All You Need to Know about Gynecomastia!

What is Gynecomastia?

Gynecomastia is a common condition that occurs when breast tissue enlarges abnormally in men and boys. It is so common that it affects approximately 90% of newborn babies, 60% of teenagers and adults, and 50-65% of middle-aged men. Gynecomastia can happen in one or both breasts. In some cases, the swollen breast tissue will go away without treatment but in other cases gynecomastia surgery is necessary.

This condition primarily occurs when teenage boys enter puberty. This is because so many sudden physical and hormonal changes during adolescence can lead to an imbalance in the level of hormones. Since boys have female hormones in their bodies too, the imbalance of estrogen (female hormone) and testosterone (male hormone) can lead to an increase in the size of the breasts. However, gynecomastia can also occur in other stages of life, notwithstanding the person’s age.

What can cause gynecomastia?

Gynecomastia is aggravated by the decrease in the amount of testosterone production in the body. This can be due to an increase in estrogen levels or testosterone production being blocked. Some of the main reasons for hormonal imbalance are:

1. Aging: aging can lead to hormonal imbalance and can lead to gynecomastia in some cases, especially in obese men.
2. Tumors: some tumors such as adrenal glands and pituitary glands can bring about some changes in hormonal levels in the body. 
3. Hyperthyroidism: This disorder can lead to the thyroxine hormone being drastically secreted from the thyroid gland.
4. Kidney failure: As one of the side effects, about half of dialysis patients complain about breast enlargement due to hormonal changes.
5. Liver failure and cirrhosis

Besides all these reasons, gynecomastia may also be a side effect of some medications. For instance, antibiotics, antidepressants, medicines for prostate cancer, chemotherapy, cardiovascular medicines, and medications used for treating ulcers. It can also be one of the side effects of consumption of illegal drugs like marijuana or heroin. 

Symptoms of Gynecomastia

Symptoms of gynecomastia mainly include feeling a lump under the nipple which is often painful. Swelling breasts, and in some cases feeling pain around nipples or in breasts, is a sign that you should visit a health provider for the right diagnosis. 

Some Ways to Avoid Gynecomastia 

In cases that are not that severe, taking some actions into account can help reduce breast swelling and might help with gynecomastia. These include:

• Consuming less alcohol 
• Dieting and exercising to reduce body fat 
• Avoid doing drugs 
• Avoid using steroids as much as possible 

Gynecomastia Diagnosis 

CT scan, MRI, testicular ultrasound, and tissue biopsy are some of the diagnostic tests that are performed only in special cases. In order to diagnose gynecomastia in men, the doctor first examines the patient’s medical records and medications.Physical examination of the breast and breast tissue can also aid in making an accurate diagnosis. Blood tests and mammography are usually prescribed by the doctor if necessary.

The purpose of the examination is to determine whether the breast inflammation is due to gynecomastia or other reasons. Some conditions that lead to symptoms similar to gynecomastia include:

• Having fat in the breast tissue
• Breast Cancer
• Breast abscess, which is an infection in the breast tissue

Gynecomastia Treatment 

As mentioned earlier, in most cases, gynecomastia can resolve on its own without requiring treatment. However, if some disorders such as malnutrition or liver cirrhosis are the cause of breast enlargement and inflammation, treatment should be done and is necessary. If the use of a specific type of medication has led to gynecomastia, the patient should stop using that medication, and ask for an alternative to be prescribed.

Considering some previous cases, it is rare for gynecomastia to be entirely treated by losing weight and dieting. Sometimes these diets may even cause further problems such as skin laxity and the patient might need to suffer from more problems. 

Undoubtedly, surgery with a suitable technique is the best, safest, most permanent, and in most cases, the only way to treat especially moderate and severe gynecomastia. Basically, surgery is the only permanent and lifelong treatment solution for those who suffer from the inappropriate feminine appearance caused by gynecomastia or the pain caused by it, even in mild cases.

Purposes of Gynecomastia Surgery 

The main goals of performing gynecomastia surgery are:

• Getting rid of an undesirable body appearance: Breasts, which represent femininity, will naturally cause psychological harm to people who wish to have a body with masculine features. Having enlarged breasts can get very annoying and set limitations for that person in social activities, sports, etc.
• Getting rid of sore breasts: There might be some pain in the breasts in men who are suffering from this condition. Therefore, performing surgery can help them deal with this issue. 
• A significant reduction in the risk of breast cancer in men: Breast cancer in men can be caused by particularly bulky and prolonged gynecomastia, and a precise and appropriate surgery, can result in a significant reduction in the risk of breast cancer in men.

Best age for gynecomastia surgery 

Previously, it was recommended that the minimum age for surgery is 16 to 17. However, considering the potential issues that may arise, there is no specific age considered as the best for gynecomastia surgery.

As soon as physical gynecomastia symptoms occur during puberty, we should wait for at least 6 months to two years to see if the problem resolves itself or not and then take action with the help of a health practitioner. If gynecomastia is not resolved after two years, surgery is better to be performed. It should be noted that by aging, surgical techniques will be more limited as the breast volume and size could increase as well. 

Preparing for gynecomastia surgery 

After the physical examination is done by the surgeon, the patient needs to have some blood tests done and these blood tests are not usually complex ones unless the patient has another serious disease and needs more detailed examinations.

Based on the surgeon’s recommendations, some patients may need to:

• Do some specific skincare 
• Quit smoking
• Avoid taking aspirin or other blood thinner medications 
• Avoid taking multivitamins or supplements 

What to expect after gynecomastia surgery 

After the surgery, the surgeon or the surgical team will give the patient some necessary explanations and directions to follow including: 

• Taking care of sutures and drainage tubes
• Paying attention to signs of infection and danger signs after surgery that require immediate care
• To what extent physical activities and movements can be done
• Sports that can be done 
• The right time to see the surgeon again
• The amount of rest the patient needs 
• Which food should be eaten or avoided 

In most cases, the patient needs to take antibiotics. Some ointments may be given to the patient to apply on the skin. Painkillers should also be taken according to the surgeon’s or professional health practitioner’s directions. Blood thinners should not be taken unless they are prescribed by the surgeon in some specific cases.

In addition, due to the use of painkillers, alcohol consumption is prohibited. Consuming nicotine for 6 weeks after gynecomastia surgery is harmful. Smoking can make the healing process slower and cause further complications.

The Results of Gynecomastia Surgeries Performed by Dr. Ariana

Dr. Mehdi Ariana is a specialist in breast surgery as one of the few surgeons who has style in gynecomastia surgeries with his very special technique and with more than thousands of surgeries in patients from all over the world. In more than 16 years of experience and obtaining extraordinary results, Dr Aryana has become a well-known figure in this field all over the world, especially in the surgery of professional athletes and celebrities.