Gynecomastia
The presence of an enlarge or over develop breast in men is called gynecomastia. It is a benign common condition amongst men (30-32%). Has different causes and three main types:
1. Causes:
- Hormone imbalance (common during puberty and peaks again after the age of 50),
- Obesity
- Health conditions (mostly related to hormonal imbalances)
- Medications (anti- androgens, diazepam, tricyclic anti depressants, cimetidine,etc)
- Abuse of certain substances like alcohol, cannabis,
- Athletic enhancer drugs like anabolic steroids or androgens
2. Types:
- True gynecomastia, caused by excess glandular tissue,
- Pseudo gynecomastia, cause by fat accumulation,
- A combination of both
Gynecomastia can be a reason for diminished self confidence, specially in teens and young adults. During adolescence this can be aggravated by psychological and emotional stress whenever are exposed, avoiding sports and outdoor practices. In most of the situations, gynecomastia is incipient and regress spontaneously in two to three years, although it can prevail into the adult age. If it don’t , might need specific treatment if it causes embarrassment or pain. After the age of 50, 1 in 4 males will show some degree of gynecomastia.
Treatment
Medical treatment is directed to reduce oestrogen stimulation using drugs that block it’s action (tamoxifen). Although these drugs are efective in same cases, they were not approved for this specific indication.
Surgery- The procedure is done to remove the breast tissue directly (subcutaneous mastectomy) or / and fat deposit using liposuction. Depending on the severity, it can be done under local anesthesia , sedation or general anesthesia, in a out patient or a over night stay at the hospital
Preparation and planning – The downtime is minimal, as is the pain. Swelling and bruising are expected, it is necessary to use a compression garment for the first two weeks and avoid extreme workouts that involve upper body weight lifting and high-impact exercises.
The outcome is usually very rewarding as the surgery ,( mastectomy or liposuction), only leave small scars, generally hidden in the areola, the volume reduction is substancial allowing normal activities without the emotional burden and embarrassment of an enlarged breast.
