Gynecomastia

What is gynecomastia?

Gynecomastia is the abnormally large development of either one or both breasts in males. Generally occurring during puberty, gynecomastia is quite common and usually goes away on its own after a few months. Gynecomastia can also occur among older men, usually due to weight gain. This condition is typically temporary and benign, but in some rare cases, may be an indication of a more serious underlying disease.

Causes:

The abnormally large development of breasts in males is mostly due to changes in hormone levels. During puberty, the way in which males use or respond to specific hormones, such as androgens (hormones responsible for male characteristics such as muscles, hair, and voice) or estrogens (hormones responsible for female characteristics) typically changes, possibly causing enlarged breasts in males.

Other causes include:

  • Aging
  • Marijuana
  • Excessive alcohol
  • Steroid use (body builders)
  • Hormonal imbalance due to certain tumors
  • Side effects to certain medication
  • Chronic liver diseases

Procedure:

Because gynecomastia can be caused by many different factors, treatment is always adapted to the patient. Usually lasting about an hour to an hour and a half, this procedure is either performed under local or general anesthesia. The classic technique usually involves an incision around the lower half of the nipple and direct excision of excess glandular tissue and fat. Newer techniques can eliminate the scar by using liposuction and gland removal by remote access.

Recovery:

Immediately after the surgery it is possible to experience some discomfort in the breast area. In the classic technique, drains are used for up to one week. In the newer techniques, drains are usually not needed. A compressive strapping is worn over the breast for four weeks. Return to work is usually possible in one to two weeks. Vigorous physical activity is restricted for four to six weeks.

Risks and Complications:

All surgeries expose patients to risks and complications. In cosmetic surgery, all efforts are made to minimize these risks, but they cannot be completely eliminated. A partial list of complications for gynecomastia includes: scarring (classic technique), infection, hematoma, loss of nipple sensation, irregular skin re-draping, and contour deformity. It is important to discuss these risks with your surgeon as part of your decision making pro