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

The term  skin disorders  is used to describe different skin problems- from widespread rashes to red small bumps on certain portions of the skin. While some conditions can be harmless but unsightly, others may be infectious and even life-threatening in rare cases.

Some skin conditions have a genetic component, while others may result from allergic reactions. Allergic skin problems occur when certain allergens stimulate an immune response such as itching or redness. Bacteria, fungi, viruses can also lead to skin problems. The most common types of skin problems are psoriasis, eczema, acne, rosacea, warts etc. Let s take a closer look at these disorders-

Psoriasis- This is an autoimmune chronic skin condition which causes a rapid increase in the number of skin cells. Due to this rapid accumulation of cells, the surface of your skin becomes dry and flaky. The white scales are usually seen in the joints of your knees and elbows. You will most likely notice redness and inflammation around the scales.
Eczema- Eczema is a medical condition that causes your skin to turn red and become inflamed and itchy. Eczema occurs in many forms, the most common among which is Atopic dermatitis. This condition begins usually in childhood, and gradually fades away or becomes milder as you age.
Acne- This is perhaps the most common skin problem particularly prevalent between the ages of 15 and 35. Almost every other person develops small raised bumps known as acne breakouts due to infected or blocked hair follicles. When the skin pores become clogged due to excess oil secretion or accumulation of dirt and dead skin cells, acne can appear anywhere in the skin. Most commonly, these are noticed on the face- cheeks, chin or the nose.
Rosacea- Rosacea is often mistaken as acne because it induces acne-like inflammatory symptoms. But this particular skin condition can occur due to a combination of genetic and environmental factors. Rosacea produces red, pus-filled small bumps on the skin, and usually affects fair-skinned middle-aged women. Visibly broken blood vessels, swollen skin, itchy dry eyes, rough patches on the skin- all these signs indicate you may have rosacea.
Warts- These are slightly raised bumps or patches on the upper layer of your skin caused by the Human Papillomavirus (HPV) infection. Warts come in different shapes and sizes and can occur in any part of your body- hands, palms, feet, knees, or face.
Role of Ayurveda in curing skin disorders-
The Ayurveda school of treatment aims to restore your body s doshic balance- kapha, vata and pitta. Treatment methods include self-care practices such as a balanced lifestyle, healthy diet, exercise and meditation. There are several Ayurvedic therapies including Abhyanga and Panchakarma that are designed to promote healthy skin.

The Panchakarma vidhi uses medicated herbs, natural ingredients like rice, sand, medicated powder on your body to soothe your senses and flush out the toxins from your body. Once your body is detoxified, your skin feels rejuvenated and nourished.
Essential rosemary oil and olive oil act as excellent moisturizers, especially for dry flaky skin resulting from psoriasis.
Ashwagandha, one of the most essential, powerful herbs packed with anti-inflammatory properties, helps remove rosacea puss. To fetch best results, apply or drink extracts of this wonder herb every alternate day.
Fenugreek seeds, or what is more commonly known as  methi , are rich in essential vitamins like C and K, folic acid and iron. This medicinal plant helps remove dry red patches on the skin. It also prevents the formation of rosacea puss and helps reduce itching.
Skin problems can be mild or severe. Sometimes a conventional treatment method that may work for one condition, may not work well for the other. Ayurveda is a holistic approach to treatment and uses natural ingredients to cure the root cause behind the apparent condition.

Psoriasis And Skin Disorders - What All Should You Know

When an injury happens, the normal tendency of the skin is to repair itself from inside out, until it is completely closed and healed. However, in some cases, due to various reasons, excessively large scars can form. These hypertrophic scars are known as keloids. Here is everything you would like to know about keloids:

Features of keloids:

Benign, fibrous, smooth, hard growths that form over a healed wound
Can be bigger than the original wound
Most commonly found on chest, ear lobes, cheeks, and abdomen
Pregnant women are usually at the risk of developing keloids
Though they do not develop into malignant lesions, they are a cosmetic issue, especially when the visible portions of skin are affected
They are localized, flesh-colored and red in color
They are raised from the surrounding tissue and are prone to repeat injury
It continues to grow with time
Could cause discomfort and irritation when it comes in contact with clothing
Sun exposure or tanning can worsen it and cause tenderness
Common injuries that can lead to keloid formation include burns, surgical incisions, skin piercings, chicken pox scars, tattoos, etc.
Treatment for keloids may not always be effective and need repeat treatments
Treatment options: If the keloid is not in a visible area and does not cause any problem, it is best to leave it untreated and observe for any changes. The following changes could indicate the need for treatment.

