within your body which may be very painful and problematic.

Common foods that trigger allergies
Some of the common foods that trigger allergies are:
1. Peanuts
2. Shellfish
3. Other forms of tree nuts such as almonds, walnuts etc.
4. Gluten rich grains such as wheat, rye barley, oats
5. Certain types of fish
6. Eggs
7. Soy products
8. Milk (allergic reactions mostly occur within children)

Some other foods which have been known to cause allergies in rare cases are:
1. Meats such as pork, chicken, beef, mutton
2. Corn and corn products
3. Gelatin
4. Certain spices such as mustard, garlic and coriander among others
5. Certain seeds such as poppy, sunflower, or sesame

Symptoms of allergies
In certain cases, the allergies might manifest immediately, almost in a matter of minutes, within the body. However, in many cases, it may take a few hours for it to show up. The symptoms may range from mild to quite severe. Mild symptoms will make it quite hard to actually diagnose it as a food allergy.

Some of the milder symptoms could be:
1. Hives or eczema could form on your skin which may be very itchy. These would look like raised swollen areas that could be red, inflamed, and dry.
2. The inside of your mouth and ears may become itchy
3. You could suddenly develop a runny or a blocked nose and start sneezing or coughing.
4. Your eyes may become watery, red and itchy
5. You may develop a funny taste in your mouth
6. Others symptoms may include throwing up and even loose motions

Other severe forms of allergies can be caused mostly by shellfish and peanuts and other forms of nuts and fish. Symptoms in such cases would look like:
1. Uneven heartbeat
2. Difficulty in swallowing and breathing
3. Feeling of extreme weakness, confusion
4. Passing out or feeling light headed
5. The tongue, throat or lips may swell up
6. Chest pain

Common Foods that Can Trigger Allergy

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 number of allergens are many and knowing what triggers your allergies can get complicated. The common triggers that are known to trigger allergic rhinitis are:

Moulds
Fungi
Pollen, the most common cause for allergies
Dust mites, and the faeces of dust mites that can cause severe allergic reactions
Cockroaches
Animal dander, which includes cat hair, dog fur, and may also include little flakes of skin
Avoiding the above mentioned triggers is more of a general guideline for the management of allergies. The lifestyle changes that you make to manage allergies:

Keep yourself hydrated at all times. Drink about eight to ten glasses of water every day. This will allow the mucous to be expelled with ease, if you experience any nose block.
During seasons like spring, when the amount of pollen in the air is at its maximum, limit your exposure. Try to stay indoors to avoid exposure to pollen or dust in the air.
Make it a point to take a shower before going to sleep as the residues of pollen and dust stuck to your skin are likely to make your symptoms worse.
Use fresh bedding and clothes every day. This will help to reduce your exposure to allergens.
Remove your carpets. Carpets are home to dust mites and pollen grains which become difficult to remove even with vacuum cleaners. Remove the carpets during the allergy season, and replace with hard flooring.
Keep windows and doors shut to avoid dust and pollen grains from entering the house and possibly causing allergies.
Avoid staying around pets. It that is not possible, then wash them at least once a week to reduce allergies.
Prevent inhaling cigarette smoke or smoking cigarettes. The smoke can be very harmful and can increase the risk of asthma in kids.
Avoid outdoor trips during seasons when the pollen count is high.

Allergies - Lifestyle Changes That Can Help Manage it!

A change in weather bring about changes in the composition of dust and pollen and induce seasonal allergies, which a huge number of people fear. The good news is that there are a number of common food substances which can help control these seasonal allergies. There are specific ingredients in these foods which improve immunity and provide antihistamine-like effects (which is what most anti-allergic drugs do). Some of these foods are mentioned below:

