Gynecomastia is an increase in the amount of breast gland tissue in boys or men. It is caused by an imbalance of the hormones estrogen and testosterone. Gynecomastia can affect one or both breasts, sometimes unevenly.
Newborns, boys going through puberty and older men may develop gynecomastia as a result of normal changes in hormone levels, though other causes also exist.
Generally, gynecomastia isn’t a serious problem. But it can be tough to cope with the condition. Men and boys with gynecomastia sometimes have pain in their breasts. It might also be a reason for embarrassment.
Gynecomastia may go away on its own. If it does not, medication or surgery may help.
Symptoms of Gynecomastia
Most men with gynecomastia report no loud symptoms. Signs and symptoms of the condition may include:
- Pain, particularly in adolescents
- Swollen breast tissue
- Breast tenderness
- Nipple sensitivity with rubbing against clothes
Causes of Gynecomastia
In most of the cases, there is no obvious reason found. But certain factors can increase the chances of gynecomastia. Due to increasing cases of obesity, increased use of anabolic steroids, and environmental pollution with estrogen-like substances, the number of patients with gynecomastia are increasing.
It is usually caused by an increase in the ratio of estrogens (female hormone) to testosterone (male hormone). Estrogen, the “female” hormone, makes breast tissue grow. While testosterone, the “male” hormone, has opposite effects on the breast tissue (it stops estrogen from making breast tissue grow).
When to go to a doctor
You should see a doctor if you have one or all of the following symptoms-
- Pain or tenderness
- Nipple discharge in one or both breasts
Who is a candidate for gynecomastia surgery?
- Men whose condition cannot be corrected through alternative medical treatments
- Healthy individuals who do not have a life-threatening illness or medical conditions that can create a problem in healing
- Nonsmokers and non-drug users
- Men with a positive outlook and specific goals in mind for improving the physical symptoms of gynecomastia
- Those who are physically healthy and of normal weight
- Men whose breast development has become stable
- Those who are bothered by the feeling that their breasts are too large
The 4 stages of gynecomastia
- Small enlargement, but without excess skin over the chest
- Moderate enlargement, but without excess skin over the chest
- Moderate enlargement with extra skin over the chest
- Marked enlargement with extra skin over the chest
The course of treatment
When opting for treatment for gynecomastia, your surgeon will-
- Evaluate your general health status and any pre-existing health conditions or risk factors
- Perform testing to determine the underlying cause of gynecomastia; this may include testing your endocrine function
- Examine your breasts and may take detailed measurements of their size and shape, skin quality, and placement of your nipples and areolas
- Take photographs for your medical records
- Discuss your options
- Recommend a course of treatment
- Discuss likely outcomes of gynecomastia correction and any risks or complications
- Discuss the use of anesthesia during your procedure
The recovery process from Gynecomastia surgery (male breast reduction/lift) can vary greatly from individual to individual. This is because each patient is unique in terms of their body’s natural recovery response and pain tolerance. The type of surgical technique used and the amount of excess tissue needing to be removed will also have an effect on recovery time. With that said, the typical recovery time for gynecomastia surgery is 4-6 weeks.
Most patients will experience moderate pain following their procedure. Especially within the first 2-3 days following the surgery. Pain severity will differ based on each man’s tolerance of pain, as well as the extent of the surgery. Pain can be managed through medications.
Depending on surgical technique and the extent of tissue being worked on, scarring along the incision areas is possible. However, a skilled plastic surgeon will place the incision in low-visibility areas. Additionally, treating the area with topical scar lightening creams can help heal and minimize the appearance of scarring. Other laser-based scar treatments are available for addressing larger, more visible scars.
Frequently Asked Questions (FAQ)
- Gynecomastia in infants. More than half of male infants are born with enlarged breasts. This is due to the effects of their mother’s estrogen. Generally, the swollen breast tissue goes away within two to three weeks after birth.
- Gynecomastia during puberty. Gynecomastia caused by hormone changes during puberty is fairly common. In most cases, the swollen breast tissue will go away without treatment within six months to two years.
- Gynecomastia in adults. Researchers have found out that the presence among men ages 50 to 80 is between 24% and 65%. However, most men with the condition experience no symptoms.
- All tests should be completed.
- Chest and under-arms completely shaved.
- Do not eat/drink 6 hours before surgery.
- Wear comfortable clothes.
- Have a responsible person accompany you.
Surgery risks include:
- Anesthesia risks
- Blood clots
- Breast asymmetry
- Breast shape problems
- Changes in nipple or breast sensation may be temporary or permanent
- Damage to deeper structures – such as nerves, blood vessels, muscles, and lungs – can occur and may be temporary or permanent
- Deep vein wounds
- Fatty tissue found in the breast might die
- Persistent pain
- Poor wound healing