Gynecomastia leads to oversized breasts among males due to higher quantities of estrogen secretion leading to higher than normal estrogen to testosterone ratio in their body.

THE REASON BEHIND GYNECOMASTIA

Several causes could result in Gynecomastia based on the age in which they occur.

In Infants: The condition may result from excess estrogen level from mother.

In Boys:The problem develops as they experience hormonal imbalance due to puberty.

In Middle-Aged and Older Men

With growing age, men may experience oversized breasts due to rise in estrogen level in their body as compared to testosterone. Hereditary traits could be another natural factor. Some external causes may also result in Gynecomastia:

• Drug addiction, or drug abuse
• Injury to testicles that could hamper testosterone’s secretion
• Thyroid
• Exposure to lavender or tea tree oil present in shampoos or creams
• obesity

Researchers are working to find more reasons behind this oversized breast condition.

SYMPTOMS OF GYNECOMASTIA

Unlike the general presumption, Gynecomastia happens due to increase in glandular tissues instead of fatty tissues. You can sense this condition if you notice a sore but painless lump close to your nipple around any one or both breasts. The lump develops due to rise in the size of glandular tissues. In extreme conditions, Gynecomastia may cause breast cancer and prompt medical intervention is necessary.

DIAGNOSING GYNECOMASTIA

Diagnosis is mainly clinical. The specialist doctor will perform varied tests and analysis to diagnose associated conditions or causative factors:

Medical Tests:This may include Mammogram test to diagnose breast cancer and other tests to find out the possibility of mastitis, cysts of fat necrosis. To confirm endocrinal causes for Gynecomastia, the expert will take your blood and urine samples.

Root cause detection: The more open you are about your body, any previous injury or medical condition, the better will be the chances of Gynecomastia diagnosis.

TREATING GYNECOMASTIA

If diagnosed for Gynecomastia, the surgeon will recommend treatment depending on various conditions.

In case of boys reaching puberty, the surgeon may ask to wait till two years as the breast size regains normalcy during this period. If the problem occurs due to medication, the surgeon may suggest an alternate course to combat its effect.

For grown up males, the experts advise the best procedure, from simple medication to surgery, depending on the severity of Gynecomastia.

TYPES OF GYNECOMASTIA SURGERIES

Liposuction: The surgeon performs liposuction to remove fatty and glandular tissues from different parts of the body. This will make the chest look more firm and symmetrical with body.

Tissue Excision: Suitable for males with large sagging breasts, which are hard to treat through liposuction. It involves removing skin and tissues around areola and in the creases between the breasts through incision.

For overweight patients, the surgeon may recommend losing weight before proceeding with the surgery.

ASSOCIATED RISKS

Undergoing Gynecomastia surgery may involve certain risks below. While some of them may be short-lived, others may extend to months.

• Burning sensation for around an year
• Fluid accumulation under the breasts, possibly due to seroma formation.
• Permanent pigmentation or scar
• Allergic behavior to anesthesia
• Possibility of postoperative assymmetry, which may necessitate the need for another surgery
• Numbness in the areas around nipples

SELECTING THE RIGHT GYNECOMASTIA SURGEON

• Qualification, experience and comfort level are among the topmost factors to consider while looking for an expert Gynecomastia surgeon.
• Make sure that he makes the patients feel at ease during initial consultations and during surgery.
• He should make you aware of the associated side effects and possible outcomes of the surgery.
• His dexterity in performing procedures like liposuction or tissue excision also holds high importance.

COST OF GYNECOMASTIA IN INDIA

On an average, the cost of surgery may range between 60,000 INR and 1,00,000 INR. Medication, tests and consultations may accompany additional charges.

PREPARING FOR GYNECOMASTIA

The surgeon may recommend following various measures:

Before-surgery

• Quit smoking for at least two months prior to the surgery.
• Avoid medicines like aspirin or anti-inflammatory drugs one month before the surgery.

During Surgery

• Inform the surgeon about any health problem occurring during the surgery

After surgery

• Ask someone to drive you back
• Do not eat for duration adviced by surgeon
• Keep the necessary items ready and easily accessible at home.
• Keep some ice packs ready
• Take rest for at least a week or as suggested by the surgeon

THE PROCEDURE FOR GYNECOMASTIA

To start with, depending on various factors, the surgeon may administer:

Local anesthesia:To numb your breast

General anesthesia: To make you go unconscious in entirety

Procedure:

The surgeon will create tiny incisions to remove excess fat through Liposuction. Another small incision may be required for removal of glandular tissues around or through nipple which is stitched back with sutures.

Observation:

You will be kept in the observation room for proper after-surgery monitoring. Your compression garment will prevent any damage to the operated area. If things go as usual, you are good to go once the anesthesia loses its effect.

AFTER CARE AND RECOVERY

These suggestions will help you in speedy recovery after the surgery:

• Avoid activities like running, jumping, swimming or jogging for around 1-2 months.
• Wear compression garment for up to 3 weeks
• You may return to your job if it is not fieldwork or requires travelling.
• Stay away from sun for few months
• Take medicines regularly

REGAINING CONFIDENCE

Patients usually observe flat chest contour after around 2-3 weeks of the surgery. You can then get back to your life with a more confident body appearance.

RESULT MAINTENANCE

Gynecomastia results will remain permanent until you maintain your body weight and live a healthy lifestyle. Additionally, avoid using any medicine that could bring your troubles back. Make sure to contact the surgeon in case of unusual pain or sensation in the operated chest area, even if it happens a few months after the surgery.

Dr. Sumit Malhotra

THE INFORMATION IS BEING PROVIDED BY COSMETICSURGERY.IN AND HAVE NO INTENTION TO REPLACE THE MEDICAL ADVICE OF YOUR DOCTOR. PLEASE CONSULT YOUR DOCTOR DIRECTLY FOR ADVICE ABOUT A SPECIFIC MEDICAL CONDITION. THIS DOCUMENT WAS LAST REVIEWED BY DR. Sumit Malhotra, PLASTIC SURGEON ON: 12-JUN-2020