Gynecomastia is a medical condition where there is an increase in the amount of breast gland tissue in male individuals, which is most usually caused due to a hormonal imbalance. If the levels of hormones like testosterone and estrogen are imbalanced, then there is a chance of gynecomastia. This condition can either have an effect on either one of the breasts in an uneven and unsymmetrical manner. In some situations, a person may be affected by this condition on both their breasts at the exact same time. Male individuals going through puberty or elderly men are susceptible to the condition due to the hormonal changes that they are subjected to.
Gynecomastia is not a serious or life-threatening medical condition, but it can be difficult to deal with. Individuals who have the condition often suffer from intermittent pain in their breasts and their shoulders. They also feel embarrassed in social and romantic situations due to their modified appearance. In most cases, the problem goes away on its own – especially if it occurs in teenagers. However, if the increase in tissue size is persistent, then one can turn to surgical and medicinal alternatives. Here is some information about what exactly causes gynecomastia.
The Preliminary Causes of Gynecomastia
Gynecomastia is generally caused due to an imbalance in the levels of testosterone and estrogen, which are the primary sex hormones in human beings. This condition generally results when the level of testosterone is comparatively much lower than the level of estrogen. The imbalance in hormone levels can be caused by a variety of factors.
. Natural Hormone Level Changes
The human body is subject to variations in its hormone level throughout its entire life. Sex hormones are in charge of regulating the secondary sexual characteristics of humans. That is why a comparative imbalance and change can result in physical effects as well.
Gynecomastia is actually extremely common in infants and pubescent males. 50% of male infants are born with swollen breast tissue for being in close proximity to their mother’s estrogen. The body also undergoes several hormonal changes during puberty, which is why pubescent males also have to face this issue. But in both these cases, the hormone level regulates itself, and the swollen breast tissue corrects itself in a very short time.
Hormonal imbalance is also a side effect of many well-known medications. For example, anti-androgen drugs such as flutamide, acrospire, etc. that are used to treat prostate cancer are known to cause hormonal imbalances and gynecomastia. Apart from these drugs, anabolic steroids and AIDS medications can also result in a hormonal imbalance and gynecomastia. Antidepressants and ulcer medications can also cause a lowering in the testosterone level and cause gynecomastia.
. Pre-Existing Health Conditions
Gynecomastia may also be caused due to pre-existing health conditions such as hypogonadism, tumors, hyperthyroidism, cirrhosis, renal problems, etc. If there is any health problem that affects the overall functioning of the body’s hormones, then that might result in the swelling of the breast tissues. That is basically why individuals suffering from diabetes, hyperthyroidism, hypogonadism, etc. are generally affected by this issue. This condition is also a common occurrence in individuals who have begun to age. During the aging process, there are hormonal changes spurred on by the countless other changes that the body begins to experience. That is the reason why many senior citizens develop gynecomastia.
. Diagnosis for Gynecomastia
If you notice that your breast tissue has increased considerably in size, the first thing you should do is make an appointment with the doctor. The doctor will ask you a number of questions about your medical history, lifestyle habits, and preexisting medical conditions. They will also perform a careful and thorough physical examination and check your vital signs, such as your blood pressure. Your breast tissue, abdomen, genitalia, etc. will also be given a thorough examination. To determine whether your swelling is indeed gynecomastia, the doctor will probably first ask you to get a mammogram and a complete blood test.
Depending on the results of these tests, the doctor will consider further testing to make sure that the swelling is only due to gynecomastia. Confirmatory tests include CT scans, MRI scans, testicular ultrasound tests, and breast tissue biopsies. The doctor might do one or more of these tests to pin down the underlying condition that you have. They will want to definitively rule out some of the other conditions that have the same symptoms as gynecomastia. These conditions include breast cancer, breast abscesses, and fatty breast tissue. Although mammarian cancer is rare in men, it has been known to occur. Also, abscesses generally occur due to an infection. Fatty breast tissue is not a problem.
The Treatment Process for Gynecomastia
Gynecomastia is not a serious medical problem, although it can be a cause for embarrassment. In most cases, the hormonal imbalance corrects itself and the swelling goes away on its own. If the swelling is due to an underlying hormonal condition, then that will require its own treatment and medication. A doctor will recommend medical or surgical intervention if the condition becomes painful or embarrassing. Even though there is no specific medication for this issue, drugs like tamoxifen and anastrozole have shown very promising results. These drugs are used to inhibit aromatase compounds and were originally intended for individuals who are suffering from breast cancer. If medication does not work, there are surgical options available.
If the enlarged breast tissue is embarrassing, persistent, and painful over some time, then the doctor will ask you to explore the surgical options that you have at your disposal. If you want to treat gynecomastia, then there are basically two options available. The short-term solution is liposuction, which will remove the excess fat from the breast gland tissue. The long-term solution is mastectomy, which will remove the breast gland tissues themselves. It is very minimally invasive and involves a very short recovery period. Here is some more detailed information about the two gynecomastia treatment surgical procedures – liposuction and mastectomy.