Change in color from pale pink to red (indicating inflammation)
Severe increase in pain/tenderness
Sudden increase in size, which could indicate malignancy (keloids are an area where benign growth can turn cancerous)
A biopsy can be done to identify if treatment is necessary. This involves removing a small part of the tissue by injection and sending it for laboratory examination.
Treatment options include both nonsurgical and surgical. Nonsurgical methods are tried first before resorting to surgery.

Steroid injections into the keloid to control growth and inflammation
Moisturization to keep it soft and avoid dryness and cracking and bleeding
Freezing the tissue (cryotherapy) to freeze the growth can help in further increase in the size of the tissue
Laser to remove the tissue, especially if it is small. Alternately, this could be used as a secondary measure after the keloid is excised to prevent further growth
Radiation therapy to shrink the growth
Surgical excision, where the keloid is quite visible or large. This could be followed by radiation or laser to prevent further growth.
Also, in people who are prone to develop keloids, surgical incisions can be treated for a longer time with pressure dressings and silicone pads.

Keloids - Know About Its Treatment!

Skin tags: causes and treatments

Skin tags, also known as acrochordons, are small brown or darker-than-skin tone growths on the surface of the skin. Tags are very common and harmless growths and tend to occur on the neck, under the breasts, armpits, eyelids and folds of the groin. They generally take place after midlife. About 25% of people report having skin tags after they cross the age of 50.

What causes skin tags to occur?

Skin tags are very common among diabetics and obese individuals. Pregnant women also develop skin tags, as a consequence of changes in the body's hormonal levels. Skin tags tend to occur when your skin rubs against clothing or skin. They are normally caused by blood vessels and collagen that gets trapped inside the thicker portions of the skin. For this reason, they are typically found in folds and creases of the skin. Sometimes, they reduce on their own if blood supply to the tissue has been disrupted due to them getting twisted.

What procedures are involved in their treatment?

Skin tags are generally removed for purely cosmetic reasons but when they do become troublesome, as in, they rub against jewelry, skin or clothing, doctors recommend their removal as the area can end up becoming irritated.

The following procedures are performed to remove these annoying growths on skin:

1. Excision - in this procedure the skin tag gets removed using a scalpel.

2. Ligation - the procedure involves the cutting off of blood supply to the skin tag.

3. Cauterization - the procedure involves the burning off the skin tag using electrolysis (process that involves decomposition of a matter by electric current)

4. Cryosurgery - in this procedure, the skin tag is frozen before removing it. An instrument containing liquid nitrogen is used to do the removal.

If you would like to consult with me privately, please click on 'consult'.
Related Tip: How does salt help in clearing skin?

Why are SKIN TAGs so annoying?

Psoriasis is a chronic skin disease where the skin cells form a mass of scales. These patches of skin are dry, red and itchy. It is an autoimmune disease which usually occurs on the skin of the back, scalp, palms, knees, elbows and around the fingernails and toenails, but some people have the diseased patches of skin all over the body. The patches may also crack, flake and bleed. The condition has no definite cure but the symptoms can be treated and managed.

Causes of psoriasis

The following factors are proven to have contributed to cases of psoriasis:

1. Genetics
More than 32% of the cases of psoriasis have been linked to genes. In case of identical twins, if one twin has the disease, the other has a 70% chance of getting it too. There are several genes associated with the disease and most of these genes are related to the immune system. T cells (lymphocytes which affect cell specific immunity) can also cause psoriasis.

