Gynecomastia- the Surgery for Man Boobs
What is Gynecomastia?
If you are a male and if you have breast development, it is called as gynecomastia. This is a result of an imbalance in the hormones, estrogen and testosterone. Gynecomastia can affect either one or both breasts. Males going through puberty and elderly people can develop gynecomastia with the normal hormonal changes. It is common to see gynecomastia in newborns as well. Gynecomastia is not a serious problem but it is a tough condition to deal with. Some males may have pain and feel embarrassed due to this.
What are the symptoms?
1. Enlargement of the breasts
2. Tenderness of the breast
It is important for you to see a doctor if you develop any of the following symptoms.
1. Discharge from nipples.
2. Pain
3. Swelling
What causes gynecomastia?
Gynecomastia is caused mainly by:
1. Changes in normal hormonal levels.
2. Medications
3. Certain medical conditions
Changes in normal hormonal levels
Estrogen and testosterone are the hormones in our body which control the sexual characteristics. Estrogen is responsible for the female characteristics such as breast development and testosterone is responsible for the male characteristics like muscle growth.
Even males produce small amounts of estrogen in the body. Receptors for estrogen, testosterone, prolactin and progesterone are found in the male breasts. Estrogens enhance breast development whereas testosterone inhibits breast development. So, when your estrogen level is more than the testosterone, the breasts begin to develop.
In newborns, they get estrogen to their system through the mother’s milk. So the estrogen level rises and they develop breast engorgement.
Drugs that cause gynecomastia include:
1.Diuretics such as spironolactone
2. Anti-androgens such as Finasteride, flutamide, etc. which are used to treat prostatic enlargement.
3. Anti-anxiety drugs like diazepam.
4. Chemotherapy
5. Alcohol also causes gynecomastia.
Medical conditions giving rise to gynecomastia:
• Hypogonadism. Conditions which affect the testosterone synthesis is associated with gynecomastia.
• Kidney failure. Patients who require regular hemodialysis develop gynecomastia as a result of hormonal imbalances.
• Cirrhosis and liver failure. The reduced liver functions and the medications used to treat this condition also can cause gynecomastia.
• Tumors like adrenal tumors over produces androgens which can cause gynecomastia.
What are the complications?
Gynecomastia is not a serious condition. However, it can cause psychological and emotional trauma to the patients.
Evaluation
Your doctor will ask you questions and examine you. For further evaluation, your doctor may order certain blood tests. A healthy man with a negative history and examination findings may not need any further investigations.
Initially, the doctor may order tests to determine the cause of gynecomastia.
1. Blood tests to assess liver & kidney function, serum testosterone, estrogen and other hormone levels.
2. Mammography
Depending on your initial results, you may need further testing. These include:
1. CT scan
2. MRI scans
3. Testicular ultrasound scan
4. Tissue biopsy
Treatment
If you have had the breast enlargement for a long time and do not have any symptoms like pain, tenderness, or nipple discharge, then you do not need any treatment.
If you have any of the symptoms as mentioned above, then your doctor will prescribe you drugs depending on the cause of the gynecomastia. If the breast enlargement is due to an underlying disease, treating that disease will ameliorate the gynecomastia. Likewise, if the gynecomastia is due to a long term drug you have been using, then stopping that drug would improve the condition.
Medications used to treat breast cancer such as Tamoxifen and Raloxifene may be helpful to some men with gynecomastia.
Surgery
If there is no relief despite the medications prescribed, your doctor will suggest you surgery as the next option. Surgery to remove breast tissue is a widely used treatment method for gynecomastia. There are 2 surgical options:
1. Liposuction – This involves removal of the fat tissue in your breasts.
2. Mastectomy – This surgery removes the breast glands. It is done using only small incisions therefore it has a fast recovery.
