Gynecomastia is an endocrine system disorder in which a noncancerous increase in the size of male breast tissue occurs. The classic feature of gynecomastia is male breast enlargement with soft, compressible, and mobile subcutaneous chest tissue palpated under the areola of the nipple in contrast to softer fatty tissue. This enlargement may occur on one side or both.
Gynecomastia is triggered by a decrease in the amount of the hormone testosterone compared with estrogen. The cause of this decrease can be conditions that block the effects of or reduce testosterone or a condition that increases your estrogen level. Gynecomastia can be caused by drugs, steroids or marijuana as well as other factors. These should be discontinued prior to surgery to minimize recurrence.
To diagnose gynecomastia, a thorough history and physical examination are obtained by a physician. Important aspects of the physical examination include evaluation of the male breast tissue with palpation to evaluate for breast cancer and pseudogynecomastia (male breast tissue enlargement solely due to excess fatty tissue), evaluation of penile size and development, evaluation of testicular development. Males with gynecomastia may appear anxious or stressed due to concerns about the possibility of having breast cancer.
The most important question you should ask yourself is: does the condition bother you both psychologically and physically? Should the answer be positive, you should consider surgery and start to gather information that will help you make an intelligent decision while consulting with a Board Certified Plastic Surgeon. Treatment of gynecomastia can help men reshape the male chest and dramatically improve the shape and proportion of your body, enhancing your appearance and your self-esteem.
In general, I recommend you wait until the age of 18 years. There are some circumstances where a person should consider it earlier. For this you will have to consult a Plastic Surgeon.
Patient needs an extensive clinical examination prior surgery by the operating surgeon. There are lots of cosmetologists and qaucks proclaiming treating gynecomastia, you need to be evaluated completely by a Board Certified Surgeon to know whether you need surgery or it needs conservative management. Surgery if required, is best done by a Plastic Surgeon.
Any new lump, one-sided growth (asymmetry of the breast), skin changes of the breast or nipple, or bloody nipple discharge should be immediately investigated by a physician. A biopsy, a mammogram or a sonogram (ultrasound) examination may be advised.
Treatment of the hormonal imbalance and stoppage of the inducing drugs may stop the progression of enlargement. Male breast reduction surgery for established gynecomastia is the only known and recognized treatment. Creams, lotions, massage, injections, exercise and “magic pills” all will do nothing for established gynecomastia. However, they will succeed in making your wallet slimmer.
Subcutaneous matectomy, suction assisted liposuction and in severe case a formal breast reduction is necessary. The procedure is done in daycare facility.
A "CBC," or complete blood count, is required of all our surgical patients. For GRS patients, a "PT / PTT" may possibly be requested if you have been using any type of aspirin-containing medications or certain types of vitamins / supplements. A preoperative TRIPLE H (HIV, HbsAg and HCV) is required by operative theaters. For anesthesia fitness Xray Chest and Serum creatinine is required.
First, diet and exercise are to be strongly recommended - they are great for your general health. But neither will do too much for your gynecomastia. Why?
EXERCISE: Many times, men with gynecomastia have worked out to build up their chest muscles only to be disappointed in their contour. Actually, the excess gynecomastia tissue on the chest sits on top of the muscle and is therefore pushed further out as the muscle enlarges - thereby continuing to mask the muscle contour. It is only after appropriate surgery, when the excess tissues have been removed, that the skin will tighten spontaneously (oftentimes right on the operating table during surgery) and will then shrink down and reveal the nice contours of the underlying chest muscles.
Every effort is made to minimize the scars for surgery. Usually a 4mm (1/6 inch) incision is made on the side of the chest just down from the armpit. This heals so well that, in time, it will resemble a small blemish rather than a scar. If an incision is made around the bottom edge of the areola, it tends to heal extremely well and, although permanent, is virtually undetectable in most patients.
Bleeding / Seroma. Bleeding occurs during surgery but it is stopped by the surgeon before the operation is completed. No patient is allowed to leave the operating room if actively bleeding. Rarely after surgery, a blood vessel.
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