Gynecomastia

Gynecomastia is a medical condition of enlarged breast tissues in men and boys. Both male and the female human body have breast glands, but mostly they are not noticeable in men. In gynecomastia, the breast glands swell and become abnormally large. The condition can occur at any stage of development and may be associated with other medical conditions.

What causes Gynecomastia?

Gynecomastia, in most cases, occurs due to an imbalance between the female hormone called estrogen and a male hormone called testosterone. The excess of the female hormone causes the breast glands to swell.

Other than random imbalances between the hormones, gynecomastia can be caused due to many different reasons such as various medications, diseases, and conditions which may include:

  • Drugs like corticosteroids and opioids
  • Antibiotics
  • Herbs like lavender, Dong Quai, and tree oil
  • Heartburn and anti-anxiety medications.

Some medical conditions that can cause Gynecomastia are:

  • Obesity
  • Low testosterone
  • Cirrhosis
  • Hyperthyroidism.

Signs and Symptoms of Gynecomastia

While checking for symptoms of gynecomastia, the most important factor is the duration of the enlargement. Some other important factors are:

  • The development of secondary sexual characteristic
  • Medical history during the period of puberty
  • Nipple discharge or pain
  • Any disturbed sexual function such as erectile dysfunction or lowered libido

In some cases, gynecomastia is accompanied with liver cirrhosis, chronic kidney failure, hyperthyroidism, testicular cancer and other medical conditions, which create a hormonal environment conducive to the enlargement of breast tissues.

Gynecomastia Treatment

Currently, there is limited information regarding the effectiveness of medications for gynecomastia due to the lack of extensive research. When it comes to managing this medical condition, there are two potential treatment options:

  • Selective Estrogen Receptor Modulators (SERMs) raloxifene (Evista) and tamoxifen (Soltamox) are usually used for painful gynecomastia; and
  • Testosterone replacement therapy is found to be effective in adult men with low testosterone levels but not in those with normal levels.

If medications are not effective in treating the breast condition, surgery options to remove the excess breast tissues are available to the patient.

Gynecomastia Surgery Options

There are two types of surgeries for gynecomastia:

  1. Liposuction
  2. Mastectomy

Liposuction

This surgery involves extraction of the breast fat through small skin incisions via suction technique.

Risks after the surgery

The risks and complications of liposuction include:

  • Fluid accumulation
  • Heart and kidney issues
  • Fat embolism
  • Contour irregularities
  • Infection
  • Internal puncture
  • Lidocaine toxicity

Mastectomy

Mastectomy is the surgical removal of the breast gland tissue from the body, and is usually carried out for the treatment of breast cancer. For gynecomastia, subcutaneous mastectomy is performed through small incisions. The benefit of mastectomy is that it is low risk as compared to liposuction and allows patients to recover quickly.

Risks after the surgery

The risks and complications after mastectomy are the following:

  • Bleeding
  • Infection
  • Pain
  • Swelling
  • Development of hard scar tissue at the surgical site
  • Joint pain and stiffness
  • Numbness
  • The collection of blood in the surgical site (hematoma)

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