Gynecomastia is enlargement of breast tissue in men. There may be enlargement of one or both breasts. There are several medical problems that may cause Gynecomastia however, in most cases there is no known organic cause of breast tissue enlargement in men.

What causes Gynecomastia?

Some of the common causes of Gynecomastia include:

• Physiologic Gynecomastia is seen in newborn infants, pubescent adolescents, and elderly individuals.
  Aging
• Obesity
• Chronic liver disease
• Steroid or Marijuana abuse
• Some medications

  • Drugs that enhance estrogen synthesis such as gonadotropins, clomiphene, phenytoin, and exogenous testosterone
  • Drugs that inhibit production or action of testosterone such as ketoconazole, metronidazole, alkylating agents, cisplatin, spironolactone, cimetidine, flutamide, finasteride, and etomidate
  • Drugs that act by unknown mechanisms such as isonicotinic acid hydrazide, methyldopa, busulfan, tricyclic antidepressants, diazepam, penicillamine, omeprazole, phenothiazines, calcium channel blockers, ACE inhibitors, alcohol, marijuana, and heroin
• Familial Gynecomastia
• Gilbert's Syndrome - Gilbert's Syndrome is a relatively common and benign congenital (probably hereditary) liver disorder, found more frequently in males
• Klinefelter's Syndrome - This is a genetic disorder characterized by abnormal enlargement of one or both breasts in men; hard tiny testicles that never grow, infertility, incomplete masculine body build, height, (6 ft. or more), may not be particularly athletic or co-ordinated.

What happens in Gynecomastia?

Gynecomastia occurs when glandular tissue of the breast swells, usually in response to an excess of the female hormone estrogen or a lack of testosterone, a male hormone.

Who is an ideal candidate for surgical correction for Gynecomastia?

If you are not over weight and have skin with normal elasticity overlying your breasts, are mentally and emotionally stable (whatever your age may be), if you do not smoke or drink, then you are an ideal candidate for surgical correction of Gynecomastia.

What does the surgical correction for Gynecomastia involve?

The surgical procedure for correction of Gynecomastia involves Liposuction or Power Assisted Liposculpture (PAL) and Breast Reduction. The procedure is performed under general anesthesia in a hospital. The surgical correction for Gynecomastia is a procedure similar to Breast Reduction which is performed in women. An incision is made around the areola, excess glandular tissue is excised out, fatty tissue is removed (either surgically or with Liposuction), excess skin may be removed to re-adjust to the new breast contour. If there is only excess fatty tissue in the breast that needs to be removed, your surgeon may just make one or two small incisions, insert a cannula through it, moving it in different directions to break and suction out the fat. The entire procedure for the surgical correction of Gynecomastia may take about 2 hours.

How do I prepare for the surgical correction for Gynecomastia?

All the routine screening tests including blood and urine examination x-ray of chest will be preformed before surgical correction for Gynecomastia. Make sure you discuss in detail all the aspects of the procedure i.e. description of the procedure, scars from the incision, risks involved, chances of post-operative complications, before and after photographs, all the prescription and non-prescription medications that you take including vitamin and herbal supplements. These discussions will help you to make an informed decision and be comfortable with your decision to undergo Gynecomastia correction. You will be advised to eat a healthy diet and stop smoking at least 2 weeks prior to surgery. You will also be advised to refrain from eating or drinking anything at least 12 hours prior to Gynecomastia correction surgery.

What to expect during the recovery period following surgical correction for Gynecomastia?

After the surgical correction of Gynecomastia, your breast will be covered with a gauze dressing. You will be instructed to wear a pressure garment to minimize swelling and bruising. A drainage tube will be inserted to collect blood and fluid which will be removed after couple of days following surgery. You may be hospitalized overnight and allowed to go home the next morning. It is common to experience some pain and tenderness for the first few weeks after surgical correction of Gynecomastia which will eventually subside. There may also be some degree of swelling or bruising. Your dressing will be removed in about 2 - 4 days however, your stitches will be removed after about 3 weeks following the surgery. You will be advised to avoid lifting anything heavy or pushing for the next several weeks although you can resume you non-strenuous daily activities with caution within a week after surgical correction for Gynecomastia. Complete healing generally takes about 3 months after surgery.

What is the outcome of surgical correction for Gynecomastia?

Surgical correction of Gynecomastia has good results and men undergoing this procedure are quite pleased with the results. The changes produced by this procedure are significant and permanent. It is important that you have realistic expectations and discuss them openly with your cosmetic surgeon.

Benefits of surgical correction for Gynecomastia

Gynecomastia can make you self conscious and as a result you may avoid gym classes, athletic activities, and swimming or beach activities and may resort to hiding your abnormal body image with clothes. Surgical correction for Gynecomastia will improve your body image, will boost your self confidence and self esteem and you will be able to enjoy the freedom of participating in sports and activities that expose your chest without being self conscious or embarrassed.

Risks of surgical correction for Gynecomastia

• Bleeding
• Infection and poor healing
• Allergic reaction to anesthesia
• Sores around the nipple that can be treated by antibiotic cream
• Scars from surgery which fade away as time goes by.
• Permanent loss of feeling in the nipple area.
• Slight asymmetry in the size of breasts and unevenly positioned nipples.
• Formation of scar tissue internally

Alternatives to surgical correction for Gynecomastia

Liposuction - Liposuction is used to remove excessive fat tissue from the breasts and under arm area

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