About Gynecomastia Surgery | Endocrinology

Gynecomastia

What is gynecomastia?

Gynecomastia is a common condition in both men and women. The breasts swell and become unusually large. Both males and females have mammary glands, but they are not found in males because they are small and underdeveloped. Enlarged breasts in men affect newborns, adolescents, and the elderly.

In adolescence, 90 percent of cases are resolved. Later in life, these events increase again with age.

This does not mean that someone is overweight without being overweight. It is caused by an excess of breast tissue. Exercise or weight loss does not reduce breast tissue in gynecomastia.

This is inflammation of the breast tissue in both boys and men. This happens when the balance of the two hormones in your body is thrown away. If you have enlarged breasts due to fat deposits, you have a different condition called “pseudo gynecomastia.”

Although breasts do not develop as women do in men, all children are born with a small amount of breast tissue.

Boys’ bodies primarily produce a hormone called testosterone, which guides their sexual growth during puberty. But men also make estrogen, the hormone that drives sexual growth in girls.

When the child is a teenager, or the body of the elderly person has little testosterone, the balance of the two hormones changes.

Sometimes when that happens, a large percentage of estrogen swells male breast tissue. Half of male adolescents and two-thirds of men over 50 have it to some degree.

Alternate name

  • Man boobs

Who gets gynecomastia?

In general, developing adolescent males may be at risk for gynecomastia, which is part of the normal developmental process. Normal baby boys can also have gynecomastia.

Other risk factors:

  • Aging, a decrease in testosterone production can cause the problem due to aging.
  • The risks of developing enlarged male breasts related to specific diseases and conditions (such as cirrhosis of the liver) are risk factors for those conditions.
  • Taking certain medications increases the risk of developing the problem.

Symptoms of gynecomastia

Gynecomastia is not usually a serious problem, but research shows that it can affect self-esteem and cause embarrassment.

The most important difference from gynecomastia is the difference from male breast cancer, which accounts for 1% of all breast cancer cases. The cancer is usually confined to one side, not necessarily centered around the nipple, feels tight, and is associated with skin discoloration, nipple retraction, nipple discharge, and enlarged lymph nodes in the armpit.

“It leads to significant deficiencies in eating behaviors and attitudes compared to general health, social performance, mental health, self-esteem, and controls,”

If gynecomastia persists, treatments are available.

Symptoms of inflammation and tenderness in the tissue of the mammary gland of one or both breasts.

Isola, the pigment around the nipple, increases in diameter, and the diameter of the skin and breast tissue appears uneven.

If there is abnormal and persistent swelling, tenderness, pain, or discharge from the nipple, or a combination of these, it is important to see a doctor.

Causes of gynecomastia

Gynecomastia is triggered by a decrease in the amount of a hormone called testosterone compared to estrogen. Declines can occur due to conditions that inhibit the effects of testosterone, lower testosterone, or increase your level of estrogen.

Many things can upset your hormonal balance, including the following:

Natural hormonal changes

The hormones testosterone and estrogen regulate sexual desire in both men and women. Testosterone regulates male characteristics such as muscle mass and body hair. Estrogen regulates female symptoms, including breast enlargement.

Estrogen is considered by most people to be a particularly female hormone, but men produce it too, although usually in small amounts. Male estrogen levels that are too high or out of balance with testosterone levels can cause man boobs.

Gynecomastia in infants. More than half of male babies are born with enlarged breasts due to the effects of their mother’s estrogen. Inflamed breast tissue usually clears up within two to three weeks after birth.

Gynecomastia in adolescence. Gynecomastia, which is caused by hormonal changes during puberty, is very common. In most cases, the inflamed breast tissue goes away without treatment in six months to two years.

Gynecomastia in adults. The prevalence of man boobs increases again between the ages of 50 and 69. At least 1 in 4 men at this age will be affected.

