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

In today s world, females have advance techniques available for shaping up their breasts. It is a part of their overall persona and beauty. Breast augmentation is one of the greatest plastic surgery operations that is done in hospitals across the globe. 

Gone are the days, when you would sit back at home and blame nature for your saggy breasts. You have the gift of plastic surgery at your rescue. Breast augmentation can enhance the beauty of your breast and uplift its features. In this process, the implant is put under the pectoral muscle so that you can still breastfeed your infant if needed.
The process is executed with the help of a small 4 cm incision. The recovery process takes a week s time. Breast augmentation can be carried out in a surgical centre or in any hospital s outpatient facility. It doesn t require a hospital stay in most cases. In some selected cases only, the procedure is done using local anaesthesia. In those cases, the patient stays awake. The breast region is made numb.

What to expect during the procedure?

The woman opting this must know what all are expected to happen during the procedure. The surgeon will insert the breast implant by making a single cut in one of the following three areas:

1. In the crease under breast 
2. Underarm (axillary)
3. Around the nipple (periareolar)

After the incision is done, the surgeon will try and separate the breast tissue from the patient s muscles and connective tissue. This will lead to the creation of a pocket either behind or in front of the pectoral muscle. After this, the surgeon will put the implant into the newly-created pocket. It will be centred behind the nipple. 

Saline implants are put in an empty form and then filled with sterile salt water. Silicone implants are, however, pre-filled with silicone gel. After the implant is over, the cut is stitched with sutures and the skin is bandaged with adhesive and tape.

What to expect after the procedure?
For a few weeks, the patient might experience Soreness and swelling. It is also possible to develop bruises. Your scars will fade away with time. It is quite possible that the scars will not vanish permanently ever in your lifetime. You must wear a compression or sports bra at the time of healing. You might be required to take painkillers, as advised by the surgeon.

Breast Augmentation - What to Expect from the Procedure?

The skin is the largest organ in the body and is one of the five sense organs, helping us with  touch.  The first outer layer is called the epidermis and the underlying layer is called the dermis. The skin has a protein known as keratin, which protects it from various external toxins and infections.

In some people, due to unknown reasons, there could be pile up of this protein in the deeper layers, producing small bumps, which feel like sandpaper. Literally, the term keratosis pilaris (KP) refers to piling up of keratin pigment. It can block the hair follicle that would normally open into the skin. When there are multiple blocks in the same area, there could be a sandpaper-like rough feeling to the touch. This gives this condition other names including goosebumps, chicken skin or chicken bumps. Though it is a cosmetic issue, it is medically a benign and very common condition.

Cause

KP, as it is popularly known as, is believed to be a genetic disorder with faulty genes leading to excessive accumulation of keratin. These appear as red, small bumps that are usually seen on the hands, arms, thighs, buttocks, and rarely on the face. The surrounding skin may be inflamed if there is a buildup of skin under the pile of keratin.

The onset of KP is usually in the first decade of life, worsens during puberty, and reduces during adulthood. There are, however, instances where the onset happens during adulthood. Twins and people with atopic dermatitis are more likely to have KP.

KP is more common in people with dry skin as oily skin seems to offer some protection.

There are also studies that give it a correlation with weather, with winter seeing more of this condition than summer. This is because our skin tends to dry more in winter than in summer. There could be some people who are completely normal during the summer months but will develop these bumps during the winter, which again subsides with the season.

Signs and Symptoms

As noted above, KP is a medically benign condition. There is a cosmetic concern if it is in the visible areas like arms and hands. Also, the area could feel rough and dry, but the affected person may not experience any itching or other harm. People with atopic dermatitis and eczema are more likely to develop KP; hence these other skin conditions require proper management.

Management

Patient education is the most important. This disease does not require any treatment and is usually self-limiting. It is very rare for KP to affect the whole body. Creams containing alpha hydroxy acid, salicylic acid, lactic acid, or vitamin A may be required to remove dead skin cells and to prevent clogged follicles from the bodies of the affected people.

Keratosis Pilaris: Signs, Causes, Treatment, and Prevention

Psoriasis is a long lasting disease characterized by patches of scaly, itchy and red skin. It can be restricted to a small areas or can even spread to the whole of your body. When the underlying infection reaches the surface of your skin, the healthy cells die. This causes red and itchy plaque covered with white scales. It mostly occurs on the elbows, knees and scalp. Sometimes these scales itch and also bleed. In severe cases the red skin grows and merges with another patch.

Conditions of psoriasis:
1. Finger nails get discolored and pitting is noticed. The nails begin to crumble and in severe cases detach from the nail bed.
2. Scales and crust start to develop on the scalp.

Types of psoriasis:
1. Guttate psoriasis- It is characterized by small red spots which occur on the torso and limbs. It usually starts in young childhood or adulthood. It triggers respiratory infection, tonsillitis and strep throat.
2. Inverse psoriasis- In this condition bright red and shiny abrasion occurs in the groin area, in the armpits and under your breasts.
3. Erythrodermic psoriasis- It is characterized by periodic redness of the skin and shedding of the skin. It also causes severe sunburn and infection.

Cause of psoriasis:
Many factors can cause psoriasis. Factors such as, trauma, infection or emotional stress can trigger this condition. Some abnormalities in the system also cause psoriasis. People who have a flare up of psoriasis are usually affected by emotional stress or some trauma like the death of a loved one or loss of a new job. These tensions may intensify because of problems in your internal system.

