Gynacomastia is the enlargement of the gland tissue of the male breast. It can affect men who are middle aged or even older and even strike during infancy or puberty. This condition occurs due to the growth of the grandular or breast tissue, which is actually present in small quantities in men. It is caused due to the imbalance of testosterone or estrogen hormones and can affect one or both the breasts. This is not a very serious problem but men with male breasts may experience some pain.
The symptoms that may be associated with gynacomastia are swollen breast gland tissue and tenderness of the breast. Male breasts can develop as part of the normal development process and can affect a normal pubertal male. However, other factors that may influence the onset of this condition are: aging, as the production of testosterone decreases with age, as a side-effect of some other disease or condition and as a reaction to some other medication.
There is no such treatment required for physiologic gynacomastia. In most of the patients, pubertal gynacomastia gets resolved within a few weeks to a couple of years. When gynacomastia occurs due to hypogonadism, parenteral or transdermal testosterone therapy is done. A patient will have to undergo medical or surgical treatment if they are suffering from idiopathic gynacomastia or residual gynacomastia. Pharmocologic therapy requires the use of some drugs. Breast surgery is recommended for those who suffer from long-standing gynacomastia or those who have not benefitted from medical treatment.
Reduction mammoplasty is done to surgically reduce the size of male breasts. The chest is flattened by reducing the size of the breasts and this helps to improve the shape of the male chest. The location and size of the areola can also be adjusted if the breast tissues are extremely heavy causing the areola to sag. On the other hand, liposuction is done if male breasts appear due to too much fat. In this procedure, a narrow canula is used to suction off the excess fat. Excision technique is utilized if excess skin and grandular tissues are to be removed.
Other than surgical interventions, some medications can also help to deal with male breasts. Testosterone replacement medications can help older men to reduce their male breasts. Clomiphone is another drug used to treat gynecomastia. Tamoxifen which is a selective estrogen receptor modulator helps to reduce the size of male breasts. This medication is mostly used to treat painful or severe disorders. Danazol is a drug which is not used as commonly as other drugs to treat gynecomastia. However, it is a synthetic derivative of testosterone and it helps to regulate the production of sex hormones.
However, it has to be kept in mind that medications help to curtail gynecomastia only in the initial stages of the treatment. Scarring of the tissues occurs after about 12 months and medications do not produce any beneficial effects after the 12 months. In this scenario, surgical intervention is required.
A man is eligible for surgery to treat gynecomastia if he feels that his breasts are too large and alternative medical therapies are not helping them to successfully address the condition. Some of the prerequisites for this surgery include: a man should be healthy and be of average weight, he does not suffer from any other medical conditions or takes medications that may interfere with this treatment and he has stabilized breast growth. Testosterone replacement therapy may be good for older men but it may cause further enlargement of breasts in men with healthy levels of testosterone.
A person who is not too old and has healthy amounts of testosterone are not eligible for testosterone therapy. A person suffering from any other medical condition for which he is receiving treatment should consult his doctor before going for gynecomastia surgery. An unhealthy person is also not eligible for any surgical intervention.
Some of the side-effects associated with testosterone replacement therapy are acne or oily skin, stimulation of prostate tissue resulting in increased urinary symptoms like decreased stream or frequency, increased risk of blood clots, occurrence of sleep apnea, reduction of size of testicles, mood swings and increased risks of heart attacks and strokes. Sometimes, testosterone replacement surgery can cause breasts to get enlarged in people with normal levels of testosterone.
A person undergoing testosterone replacement therapy needs to go for regular check-ups and adhere strictly to the guidelines recommended by the doctor. A person should take proper rest for at least 3 days after the gynecomastia surgery. Movement of the limbs is also restricted in some cases. A person can resume normal physical activities only after 3 weeks. After the surgery, direct exposure to sunlight should be avoided till the bruising and swelling subsides. Consumption of alcohol and other drugs should be completely halted till a few days after the surgery.
A person undergoing reduction mammoplasty will have to take a break for about 1 month to recover from the effects of the surgery. A person will feel tired and may also experience some pain due to bruising and swelling. It will take about 4-6 weeks for these effects to subside. A person undergoing testosterone replacement therapy will experience the beneficial effects within 4-6 weeks in most cases. However, the entire treatment may take a lot of time and the duration varies from person to person.
Gynecomastia surgery in Indian generally costs something around Rs 60000. It can vary according to the procedure used and also according to which surgeon is performing the surgery. Clomifone may cost between Rs 650 – Rs 6500 depending on the duration of the treatment cycle. Tamoxifen medication for 1 month also costs around Rs 6500. Testosterone injections are available for Rs 5000 per injection approximately.
The effects of breast reduction surgery in males are deemed permanent. However, a man may again develop a larger breast if he gains weight or due to the effect of some other medications. Medications used for breast reduction normally help to deal with the external manifestations but do little to address the underlying causes. Therefore, their effects are not permanent as a person may again develop larger breasts once he is stops taking the medication.
Breast reduction can be done by men by reducing their body weight. A couple of cups of green tea every day helps in this aspect due to it is a natural anti-oxidant. Turmeric boosts the levelof testosterone and so helps to address gynecomastia. Milk thistle contains silymarin and so helps to cure gynecomastia. Other treatments may include consumption of hot water and dandelion leaves, consumption of ginger root tea and taking a bath in water mixed with Epsom salt.