Gynaecomastia (Male Breast Reduction Surgery)
Gynaecomastia is the medical term for enlarged or feminized male breasts. Colloquially called as “male boobs” OR “moobs” it refers to enlarged breast in men is caused due to imbalance of the hormones oestrogen and progesterone. It can affect one or both breasts, sometimes affecting more on one side than the other.
Gynaecomastia during puberty: Gynaecomastia affects 60 % of teenage population due to the hormonal changes during puberty but most of the time it is a temporary condition which resolves without any treatment within 6 months to 2 years. It can be physically and psychologically uncomfortable, impacting child’s self-confidence and body image. Parental and patient’s anxiety is reduced by explaining the natural course of the condition as spontaneous regression is common. Thus, surgical intervention is appropriate if the condition persists despite treatment of underlying conditions and/or for greater than 1 year.
Gynaecomastia in Adults: Gynaecomastia, is an extremely common condition affecting 1 in 4 men between 50-69 years of age*. Generally, gynaecomastia isn’t a serious problem, but the embarrassment men feel can have a negative effect on their lives. It often affects their self-confidence, willingness to socialize and intimate relationships. Many avoid removing their shirts at the beach or hide their bodies in layered outfits.
Pseudogynaecomastia, which is related to fatty hypertrophy, exhibits a pattern of increasing frequency conterminous to that of obesity rates.
Causes:
The hormones testosterone and estrogen control sex characteristics in men and women. Testosterone controls male traits, such as body hair and muscle mass. Estrogen controls female traits, including the growth of breasts. Both hormones are present in men and women in different ratios. Gynaecomastia is caused when male estrogen levels are too high or are out of balance with testosterone levels.
Possible causes include genetic predisposition, hormonal imbalance (excessive estrogen), chronic obesity, and use of various drugs, including some anabolic steroids.
Symptoms:
Majority men do not report any symptoms. Signs and symptoms of the condition may include:
- Pain, particularly in adolescents
- Breast tenderness
- Nipple sensitivity with rubbing against clothes
- Swollen breast tissue
Goal of Gynaecomastia Surgery:
The goal of male breast reduction surgery is to create a more masculine chest appearance.
Male Breast Reduction Techniques:
Male breast enlargement may be caused by excess fat or breast tissue, excess areolar tissue or excess skin. It’s important to diagnose exactly what needs to be removed to achieve a slimmer, smoother chest. Male breast reduction is a procedure that removes excessive fat, chest gland and in some cases the skin to re-create male chest contour. There are a variety of different techniques used to treat gynaecomastia which include:
Liposuction for Male breast reduction: In patients who have breast enlargement due to fat alone and have good skin elasticity, achieve handsome results with liposuction alone.
Gland excision along with liposuction: Often there is a more solid breast tissue under the areola (dark area of skin around the nipple) that may require excision in addition to liposuction around the chest to remove the fat.
Skin excision: In extreme cases, such as following massive weight loss, skin removal may be necessary as well. In these cases, the position and size of the areola can be surgically improved and excess skin may need to be reduced, leading to an additional scar.
Recovery:
Improvement in the chest contour is noticed almost immediately. After surgery, patients are advised to wear a support garment, like a vest, for about a 2-4 weeks to minimize swelling and bruising. Some discomfort is expected, but it is easily managed with mild pain medication. Patients return to their routines within a few days, light-duty work is resumed after 3-5 days but strenuous activities should be avoided for 4-6 weeks.
Risks:
Possible but uncommon risks include infection, bleeding, and seromas (pockets of fluid). Each of these complications may be treated effectively with diligent post-operative care.
Conclusion:
Male breast reduction is a simple, effective way to attain a more masculine-looking chest. Gynaecomastia surgery can help to improve self-image and confidence in social interactions. Many men find that they are more sexually confident and report improved sexual prowess following surgery.