Ayurvedic treatments for psoriasis:
1. Consuming medicated ghee.
2. Herbal medicines or herbal concoctions can also be consumed.
3. Basthies are medical and herbal enemas which should be taken for 8days.
4. You should avoid having meat and only consume vegetarian dishes to reduce psoriasis. Also avoid yogurt, black gram, salty food products and chilies.
5. You can also remove impurities from your body by means of vomiting and purging.
6. You can also cure psoriasis by covering your entire body in a paste of mud.
7. Consume turmeric and Neem daily to treat psoriasis.

Some medicine like arogya vardhini vati, kutaki, ras manikya, Giloy ghan vati must be taken after consulting an Ayurvedic expert.

7 Best Ayurvedic Medicine for Psoriasis Treatment

Breasts are integral to womanhood. They define a woman s beauty. Well grown, firmer breasts are what every woman dreams of. However, not many women are lucky enough to have the perfect shape and size of breasts. A common belief among people is that bigger the size of the breasts, the better they are. This is a big misconception. The ideal breast size is the one that is in proportion to the rest of the body. Bigger breasts do not look good on women with smaller structure and are also prone to sagging. Apart from a disproportionate figure, many women with larger breasts complain of backache, neck and shoulder pain due to the physical burden born by the upper body. Hence, the need for a medical intervention. Such women can consider breast reduction as a permanent solution to their problem.

Breast reduction or reduction mammoplasty is a procedure that reduces the size of the breasts through surgical removal of tissues, fat and skin, thereby making it ideal as per the body structure. The procedure is performed under the guidance of a trained aesthetic plastic surgeon and takes about three to five hours.

Hospital admission is usually required and a general anesthesia is given to the patient. Healing of wounds may take a few days. Breast reduction surgery also deals with issues of sagging breasts and helps them give an uplifted and firmer appearance. Another advantage of this surgery is that it can reduce the size of areola making the breasts appear younger and better.

Like any other surgery, reduction mammaplasty is not free of side effects. There are risks associated and one has to carefully weigh the risks and benefits before taking this decision. It can cause complications like excessive bleeding and adverse anesthesia reactions. Apart from this, some of the common side effects of this surgery are loss of sensation in the nipples and areola, inability to breastfeed and scarring. Sometimes, the procedure may need to be repeated in case there is a visible asymmetry in the size of both the breasts.

In general, women considering this option are overweight, have no plans to bear children in future and are suffering from heaviness and pain in upper part of the body due to larger breasts. However, many women desire to improve their appearance. Cosmetic market delivers many new gels and creams for breast reduction, claiming them to be simpler and safer than surgery, but their effectiveness is doubtful. Women looking for a more permanent solution may consider a surgical procedure. However, following the surgeon s instructions is important pre as well as post-surgery. If you are worried about the size of your breasts, do visit a plastic surgeon and discuss your options.

Should You Get Breast Reduction Surgery? 

Alternative medicine is fast picking up with its beneficial treatment for several skin disorders. Vitiligo or patchy skin is a common skin problem that can be effectively treated by the ancient Unani system of medicine.

What is vitiligo?
Also referred to as leucoderma, it is a patchy loss of skin colour that occurs due to acquired depigmentation of the skin. The absence of skin cells called melanocytes leads to nonproduction of the melanin pigment and as a result, manifests itself as patchy skin in several parts of the body. It can affect any area of the body including the face, neck, back, hands, and legs.

Unfortunately, conventional medicine has not been able to discover a full-proof treatment for this skin disorder, except for surgical intervention. Thanks to the yesteryear s Unani medicine system, which has its foundations in the ancient Greek, Roman, Persian, and Indian medicine, certain herbal formulations help to treat conditions of vitiligo or leucoderma. The Unani system of medicine aims to create the right balance in the body by stabilizing the four humours   blood, phlegm, yellow bile and black bile, which constitute insulin, hormones and other fluid releases.

Herbal powder and capsules are prescribed for the patient s consumption depending on the severity of the disorder.
Herbal ointment for external application   The affected individual must apply the topical ointment or balm before 10:00 am and then expose it to sunlight for around 10 to 15 minutes. After that, it should be shown back in shade and kept for one hour before washing it off.
Diet for vitiligo
Certain food items like banana, beef, sea food, poultry, citrus foods, pickles and dairy products are to be restricted during treatment. Foods with excessive tamarind and cashew nuts are also to be avoided. Recommended food includes all vegetables, fruits, eggs, and organic chicken.

How effective is Unani in treating vitiligo?
For years together, Unani compound formulations for systemic as well as topical usage are catering to the needs of patients. It helps to treat and induce re-pigmentation. There are several treatment modalities available to control the spreading of the disease and minimize the chances of a relapse of the skin condition.

There have been no reported side effects of Unani medicines and they are well tolerated even after prolonged use. It usually takes about 2 to 3 months to see a visible improvement of the condition. The disease tends to become stable after regaining pigmentation.

The Central Research Institute of Unani Medicine located in Hyderabad, India has taken several measures to eradicate Vitiligo. While conventional medicine does try to offer remedies to treat vitiligo, Unani medicine offers a cost-effective approach that is more promising.

Best Unani Medicine for Vitiligo Treatment

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