Medications

Many medications can cause gynecomastia. In addition to:

Anti-androgens are used to treat an enlarged prostate, prostate cancer, and other conditions. Some examples are flutamide, finasteride (Proscar, Propecia), and spironolactone (Aldactone, Carospir).

Anabolic and androgen steroids, prescribed by doctors for certain conditions or sometimes used illegally by athletes to build muscle and increase performance.

AIDS drugs. Gynecomastia develops in men who are HIV positive and receive a course of treatment known as highly active antiretroviral therapy. Efavirenz (Sustiva) is more likely to be associated with gynecomastia than other HIV medications.

  • Anti-anxiety medications such as diazepam (Valium)
  • Tricyclic antidepressants
  • Antibiotics
  • Ulcers from over-the-counter medications such as cimetidine (Tagamet Hb)
  • Cancer treatment
  • Heart medications, digoxin (Lanoxin), and calcium channel blockers
  • Medicines to empty the stomach such as metoclopramide (Reglan)
  • Street drugs and alcohol

Ingredients that cause gynecomastia:

  • Alcohol
  • Amphetamines are used to treat attention-deficit/hyperactivity disorder
  • Marijuana
  • Heroin
  • Methadone (Methodos, Dolphin)

Healthy conditions

Many health conditions can cause gynecomastia by affecting the normal balance of hormones. In addition to:

Hypogonadism Conditions that interfere with normal testosterone production, such as Klinefelter syndrome or pituitary insufficiency, are associated with gynecomastia.

Aging. Hormonal changes that occur with normal aging can cause gynecomastia, especially in overweight men.

Tumors Some tumors, such as the testicles, adrenal glands, or pituitary gland, produce hormones that upset the balance of male and female hormones.

Kidney failure. About half the people being treated with dialysis experience gynecomastia due to hormonal changes.

Liver failure and cirrhosis. Changes in hormone levels related to liver problems and cirrhosis medications are associated with gynecomastia.

Malnutrition and starvation. When your body is deprived of adequate nutrition, testosterone levels drop while estrogen levels remain the same, causing a hormonal imbalance. Gynecomastia can also happen when normal nutrition resumes.

Treatment for gynecomastia

Gynecomastia usually resolves without any treatment, but if there is an underlying condition, it may require treatment.

If the condition is due to action drugs, the patient may need to switch to another drug. If the patient takes the drug for only a short time, the condition may be temporary.

If the condition does not resolve in 2 years or causes discomfort, pain, or tenderness, treatment may be necessary.

Treatment is very rare. Breast reduction surgery or hormone therapy options to prevent the effects of estrogens.

Medicines to treat gynecomastia.

Tamoxifen is a drug that inhibits the action of the female hormone estrogen in the body. It is used to treat and prevent breast cancer, but it also reduces symptoms of breast pain and enlargement in men.

Aromatase inhibitors used to treat breast and ovarian cancer in postmenopausal women can be used off-label to prevent or treat gynecomastia in men.

Establishment of testosterone replacement therapy for man boobs in the elderly with low testosterone levels.

Surgery for gynecomastia

The breast contains glandular tissue, which is firm and dense, and adipose tissue is soft.

The proportion varies among individuals. A man with gynecomastia can have more than two types of tissue.

Liposuction can remove excess fatty tissue. It is the insertion of a small tube through a 3 to 4-millimeter incision.

Excision means cutting through tissue with a scalpel to remove excess glandular tissue. This usually leaves a scar around the edge of the nipple.

If a large reduction of tissue and skin is required, the incision and scar will be larger.

In some cases, both excision and liposuction are used.

After surgery, the chest becomes swollen and puffy, and the patient may need to wear an elastic bandage for 2 weeks to help reduce swelling.

Usually, it takes 6 weeks to get back to a normal routine. Complications from surgery are very rare. They have adequate removal of breast tissue, irregular breast shape, and reduced sensation from one or both nipples

Excision: There is a risk of blood clots. This may require drying.

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