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

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

While some people look forward to spring and the beautiful flowers that bloom, for others this is a time of extreme discomfort triggered by pollen allergies. Pollen is probably one of the most difficult allergies to fight as it is invisible and is literally present everywhere. Sneezing, coughing, a runny nose, congestion and watery eyes are the most common symptoms of a pollen allergy. However, you can minimise your troubles by following a few simple steps.

Keep an eye on the pollen count: Not every day has the same amount of pollen in the air. Pollen density is also affected by the time of the day. Pollen count refers to the amount of pollen present in the air during a specific time period. You can find out the pollen count of your area online or through a number of apps. Once you know the pollen count. You can plan your day accordingly and step out or stay in.
Plan your time spent outdoors wisely: It isn t always possible to stay indoors even if you know the pollen count is high. However, you can still plan your time so as to not be outdoors at peak pollen times. 5am to 9am are the worst times to step out as this is when most plants pollinate. Hence avoid stepping out during this time. Windy days can also worsen the situation by spreading pollen around. If you must go for a jog early morning, avoid thoroughfares and gardens and instead pick a route around residential streets.
Protect yourself: Face masks may not look very good but can help reduce the amount of pollen being inhaled. If you find yourself sneezing a lot during pollen season, consider investing in a painter s mask that can filter the air being inhaled and exhaled. If you are stepping out to do yard work or know that you re going to spend a lot of time in heavy traffic areas, take your antiallergenic medication before you step out instead of waiting for an allergic reaction to begin.
Have plenty of showers: Try making it a habit to have a shower and changing your clothes as soon as you come home. This prevents the outdoor pollen from circulating in your home. Follow this routine even if you ve simply been gardening outdoors. While showering, do not forget your hair. If you do not want to shampoo it every day, simply rinse it out to get rid of all the pollen.

Pollen Allergy - 4 Tips To Keep Yourself Safe!

A rash on your child s body or their regular cough bouts can sometimes be triggered by an allergy. We can excuse it by calling it a common flu or a heat rash, but the reason behind it might be something you are not aware of. Your child might be allergic, and it is imperative for you to find out that exact thing your child is allergic to, it can be dust, nuts that you may think is beneficial for your child s health or even the fabric of the clothes you put on them. Allergies are caused when children come in contact with allergens, which can he inhaled, injected or even eaten unknowingly. If you see any of the symptoms of allergies, consult your doctor at the earliest and do not treat it lightly.

Some common triggers for allergies

These are divided into four groups

Foods: Certain foods like peanuts, eggs, milk and it products which you feed your child might be triggering their allergy.
Outdoors: When kids play outside pollens from trees or flowers might causes allergies. Even insect bites and stings are a major trigger
Indoors: Animal fur or hair and even dust mites and mold that exist in your house can trigger an allergy
Irritants: Common irritants like cigarette smoke, perfumes or even car exhaust should be watched out for.
Symptoms of common allergies

Nasal Congestion: It is referred to as stuffy nose, which is very common in kids. Allergies are the most common cause of chronic nasal congestion (a stuffy nose) in children. Sometimes a child s nose is congested to the point that he or she breathes through the mouth, especially while sleeping.
Allergic rhinitis (hay fever): It is also common and its symptoms include a runny or itchy nose and constant sneezing. A child with allergies may also have itchy, watery, red eyes and chronic ear problems. Even though it s commonly known as  hay fever,  allergic rhinitis isn t triggered by hay and doesn t cause fever.
If you suspect your child has an allergy, make an appointment to see a specialist. Start a diary before the appointment and keep track of what symptoms your child experiences and what you think causes them.

Common Allergies in Children - That You Need to Know!

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

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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