Gynecomastia refers to the enlargement of male breasts. It is caused by an imbalance between the hormones testosterone and estrogen. This growth in breast tissue is non-cancerous and can occur in one or both breasts, sometimes with asymmetrical size. Newborn male babies can also develop gynecomastia due to exposure to high levels of estrogen from the mother during pregnancy. It can also occur during adolescence or old age. Although it does not pose a threat to health, it can cause psychological and social distress such as insecurity, shame, and social isolation. In some cases, it may also result in breast pain. While some cases of gynecomastia resolve on their own, others may require medication or surgery as treatment options
Causes of Gynecomastia
- Gynecomastia is caused by an increase in estrogen levels or a decrease in testosterone. Alcohol and drug use and the side effects of herbal products and medications cause this condition.
- Some of the medications that pave the way for the development of gynecomastia are Calcium channel blockers, chemotherapies, ulcer drugs, some antibiotics, antidepressants in the Tricyclic group, various anxiety drugs, antiretroviral drugs, anabolic androgens and steroids, anti-androgen drugs used in the treatment of prostate cancer or prostate enlargement.
- Health problems such as pituitary insufficiency or Klinefelter syndrome can cause gynecomastia.
- Dialysis treatment due to cirrhosis, liver disorders, and kidney failure can lead to gynecomastia.
- Tumors affecting the pituitary gland, adrenal glands or testicles play a major role in the development of gynecomastia.
- Persistent malnutrition and extreme hunger can lead to a decrease in testosterone, which can lead to gynecomastia.
Gynecomastia Symptoms
- breast tenderness
- swelling of the breast tissue
- chest pain
- Nipple discharge.
How Is Gynecomastia Diagnosed?
First, the patient’s medical history is taken and a physical examination is performed. Gynecomastia diagnostic methods may also include blood tests and imaging techniques such as MRI and tomography. On the other hand, examinations such as tissue biopsy and testicular ultrasound may also be necessary.
What is thought to be gynecomastia may be excessively fatty breast tissue. Sometimes the enlargement of the breast can be caused by a breast abscess or cancer. Additional testing may be needed to rule out other possibilities.
How Is Gynecomastia Treated?
If gynecomastia does not go away on its own or if it causes sensitivity, pain or psychological problems that impair the person’s quality of life, treatment is required.
Gynecomastia treatment methods are closely related to the underlying problem. If there is a problem such as cirrhosis, malnutrition or hypogonadism, these should be treated first.
If gynecomastia is caused by normal hormonal changes during puberty, no treatment is needed. Because it will probably get better on its own. However, the patient may need to be evaluated every 3-6 months.
If the drugs used for treatment and other applications do not work, surgical methods are applied.
Gynecomastia Treatment with Liposuction
In this surgery, only the fat in the breast is removed. The mammary gland tissue is not damaged. Fatty-type gynecomastia can be treated with this method.
Gynecomastia Treatment with Mastectomy
In this operation, the surgeon completely removes the mammary gland tissue. Small incisions are used during the surgery. In glandular-type gynecomastia, hard breast tissues need to be removed. In the mixed type, both methods are combined to remove excess adipose tissue and glandular tissue.
How Long Does Gynecomastia Operation Take?
If only liposuction is to be applied, the patient is given sedative drugs. This method is preferred in lipomatous type gynecomastia. The procedure can be performed under local or general anesthesia. This takes an average of 45 minutes.
If mixed-type gynecomastia is present, it is also necessary to reduce the mammary gland. This will prolong the operation time. General anesthesia is preferred in these patients and the operation takes approximately 1-1.5 hours.
After Gynecomastia Surgery
- The process to be experienced after the operation varies according to the technique used in the surgery. If laser or Vaser liposuction methods are used during the treatment, it can be said that the patient will have a comfortable recovery period. Effective results begin to be seen after 3 weeks.
- It is normal for swelling, numbness and edema to occur after surgery. These heal on their own within 1 month. After 1 month, you can start massaging the area manually or with the help of various tools. This speeds up the healing process.
- Again, muscle pain can be seen after the surgery. It is recommended to rest for 3 days and not to move the arms and shoulders too much.
- On the 3rd day after the operation, the person can take a shower and start taking light walks.
- You can go back to work after 3-7 days if you do not have a physically demanding job.
- Smoking should be avoided as it may delay wound healing.
- Heavy sports should be avoided for the first 1 month.
- Generally, there is no need to remove the stitches after the surgery as dissolving stitches are used.
- A medical corset is used after gynecomastia surgery. The patient starts wearing it on the first day of the operation and you should keep wearing it for the period determined by the physician. It is generally recommended to use for 2-3 weeks. After the third week, it will be beneficial to wear it only during the daytime, especially during heavy activities. After 6 weeks, the use of corsets can be stopped.
- Antibiotics prescribed by the doctor should be used regularly. This protects the person from infections.
- At what intervals your doctor has called you for a check-up, you should pay attention to these dates and you should not delay your examinations.
Does Gynecomastia Surgery Leave Scars?
It is not enough to remove only the mammary gland and excess fat in the breasts that are highly enlarged and sagging. The breast tissue should be taken together with the skin on it. The nipples are also reduced and placed in the area where they should be, as a skin patch.
In this way, the clarity of the rib cage is eliminated and a flat breast structure is obtained.
However, the process in question creates a fine-line scar on the rib cage. Since the male chest is hairy, this scar does not cause serious visual distress.
If the patient engages in sports and develops their pectoral muscle, this scar acquires a natural fold appearance.
