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

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

Nuts are a rich source of energy but are also one of the most common food allergens. Both children and adults can suffer from nut allergies. While some children may outgrow the allergy, for others this is a lifelong condition. When it comes to children, the sibling of a child who is allergic to nuts also has a high risk of being allergic to them as well.

Nut allergies can be categorized as an allergy to peanuts or an allergy to tree nuts. Tree nuts are nuts that grow on trees such as walnuts, cashew nuts and almonds. Peanuts are not considered tree nuts as they grow underground in the form of legumes. A person can be allergic to both types of nuts but it is not necessary that if you are allergic to peanuts, you should avoid almonds as well and vice versa.

There are laboratory tests to determine the types of food you can be allergic to but in most cases, you realize you are allergic to something only after consuming it. Some of the symptoms of nut allergies include:

Redness
Rashes
Tenderness of the skin
Hives
Swelling of the hands and feet
Sneezing
Runny nose
Sore throat
Watery eyes
Nausea
Vomiting
Stomach cramps
Diarrhea
Shortness of breath
Most of the symptoms that affect the skin and respiratory system can be relieved with the help of antihistamines. Cold compresses can also help relieve itchiness caused by nut allergies.
One of the most severe forms of nut allergies can result in Anaphylaxis. This can be described as the swelling of the throat so much so that the airways are blocked and it becomes difficult to breathe. It is often accompanied by swelling of the facial features and itchiness. The only way to relieve this swelling is with an adrenaline injection. This reduces the swelling and reopens the airways. The most common type of adrenaline injection is known as an epi pen.

Some types of foods that commonly contain nuts and should be avoided include baked goods, pesto, nougat, marzipan, soups, multigrain bread, honey, granola, sauces such as hot sauce and barbeque sauce, salad dressings and veggie burgers. Nuts are often also used as thickening agents and hence if you know you are allergic to nuts, pay attention to food labels before you buy any product and make it a habit to tell your server in a restaurant that you are allergic to nuts.

Nuts - How To Know If You Are Allergic To Them?

Can Food Allergies Be the Likely Cause of Your Infertility?

Infertility in a woman refers to the inability to conceive after having regular unprotected sex. Cases of unexplained infertility have been on the rise recently.  Though obstructed fallopian tubes and ovulation disorders are some of the common causes of infertility, reasons pertaining to dietary changes can also be responsible. Food allergies and dietary changes affect infertility to a great extent; and if you're struggling with conception or infertility, heeding to your diet can help.

Below is a list of diet constituents that are likely to cause infertility.

1. Gluten - Gluten is a protein found in grains like wheat, rye, and barley. Among the general population, women suffering from unexplained infertility have a higher incidence of gluten intolerance. Gluten intolerance is also related to miscarriages, and if left undiagnosed can lead to malabsorption of micronutrients like iron and zinc. Following and maintaining a gluten-free diet may relieve a sufferer from the symptoms. Try and include gluten free cereals like rice, corn and gluten free oats to manage the situation.

2. Inflammation - Another connection of food allergies and infertility would be inflammation. Inflammation occurs when the food allergens reach the stomach. This inflammation, if heightened, can cause damage to the fallopian tubes and the ovary. The body responds to the food allergens by treating it like a foreign substance that needs to be eradicated, and when your immune system is subjected to chronic inflammation, it can lead to infertility.

Additionally, apart from food allergies, even the consumption of certain foods and beverages can be a reason behind infertility, with those being rich in caffeine being a major cause. Increased consumption of caffeine can augment the risk of infertility and delayed conception. However, avoiding caffeine and eliminating problematic foods along with a careful scrutiny of your diet can increase your chances of getting pregnant.



Can Food Allergies Be the Likely Cause of Your Infertility?

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

When it comes to a man's physique, enlarged breasts can be quite embarrassing. This is a condition known as gynecomastia or men boobs or  enlarged breast in men and affects more men than you would imagine. It may affect one or both breasts. It can result in terrible embarrassment, teasing, and social trauma. Many will try to hide it with thick loose shirts, avoid bare chest activities like swimming, exercises etc and withdraw from public exposure.Though it does not pose a significant health risk, it can affect a man's psychological health and lower his self-confidence. The good news is that men suffering from this condition do not need to live with it. 

Male breast reduction surgery or gynecomastia surgery, aims at reconfiguring the contours of a man's chest by removing excess breast fat & if needed extra gland tissues. The only permanent solution to this condition is surgery. This is because fat tissues are not solely responsible for enlarged breasts. Often glandular tissue is present in excessive amounts as well. Patients need careful evaluation by Plastic Surgeon & sometimes if needed by endocrinologist to determine the source of their breast enlargement. 

Gynecomastia surgery is usually a daycare procedure. It is performed by Plastic Surgeons under local anesthesia with liposuction being the most preferred procedure. This procedure begins when the surgeon makes a small incision on each side of the chest. These incisions are usually placed along the natural contours of the body, around the edge of the areola or near the armpit so as to reduce the visibility of scars. Excess fat and glandular tissue are then sucked out of this incision. Simultaneously, the surgeon sculpts the other tissues in the chest to redefine chest contours. Patients are usually advised to wear a compression garment after the surgery to support the healing tissues and minimize swelling. 

Results of this procedure are visible almost immediately. Recovery from gynecomastia surgery is usually quick and many men find themselves back to their normal routine within a few days. However, vigorous exercising and heavy lifting should be avoided for a few weeks after the surgery. The patient may also experience slight soreness and minimal pain that can be relieved with over the counter pain killers. 

The results of this procedure are generally permanent if there are no hormonal abnormalities. It is important to maintain a healthy lifestyle and avoid drugs that influence your testosterone levels. Regular exercise can also help tone the chest muscles and maintain the achieved good shape of chest. It is really a very simple but rewarding surgery for the male & it definitely boosts his confidence, body image & self-respect.

Enlarged Breast In Men - Causes And Treatment 

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