Gynaecomastia is a benign enlargement of the male breasts occurring usually unilaterally or bilaterally and has the appearance of female breasts. The literal meaning of this term is ‘female breasts ‘. Gynaecomastia typically appears in males due to imbalance between the masculine and feminine sex hormones; estrogens exceed the androgens in the blood, which act on the male breast bud to cause gynaecomastia.
The majority of the cases of gynaecomastia have no recognisable cause; however , certain considerations associated with this disorder are:
Physiological
- When born, maternal estrogens cross the placenta and cause gynaecomastia in the baby boy that typically resolves without further action inside a few weeks.
- At adolesence, 50% of the boys have asymmetrical gynecomastia, which might be a source of embarrassment for them. It commonly resolves spontaneously in 16-18 months. Surgical removal (male breast reduction) is needed if it doesn’t resolve in the stipulated time, as fibrous tissue is laid down.
Pathological
- Hyperthyroidism
- Liver disease – it alters the metabolism of estrogens, so raising their levels in the blood.
- Estrogen manufacturing tumors (testis and adrenals).
- Human chorionic gonadotropin (HCG) producing tumors (testis and lung).
- Starvation
- Cancer of breast
- Atherosclerosis of testicular artery impairs testosterone production and cause ‘senile’ gynaecomastia.
Medications – affect metabolic and hormonal pathways causing gynaecomastia.
- Estrogenic drugs like estrogens, digoxin, cannabis and diamorphine.
- Anti-androgens like spironolactone, cimetidine and cyproterone.
- Other drugs like gonadotrophins and cytotoxics.
Gynaecomastia is still regarded as a taboo in our society. Only a few men developing this condition talk about the subject and adolescent boys even don’t share it with their parents or friends. They just try to hide in a corner to avoid naive remarks that can affect their self-worth badly.
Gynaecomastia surgery has started to become very popular in the U.S and worldwide. In teens and adults the definitive indication for gynaecomastia (male breast reduction) is the presence of stable enlarged breasts for two years, without any change.
There’s a combination of fat and breast tissue in the chest of men having gynaecoamastia, certain instruments have been designed so as to remove both sorts of tissues simultaneously. A sharp liposuction instrument is employed for this treatment. A tiny nick is made close to the armpit and the excess tissue is removed. This technique minimises the scar tissue formation, an important aspect of cosmetic surgery.
After the medical technique the time required for recovery can be short; soreness in the breasts is felt for a few days which can on occasion be resolved by taking analgesics. Patients are usually able to resume light work after seven toten days and commence some exercise. Driving is permitted usually after roughly a week to reduce irritation due to the seat belt.
Where the breast enlargement is predominantly due to fat accumulation, this is termed pseudo-gynaecomastia and can be treated in a similar way.
Before starting on any cosmetic medical technique, it is essential to review the treatment’s suitability with a qualified cosmetic surgery consultant.
Anna Sola is a longtime article writer, publishing articles on a wide range of subjects including travel and cosmetic surgery. How to select a cosmetic doctor is a specific field of interest.
