Enlarged Breasts in Men – Gynecomastia

Gynecomastia is nothing to be embarrassed about because it’s fixable. It happens in boys or men who have an imbalance of the testosterone and estrogen hormones leading to an excess amount of breast gland tissue. Gynecomastia can affect both breasts or one breast and sometimes in an uneven manner.

Hormone levels in older men, newborns, and boys going through puberty normally change, leading to gynecomastia.

Gynecomastia can be a tough medical condition to cope with, although it isn’t a serious problem. Sometimes, boys and men with gynecomastia experience pain in their breasts, causing them to feel embarrassed.

Although gynecomastia can sometimes go away on its own, other times, it doesn’t. If it persists, you can always count on for medication or surgery to treat this issue.

 

Gynecomastia Symptoms

Gynecomastia has very visible symptoms and signs, including:

  • Breast tenderness
  • Swollen breast tissue

Male normal chest tissue and Gynecomastia

Gynecomastia Causes

When the amount of testosterone compared with estrogen hormone is low, it triggers g gynecomastia. Some medical conditions can cause a hormonal level decrease by blocking the effects of testosterone, increasing your estrogen, or reducing testosterone levels.

Several things, including the following, cause the hormonal balance:

Normal Hormone Changes

Testosterone and estrogen hormones control our sexual characteristics in men and women. Male characteristics like body hair and muscle mass are controlled by testosterone. Female traits like the growth of breasts are controlled by estrogen.

Usually, estrogen is thought of as an exclusively female hormone when men produce it in smaller quantities. Gynecomastia occurs when estrogen levels in males are out of balance with testosterone levels or too high.

  • Gynecomastia in infants.

At birth, most male babies are born with enlarged breasts as they are affected by their mothers’ estrogen. However, after birth, the swollen breast tissue of male infants normally fades away in two to three weeks.

  • Gynecomastia during puberty.

During puberty, gynecomastia is more common and expected because of hormonal changes. Usually, the swollen breast tissues don’t need treatment and will fade away within six months to two years.

  • Gynecomastia in adults.

At the ages of 50 and 69, the probability of gynecomastia peaks again. In a group of4 men, at least one is affected.

 

Medications

Several medications can cause enlarged breasts in men; including:

  • Anti-androgens that treat prostate cancer, an enlarged prostate, or other conditions can cause gynecomastia. Common anti-androgens include spironolactone (Aldactone, Carospir) and finasteride, flutamide (Propecia, Proscar).
  • Anabolic steroids and androgens treat certain medical conditions. Also, sometimes athletes use them illegally to build muscle and boost their athletic performance.
  • AIDS medications. HIV-positive men sometimes receive a treatment regimen called highly active antiretroviral therapy, which can cause gynecomastia. Efavirenz (Sustiva) is an HIV medicine that is more associated with gynecomastia than other medications.
  • Cancer treatment.
  • Tricyclic antidepressants.
  • Stomach-emptying medications, like metoclopramide (Reglan).
  • Anti-anxiety medications, like diazepam (Valium).
  • Ulcer medications, like the OTC drug cimetidine (Tagamet HB).
  • Heart medications, like calcium channel blockers and digoxin (Lanoxin).

 

Street Drugs And Alcohol

Gynecomastia can be caused by:

  • Alcohol
  • Marijuana
  • Heroin
  • Methadone (Dolophine, Methadose)
  • Amphetamines used to treat hyperactivity disorder/ attention-deficit

Health Conditions

Health conditions affecting the normal balance of hormones can cause gynecomastia. Some of these medical conditions include:

  • Aging. As we get older, it’s normal for hormonal levels to change, sometimes causing gynecomastia, especially in overweight men.
  • Malnutrition and starvation. When you deprive your body of necessary nutrition, it causes a hormonal imbalance where testosterone levels drop and estrogen levels don’t change. Also, when you start properly nourishing your body, it can sometimes lead to gynecomastia.
  • Hypogonadism. Medical conditions like pituitary insufficiency or Klinefelter syndrome affect normal testosterone production and can cause gynecomastia.
  • Hyperthyroidism. It’s a medical condition where the thyroid gland produces too much thyroxine hormone.
  • Tumors. Tumors that involve the testes, pituitary gland, or adrenal glands can secrete hormones that change the balance of the male-female hormone.
  • Liver failure and cirrhosis. Sometimes cirrhosis and liver problems medications change hormone levels associated with gynecomastia.
  • Kidney failure. Gynecomastia occurs in nearly half the people being treated with dialysis due to hormonal changes.

Herbal Products

Lotions, shampoos, or soaps with plant oils, like tea tree or lavender, have been associated with gynecomastia. Scientists associate it with their weak estrogenic activity.

 

When To See A Physician

You should seriously consider seeing your doctor if you have:

  • Tenderness or pain
  • Swelling
  • Nipple discharge in one or both breasts

 

Gynecomastia Risk factors

Risk factors for gynecomastia include:

  • Older age
  • Adolescence
  • Use of androgens or anabolic steroids to improve athletic performance
  • Certain health conditions, including thyroid disease, kidney and liver disease, Klinefelter syndrome, and hormonally active tumors

 

Complications

Gynecomastia surgery, like any other surgery, has some complications after surgery like the risk of bleeding and infection. However, it also has a few physical, psychological, or emotional complications caused by appearance.