2. Hiv
Human immuno-deficiency virus adversely affects the immune system and increases susceptibility of all kinds of infections and diseases. Hiv-positive individuals have been found to have an increased risk of psoriasis than hiv-negative people.

3. Other diseases
Diseases like strep throat, chronic infections, skin infections and stress may be responsible for the condition. Other factors like obesity, alcoholism, skin dryness and smoking can also lead to psoriasis.

4. Medication
Anti-malarial, anti-inflammatory and blood pressure medicines can cause psoriasis as a side effect. The disease is also an effect of withdrawal from topical steroid creams and other steroid-based medication.

Symptoms of psoriasis

The symptoms of psoriasis may vary from patient to patient. However, if more than two of the following signs are seen, it is likely that psoriasis is the causative condition:

1. A whitish and silvery mass of scales surrounded by red patches of stinging, itchy skin
2. The appearance of blisters or rashes on the dry scaly skin and also along the nails
3. Bumps on the folded skin like back of the knees, armpits etc.
4. Diseased patches of skin can crack, peel and bleed
5. A sharp and localized pain in the joints accompanied by stiffness
6. Soreness in the throat
7. Tiny depressions in the nails or large brown patches under the nails
8. Swelling and tenderness of the limbs
9. Dental plaque
10. Muscle pain due to the swollen bands of connective tissue


Causes and Symptoms of Psoriasis

Facial surgery can be opted for by people for a number of reasons, and these include being born with facial impairments like cleft lip, birthmark or other birth defects, the effects of aging, sun damage, or other facial traumas that are noticeable on the face as well as a sense of general dissatisfaction with your facial features. Depending on these factors, facial plastic surgery can be divided into two categories:  reconstructive and cosmetic.

Reconstructive plastic surgery is performed for correcting conditions that may be present from birth, including birthmarks on the face, cleft lip and palate, protruding ears, and a crooked smile. Conditions resulting from accidents, traumas, or burns are also corrected by this type of surgery.

Cosmetic facial plastic surgery is performed to enhance the visual appearance of facial structures and features which include facelifts, eye lifts, rhinoplasty, cheek and chin implants, and liposuction. 

If you are planning to get facial surgery done, there are certain things you need to do to prepare yourself for it. These are:

Choose a qualified surgeon: It's important to choose a board-certified plastic surgeon or facial plastic surgeon who has experience performing the specific procedure you are considering. You should also ask to see before-and-after photos of the surgeon's previous patients.

Understand the risks: As with any surgery, facial surgery carries some risks, including infection, bleeding, and scarring. Make sure you understand the potential risks and complications of the procedure before making a decision.

Have realistic expectations: While facial surgery can produce excellent results, it is not a magic cure-all. It's important to have realistic expectations about what the surgery can and cannot do.

Follow post-surgery instructions: After your surgery, it's important to follow your surgeon's instructions for care and recovery. This will help ensure that you get the best possible results and minimize the risk of complications.

Schedule a surgery when you are healthy: If you are planning for either of the surgeries, try to schedule it during a period of relatively good health. Your immune system will have the best chance of a speedy recovery. Scheduling the surgery at the year-end is ideal when you can take a few days of paid leaves. 
Get enough essential nutrients: Your diet, before and after the surgery, should be rich in vitamin A, vitamin C, zinc, copper, and selenium. They help the wound to heal quickly and build immunity, thereby reducing the chances of an infection. You can recover from more comprehensive procedures like tummy tuck, facelift or liposuction by including the requisite nutrients in your diet.
Stay hydrated: Consuming 6-8 glasses on the day prior to the surgery is very important to help cleanse and hydrate the body. Since fluid intake is reduced on the day of surgery, water intake is especially important prior to the surgery. To avoid complications during surgery, ensure that you do not drink anything after midnight on the night prior to your surgery unless advised by your surgeon.
Overall, it's important to do your research and consult with a qualified surgeon before making a decision about facial surgery. Good luck!

Related Tip: "Causes and Risks of Craniofacial Surgery"

7 Things To Keep In Mind For Facial Surgery

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