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Evolve Cosmetic » Cosmetic Surgery » Gynecomastia-Male Breast Reduction

Male breast Reduction (Gynaecomastia correction Surgery)

Even males have breasts and in contrast to the females, they are embarrassed by large breasts!
On a serious note, it is a serious issue especially in teenage boys if their breasts are large. They feel embarrassed and feel secluded. They have problems in being bare chest and are unable to wear T-shirts. They suffer from peer pressure syndrome and their core competence and studies also get affected at times. Correction of the deformity has huge positive psychological impact. The parents are not only anxious because of their children’s psychology but also because they have plenty of doubts right from personality to infertility. They feel that it may be a tumour especially if the enlargement is asymmetrical. They may feel that breast enlargement may mean some female deformity component inside the body. They are worried about the implication of this in regards to the sexual function and orientation of the child. There may be plethora of unresolved thoughts in their mind. Often they are not able to share with anyone and do not even know that this can be corrected. It is thus very important to address this seeming small issue because it can have big ramifications.

Male Breast Reduction

Causes for male enlargement in Males

Breast enlargement in males usually happens during the time of puberty and is usually minimal (which is normal). In some boys the breasts enlarge more. Some enlargement of breast is normal in old persons because of diminishing male hormone levels. This enlargement may be Genetic, environmental or due to a disease.

Genetic: Children of men who have large breasts are more likely to have larger breasts. At the same time, there is no standard prediction index for the same.

Environmental: The environmental factor is the change in diet and lifestyle. With the popularity of fast food and fuzzy cold drinks, the level of obesity in children has increased. This obesity in turn has profound impact on the level of female hormones in the body. These hormones which are usually in minute quality even in males are produced more in obese patients. The female hormones which are in excess are produced by the fat. Fat thus increases the female hormone levels. The female hormone estrogen also increases the fat thus leading to more obesity. This further obesity leads to more estrogen production. Thus a vicious cycle is precipitated. Female hormone increase the amount of breast tissue.

Lack of exercise: world over, the behaviour of children has changed with the availibilty of Online and computer games and the shrinkage of open spaces especially in Urban population. This lack of sports and outdoor activity along with diet change has led Child obesity epidemic. And along with Obesity comes large breasts.

Diet: There are synthetic substances in the fast food which have action similar to oxytocin which is another female hormone with similar features. High sugar content of the cold drinks high fat content of the fried food increase the obesity directly, which apart from the estrogen effect, directly gets deposited all over the body including the chest.

Diseases of Liver and adrenal gland and tumours of the testes and some other tumours can also cause rise in the female hormone levels and cause male breast enlargement.

Medicines: Long term uses of some medicines can also give rise to large breasts. It is best to disclose to the doctor if any medication is going on especially from a long time.

Ideopathic: Many a times, there is no obvious cause which is called idiopathic. These enlargements are bilateral or both sided. Unilateral enlargement can occur in the tumours of the breast or sometimes idiopathic (cause not known or without any cause!).

Investigations: The most important aspect of the approach is to do a detailed history taking and clinical examination. The most important and often omitted part is the examination of the testes to rule out any testicular tumour. Since the problem is in the chest, examination of testes especially in young boys may be little embarrassing for the child. This should be handled with due sensitivity after proper counselling of the child and the parents. It is preferable to do such an examination in front of the parent and in presence of a staff. Other general examinations and abdominal examination is also done as and when required. The specific test which is used to start with is an ultrasound of the breasts which can show the anatomy of the breasts. Usually this is the only test required. In case of tumour or other diseases other tests may be asked for like FNAC, Biopsy or MRI or the breast Tests for fitness for surgeryis required if surgery is contemplated.

Assessment: Gynaecomastia or male breast enlargement can be mild or severe. The breast which is enlarged consists of fat, the breast tissue and the enlarged skin envelop. To treat the condition well, one needs to know each one of the parameters. It has been classified into grade 1 to grade 4. The grades are based on the size of the breasts and the laxity of the skin. Technicalities apart, the aim of these classification is to understand how good the final outcome would be after the treatment and how and where the scar will be there after the surgery. Naturally, if the patient has a huge breast with large excess sagging skin, the patient will have bigger scar due to removal of the excess skin. In contrast, patients with firm skin and not very big breasts may have a very minimal scarring.

The treatment is usually surgical unless the gynaecomastia is due to some secondary cause like Tumours of the testes or liver issues where the treatment of the primary cause may treat the breast enlargement also. Similarly losing weight or stoppage of the offending medicines if any can lead to some reversal. Surgery remains the gold standard for the treatment of Gynacomastia. With the advent of Liposuction, the surgery is so simplified now a days that the results are almost always gratifying with minimum morbidity and hospital stay. Usually liposuction is used to suck out the fat component of the breast and looses the dense breast tissue. The residual breast tissue is removed through a small periareolar incision at the junction of areola to the normal skin. This cut is hardly visible in the long run. For larger breasts with loose skin the techniques may be different including the techniques which are used for female breast reduction or at that time staged surgery is performed.

Sutures are removed after 7 to 10 days time. The swelling lasts for about 6 to 8 weeks’ time. Final result is obvious by around 6 weeks after which gradual improvement takes over some months. Office work can be resumed in a couple of days. Aerobic exercises can be started after about 10 days but isometric exercises are avoided till about 6 weeks.

Pressure garments need to be worn for about a month or so and massaging of the tissue is advised after a couple of weeks

Hospitalization: Usually Gynaecomastia surgery is done under general anaesthesia and as a day care procedure. Sometimes local anaesthesia may be contemplated. In large breasts hospitalization may be required.

Complications:Usually the results of the surgery is very gratifying. Sometimes there may be bruising, pain and swelling which may last longer than usual. Blood clots or hematoma may happen rarely. Irregular contour of the reduced breast may happen which usually settles with time. At times a secondary correction may be required.

Other surgeries which are usually combined with Gynaecomastia correction surgery is liposuction of the tummyor lateral chest wall. Usually liposuction of only the breast area will leave fat on the side of the chest leaving a feeling of depression on the chest wall. This is best avoided by fully marking the surrounding area in the standing position for liposuction which means the upper adjacent abdomen and sides of the chest. This being not an extensive surgery, it can be combined with other procedures as well.

Words of Wisdom: Male breast surgery or Gynaecomastia correction surgery is a simple surgery with minimal scarring. Contrast to the older days before the use of Liposuction, there used to be a large scar along the chest wall. Such incisions are obsolete now except for exceptional cases. It is imperative thus, that the patient discusses in detail about the incision and the post op scarring to avoid any disappointment post operatively. On the part of the patient it is equally important to know that there may be small irregularities which are likely to be minimised over a few months time. Very rarely any additional secondary surgery may be required. At La transfromatione, we have helped plenty of patients usually young boys overcome their anxiety and complex due to enlarged breasts. These patients and their parents are so anxious before the surgery but with detailed counselling and the surgery almost all of them are satisfied.

Clinic Address

Flat no 102 first floor,The central,
Near Railway Level Crossing,
Chembur Station Road,Chembur(E),
Postal Colony Chembur East, Mumbai-400071.