A Closer Look At Liposuction
Liposuction is a cosmetic surgical procedure that surgically removes the fatty tissue from specific areas of the body. Some of the areas that are generally subjected to liposuction include the hips, the abdomen, the buttocks, the neck, and the breasts. Apart from removing the excess fat from these areas, liposuction also involves the surgical contouring and shaping of the body to look more attractive and aesthetically pleasing. Apart from cosmetic reasons, liposuction is also a very effective treatment of the condition of gynecomastia, where there is an excess fatty tissue buildup in an individual’s breasts.
Liposuction removes the fat cells from the affected area and basically decreases the number of these cells. Fat cells are actually known to expand proportionally in size and volume as a person gains weight. To ensure that the change in the shape and contour remains permanent, the individual has to work hard to ensure that they do not become overweight again. To be eligible for liposuction surgery, you will need to be in sound health. You will also have to be without conditions that can endanger your life and complicate matters, such as diabetes, bleeding disorders, immune system disorders, etc.
Preparing for Liposuction
Before getting the surgery, you will have to discuss your expectations and exact needs with the plastic surgeon who will be operating on you. To ensure that there are no bleeding complications during surgery, your surgeon will ask you to stop taking blood thinning medication such as ibuprofen, aspirin, and NSAID for at least 2-3 weeks prior. The time assigned for recovery will depend on the amount of fat being removed. To correct a case of gynecomastia, the surgeon will use a local anesthetic such as lidocaine. Here are the various kinds of liposuction procedures that are available.
1. Tumescent Liposuction: First, the area is injected with a sterile solution consisting of saline water, anesthetic, and epinephrine. This causes the area to go numb, swell and stiffen. After this, the surgeon inserts a tube called the cannula into the area. This tube suctions the fat from the body.
2. Laser-Assisted Liposuction: Instead of using the sterile solution to break down the fatty tissue, a high-intensity laser is used to do so. The surgeon will insert an optical fiber into the affected area and emulsify the fatty tissue with the help of the laser. The fat is then removed.
3. Ultrasound-Assisted Liposuction: The surgeon inserts a metal rod into the affected area which will emit ultrasonic energy beneath the skin. This energy will rupture the cell walls of the fatty tissue and make it very easy to remove. The surgeon will then remove the tissue with a suction cannula.
4. Power-Assisted Liposuction: In this sort of liposuction, a kinetic cannula is used which moves in a back-and-forth motion when placed underneath the skin. This breaks down the adipose tissues, which are then removed with the help of the vacuum suction pump that’s attached to the end of the cannula.
A Closer Look at Mastectomy
A mastectomy is a surgical procedure that involves the total removal of the tissue and glands from one or both of the breasts. Mastectomy is most usually used for patients with breast cancer and is a very effective way of preventing a recurrence. Some breast cancer patients prefer to go for a lumpectomy instead, which removes the tumor and not the breast tissue itself. But this choice is not available for all breast cancer patients. Mastectomy is a very effective and long-term solution for individuals who want a permanent and long-term solution for their gynecomastia.
The mastectomy procedure that is used for removing one breast is called unilateral mastectomy whereas the one that removes both breasts is called bilateral mastectomy. For individuals with gynecomastia, there are several criteria that they have to satisfy before they can opt for this procedure.
The tissue that has to be removed has to be present due to a persistent reason, not common correctable conditions like obesity, pubescence, and medication. Mastectomy is also the only viable treatment option out there if there is a risk of breast cancer. Even though it’s statistically rare, mammarian cancer is still a serious issue.
Preparing for Mastectomy
Before your surgery, you will have to sit down with your surgeon and your anesthesiologist and go over your complete medical history, underlying drug usage, family medical history, etc. This is the perfect time for you to talk to your doctors and figure out what the procedure is going to be like and what your expectations from it should be like. This is also the time when your doctors are going to develop a detailed anesthesia plan suited to your allergies, requirements, etc. You will also have to stop taking blood thinning medication like aspirin, ibuprofen, etc.
The entire procedure will be performed while you are under general anesthesia, and you will be unaware of it. First, your surgeon will make an elliptical incision around your breast and surgically remove all the breast tissue and glands present. Your breast tissue and lymph nodes will be removed and examined regardless of the kind of mastectomy that you spring for. After the surgery is completed, the surgeon will close your incisions with the help of stitches. If there is a collection of fluid near the surgery site, you might find some tubes attached for tissue drainage purposes.
The Aftermath of the Procedure
Once your gynecomastia has been treated with the mastectomy procedure, you will have to cope with quite a few issues as you get on the path towards total recovery. Firstly, you will discover that there is a dressing over your breasts. You might also experience some pain and numbness in your chest and your underarms. Your nurses and doctors will give you detailed instructions about taking care of your surgery site, such as cleaning and noticing signs of infection. You will also be given pain medication for pain management and antibiotics to prevent any infections.
These are the basic surgical procedures that you can opt for if you want to treat gynecomastia. Based on the severity of your problem, you will have to choose the option that’s right for you.