Green tea: With its natural dose of antihistamines, it prevents you from developing allergies. A hot cup in the morning acts as a good shield against sneezing, which is common with pollen and dust allergies.
Oranges and strawberries: Vitamin C is essential for controlling allergies and it is always recommended to reach for a couple of fresh oranges or strawberries than popping a vitamin pill. They also contain other substances like traces of Omega-3 fatty acids and Quercetin.
Garlic: This blocks the production of chemicals that can cause allergies. Eating a couple of cloves in the morning daily will do wonders for the allergy prone people.
Turmeric: This miraculous Indian spice has strong anti-inflammatory properties and helps prevent all kind of allergies.
Nuts and seeds: For the vegetarians, eating walnuts and flax seed is a good alternative. A handful of walnut is equal to 3 ounces of salmon. Flax seed also contains selenium which has anti-allergic properties.
Cabbage and broccoli: The flavonoid called quercetin helps by reducing inflammation that is usually associated with allergies. Other sources include apples, onions, berries, and cauliflower.
Fatty fish: These contain a good amount of omega 3 fatty acids, and work better than the supplements any day. Take your pick from mackerel, sardines, salmon, tuna, trout, bluefish or herring. These have two types of Omega-3 fatty acids (DHA and EPA) which are known to prevent people developing allergic symptoms. This anti-allergic property provides great relief in people who see seasonal allergic changes.
Local honey: For those who suffer from pollen allergy, a morning dose of honey helps build tolerance to this kind of allergy.
Wasabi: This pungent green paste helps breathing by opening up the airways and is very good for blocked nasal passages. It also is rich in antihistamines and helps prevent you from developing allergies.
Yoghurt and Kefir: These and other dairy products are rich in probiotics which contain a lot of friendly bacteria like Lactobacillus and Bifidobacterium, which are generally found in the intestines. They also help build immunity and increase bodys ability to fight allergens better.
So, for those prone to seasonal allergies, there are few things that are easy to find and well within the reach of regular kitchen and can shield against allergies.

10 Foods That Help You Fight Allergies

Allergies are a reaction of your immune system to any foreign matter, such as pet dander, pollen or bee venom, and not everyone is affected in the same way.
Antibodies are substances produced by your immune system to protect you from harmful invaders that can cause infections or make you ill.
The immune system produces antibodies when it comes into contact with allergens. Your immune system can recognise any allergen as threatening even if it s not. As a result, your skin, airways, digestive system or sinus gets inflamed.
Allergies can vary greatly in severity from mild irritations to anaphylaxis (a likely life-threatening emergency). Allergies are mostly incurable; however, there are various treatments available to alleviate allergy symptoms.
Causes-
Common triggers of allergy include:
Airborne allergens, such as mould, dust mites, animal dander and pollen.
Certain foods, especially milk, eggs, shellfish, fish, soy, wheat, tree nuts and peanuts.
Insect bites, such as wasp stings or bee stings.
Medications, specifically penicillin-based antibiotics or penicillin.
Latex, or any allergen you touch, causes skin infections.
Symptoms-
Symptoms of allergy depend on its type.
Hay fever (allergic rhinitis) symptoms include:
Sneezing
Itching of the roof of the mouth, eyes or nose
Stuffy, runny nose
Swollen, red or watery eyes (conjunctivitis)
Symptoms of food allergy include:
Tingling mouth
Swollen throat, face, tongue or lips
Hives
Anaphylaxis (a critical, deadly allergic reaction)
An allergy caused by insect stings can manifest in symptoms such as:
Swelling at the site of the sting
Hives or itching
Breathing problems, wheezing, coughing or chest tightness
Anaphylaxis
A drug allergy can lead to symptoms such as:
Hives
Itchy skin
Rashes
Facial swelling
Wheezing
Anaphylaxis
Atopic dermatitis (skin allergy) symptoms include:
Itching
Reddened skin
Peeling or flaky skin
Treatment-
Treatments of allergy include:
Avoiding Allergens: Your doctor can help you take necessary steps to recognise and avoid the allergens that trigger allergies. This is usually the most relevant step in the prevention of allergic reactions and reduction of symptoms.
Medicines to Lower Symptoms: Eye drops, nasal sprays or oral medications are commonly prescribed to reduce reactions and alleviate symptoms.
Immunotherapy: If the allergy is severe or other treatments fail to relieve symptoms, allergen immunotherapy is recommended. In this treatment, you get injected by a number of clarified allergen extracts over the years.
Emergency Epinephrine: If your allergy is severe, your doctor will provide you with an emergency epinephrine shot that you can carry with you everywhere. 

Allergies: Causes, Symptoms and Treatments

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