Prevention

You can control some factors in your life that might help minimize the occurrence of the risk of gynecomastia:

  • Avoid alcohol. If you drink, do so in moderation. However, it’s always best not to drink alcohol.
  • Don’t use drugs. Steroids, amphetamines, androgens, marijuana, and heroin are some of the drugs you should avoid to prevent gynecomastia.
  • Review your medications. Ask your doctor if your medications cause gynecomastia and if there are other alternatives.

 

How do I know if I have gynecomastia?

Usually, gynecomastia affects both breasts. However, some patients may have asymmetric or unilateral gynecomastia breasts. You can always do self-exams to see if you notice a palpable, mobile, firm, tender, disc-like mound of tissue in your breasts that is located in the middle under the nipple-areolar complex and is not as hard as breast cancer.

Surgeons sometimes suspect breast cancer when they find palpable masses unilateral, fixed, hard, peripheral to the nipple, and associated with nipple discharge, skin changes, or enlarged lymph nodes. To confirm or eliminate the suspicion of cancer, your surgical team performs lab exams, mammograms, and MRIs.

 

Gynecomastia Correction Surgery

Usually, patients with gynecomastia complain about lumps in their breasts with or without excess fat. Your surgeon will typically resolve to liposuction of the excess fat from the breast tissues. Also, patients with very large male breasts require surgical removal of the excess glandular breast tissue through skin excision and/or an incision in the nipple-areolar complex margin.

At Hopitalista, our certified surgeon will perform a proper physical exam of the breasts to confirm gynecomastia and eliminate the suspicion of male breast cancer.

 

How to Prepare for Surgery

Your surgeon will ask you to stop consuming any medications that increase the risk of bleeding and smoking. Also, you’ll be advised to increase your nutrition to support your recovery and healing after gynecomastia surgery.

Most surgeons operate under general anesthesia. However, after examination, your surgeon might find it okay to operate under local anesthesia and oral sedation. After surgery, your surgeon will use drains to minimize the possibility of fluid accumulation. Also, your surgical team will advise you to use compression vests and icing to help reduce swelling, control pain, and control bruising.

 

Recovery after Gynecomastia

Typically, in less than a week, males who correct their enlarged breasts by liposuction only can return to work and exercise. However, patients who remove excess breast tissue surgically can take two to four weeks to recover and resume daily activities.

Patients can go back to work after gynecomastia at 7-10 days. Also, they can do cardio at the gym at two weeks and weightlifting at four weeks, except for those who experienced any complications from surgery.

 

Gynecomastia Surgery Risks & Complications

Generally, patients have smooth recoveries, and gynecomastia surgery is safe. Complications can occur with gynecomastia even though the surgical team and patients pay great attention to safety instructions.

Common risks and complications of gynecomastia include:

  • Visible Scarring,
  • Bleeding,
  • Bruising,
  • Contour Irregularities,
  • Fluid Collections,
  • Loss Of Nipple Skin,
  • Inverted Nipples,
  • Numbness Of The Nipples,
  • Loose Breast Skin, And Asymmetries.

we maximize the possibilities of good results by paying attention to pre/peri/postoperative management and careful surgical technique.

 

FAQ Gynecomastia

When can a patient undergo gynecomastia surgery?

Generally, it’s best to wait until you are 18 years old to undergo gynecomastia. Hormonal fluctuations that occur with adolescence spontaneously resolve within a few years, bringing along the potential resolution of breast tissue enlargement.

Which type of anesthesia is administered?

Your surgeon will consider the patient’s medical condition and his tolerance to determine the type of anesthesia. It can be either local or general anesthesia can be applied.

What results can I expect after gynecomastia surgery?

First, you should discuss with your surgeon the results to expect before the operation so you can have realistic expectations. Your surgeon and surgical team will help you set realistic expectations and inform you of the potential outcomes.

When can I return to my work and social life after surgery?

Your surgeon performs gynecomastia by applying a small incision. Therefore, it may take one day after surgery to resume your usual work and social life. Depending on your condition and unique surgery, your surgery may discharge you from the hospital on the same day or accommodate you for one night.

Will I have pain after the gynecomastia surgery?

Usually, after surgery, patients will either feel no pain or a minimum level of pain.

When can I take a shower after the operation?

You may take a shower the next day of the gynecomastia surgery.

After gynecomastia surgery, what kind of scar will I have on my breast?

Gynecomastia surgery performed without incisions in your chest involves only the fat withdrawal through a thin micro cannulae. Therefore, you may end up with scars of the grain size that will fade away in time.

When can I start workouts?

Your surgeon will recommend that you start exercising and working out your chest area at least three weeks after surgery. There’s a great possibility that you may experience pain and edema if you start earlier.

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