Gynecomastia – Enlarged Breast Tissue
Learn More About Gynecomastia
Gynecomastia is a medical condition that causes the enlargement of breast tissue in men. The enlargement is caused by genetics, some medications or a combination of a chemical imbalance effecting estrogen and testosterone levels in men leading to an increase in breast fat cells and tissue. Although short term gynecomastia is a normal part of male development during puberty, the size of the breasts usually contract after puberty. However, gynecomastia can continue after adolescents or present later in life.
Though it is not a medical condition with serious side effects, gynecomastia does have significant negative consequences on psychological health and can lead to poor body image and depression. One of the first courses of treatment for males with gynecomastia is non-surgical and involves hormone regulation, some weight loss and the use of additional prescription medicine. However, the most successful treatment is surgical reduction. Surgical reduction for males with gynecomastia is one of the most uncomplicated of surgical procedures, and can be treated using two different methods.
Men presenting with gynecomastia have a solid or hard elastic type ball shaped mass they can feel under their nipple in one or both breasts. The mass is usually about an inch or two in diameter and painful to the touch. Men with gynecomastia may notice discharge.
- Puberty. Short term gynecomastia is caused by the temporary hormone imbalance during puberty and usually will resolve after puberty.
- Hormone levels. For men who have completed puberty and still present with enlarged breasts, a chemical imbalance could be the reason.
- Use of heroine, marijuana, amphetamines and anabolic steroids can cause enlarged breasts.
- Heavy use of alcohol.
- An overactive thyroid, kidney disease and tumours can also cause gynecomastia.
What is Right For You
If you are considering surgery to reduce enlarged breasts, Dr. Craft will work with you to create a surgical plan and choose the method most beneficial to you. Men with gynecomastia may experience the following difficulties and challenges resulting from their affliction:
- Poor body image and self-esteem.
- Negative side effects from the chemical imbalance.
- Interfere with sexual relationships. Some men report the size of their breasts are unsightly and negatively affect the intimacy and relationships with their sexual partner.
- Some men presenting with gynecomastia may experience pain during exercise and other physical activity.
Not everyone is a suitable candidate for liposuction. Before determining that liposuction is right for you, consider the following ideal candidate qualities:
- Men who have had their hormone levels have been tested and hormone therapy to level and regulate any imbalances has been attempted without decrease in breast size.
- Men who have completed puberty but present gynecomastia minimum of 12 months following puberty.
- Individuals with a body mass index that is below 35, and preferably less than 30. As the BMI increases, the complications post-surgery also increase.
- Individuals without co-morbidities or other factors that may impede healing post- surgery.
- Individuals who do not smoke.
- Men who are not using recreational drugs or anabolic steroids.
When gynecomastia is primarily caused by an oversufficiency of fatty tissue, your surgeon may recommend liposuction. Liposuction (or lipoplasty) is a body-sculpting procedure to remove localized fat that is unresponsive to dieting and exercising. Liposuction differs from traditional plastic surgical procedures in that it is commonly used on multiple areas, including the chest. The initial phase of liposuction involves the dislodgement of fat and tissue. Once the fat is dislodged, the surgeon makes very small incisions in the skin and inserts very small tubes called cannulas into the incisions. The surgeon then removes the fat through the cannulas. After eliminating the excess fat, the incisions are closed by applying an advanced dressing to the area in order to prevent bleeding, reduce swelling, and support the affected area.
If gynecomastia involves excess of glandular breast tissue or there is excess skin, or if the nipple needs to be repositioned to enhance contour and overall appearance. During excision, the surgeon removes the tissue and skin through a more invasive technique. Excision involves two incisions along the top and bottom of the breast. The position and the length of the incision depends on the amount of tissue to be removed but are usually situated around the areola or in the fold of the chest. The excess tissue and skin is removed as well as the nipple. Once the surgeon has removed the appropriate amount of tissue and fat, the nipples will be repositioned.
Combination of Liposuction and Excision
For men who have a lot of fat tissue as well as excess glandular breast tissue and skin, the surgeon may recommend a combination of liposuction and excision. The surgeon will perform the liposuction first followed by excision.
Dr. Craft will work with you to choose a surgical technique that matches your goals and provides the most beneficial outcomes.
Procedures & Techniques
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The length of the recovery will depend on how extensive of a procedure the patient undergoes. Although some results are apparent immediately following surgical procedures, for the first few weeks post-surgery, most patients report swelling and puffiness. These symptoms are gradually reduced and resolve within four to six weeks following the surgery.
Patients sometimes report pain after the procedure. Commonly, the most pain is felt the first 48 hours following the procedure and slight pain may be reported for several weeks following the procedure. The pain can be treated effectively with oral medication. While complications are rare, patients can minimize the risk for potential problems by carefully following the directions given after surgery.
The stitches will be removed shortly after the surgery depending on the procedure(s) involved. Your surgeon will give you instructions for follow-up appointments as necessary. Although there will be a scar, your surgeon may recommend scar diminishing cream. With time the scar will become less prominent.