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What is Gynecomastia? Causes, Diagnosis and Surgical Treatment

By: Dr. Ganchi

Gynecomastia is the benign, abnormal growth of breast tissue in males.  This overdevelopment of the male breast is sometimes referred to as male breast enlargement.  This enlargement includes excess growth of glandular tissue.  Gynecomastia, is fairly common, affecting approximately 40% of males.

But, What Causes Gynecomastia?

The condition of gynecomastia is caused by an imbalance in hormone levels. With a decrease in the amount of testosterone in relation to the estrogen in the body, the male can begin to develop the female characteristic of having breasts.  Males do normally have some of the hormone estrogen, but in very low levels.

Various factors can cause this kind of imbalance, creating gynecomastia:

Obesity:

As the body increases in weight the fat gets stored in various locations, including the chest.  Additionally, the excess fat leads to the production of estrogen, which causes growth of more breast tissue.

Aging:

Aging can also be a factor in the development of enlarged breasts in men.  As a man grows older, a disruption in his hormone balance can cause the breasts to grow larger. 

Alcohol Abuse and Street Drugs:

If alcohol is abused to the extent of causing liver damage a hormone imbalance can be created causing gynecomastia.  Additionally, gynecomastia has been linked to the use of heroin, methadone, marijuana and amphetamines.

Steroid Abuse:

The abuse of certain steroids by bodybuilders can cause the over-development of breast tissue in males.  These steroids can be chemically changed into estrogen, once inside the body, causing the growth of not only muscle but breast tissue as well.

Health Conditions:

Less frequently, certain health conditions can lead to gynecomastia, such as:

Some glandular tumors can disrupt the male-female hormone balance.

Hyperthyroidism (over-active thyroid) can create a hormone imbalance.

People with kidney failure, undergoing dialysis, can experience gynecomastia due to hormonal changes.

Certain types of cancer including lung cancer and testicular cancer can cause hormone imbalances resulting in male breast enlargement, as can certain chemotherapy drugs used in the treatment of cancer.

Hormonal changes related to liver problems, as well as medications taken for cirrhosis, are associated with gynecomastia.

Gynecomastia can also be caused by malnutrition.  When the body becomes starved the testosterone levels drop, while estrogen remains constant thus causing an imbalance.

Prescription Drug Side Effects:

Gynecomastia is one of the potential side effects of several types of prescription medications.  These include such drugs as amphetamines, antidepressants, blood pressure drugs, ulcer medications and antipsychotics.

Heredity:

In rare circumstances, hereditary disorders such as Klinefelter’s Syndrome can cause breast enlargement in males.

Puberty:

During puberty, some boys will develop enlarged breasts due to the increased production of hormones that occurs at that period of life.  Many of these cases resolve without any medical interference. 

Gynecomastia Before After PhotoLiposuction and excision of gynecomastia + liposuction of midsection

How can I tell if I have Gynecomastia?

The symptoms of gynecomastia are not difficult to see, which is one reason men afflicted with this condition find it such a problem.  The signs include swelling of the glandular tissue in one or both breasts, breasts becoming tender to the touch, an increase in localized fat in the area of the breast, and in some cases an excess of breast skin.

How do you Treat Gynecomastia?

As is the case with other medical conditions, the treatment for gynecomastia depends on the cause.  

If, for instance, the breast enlargement is due to a prescription drug side effect, your doctor may be able to put you on a different medication, or in some cases wean you off the drug entirely by finding another solution.

Gynecomastia brought about by puberty may resolve over time.

If the man’s unnatural breast enlargement is due to weight gain, losing weight may, at least partially resolve the problem.

If you suspect you may be suffering from gynecomastia, it’s best to have the condition evaluated by a doctor.

Gynecomastia Before After PhotoLiposuction and excision of gynecomastia

Treating Gynecomastia with Surgery

For many with persistent gynecomastia, surgery is the only effective long term treatment option.  When planning surgery for gynecomastia, it is important to address any gland tissue, excess fatty tissue and loose skin while keeping scars hidden and to a minimum.  Almost all cases should have breast gland and excess fatty tissue removed.  This is best carried out through a small incision in the areola, the specialized skin around the nipple.  Scars in this specialized skin heal quicker and fade better than scars on regular skin leading to excellent results.

For men whose gynecomastia is complicated by loose skin, the above is combined with a breast reduction procedure to tighten the excess skin.  This is a very specialized procedure that should be performed by an experienced plastic surgeon who performs many gynecomastia procedures.  Unfortunately, most surgeons perform the same operation for male breast reduction as they do for female breast reduction, a more common procedure.  As a result, these men end up with a persistent feminine shape to their chests and more scarring than otherwise necessary.

If gynecomastia surgery is deemed the appropriate solution to your breast enlargement, be sure to find a highly trained and qualified board certified plastic surgeon for your procedure. You deserve to have the best gynecomastia surgeon.

Harvard trained, board certified plastic surgeon, Dr. Ganchi and staff lavish you with attention and make your experience enjoyable and comfortable.

WE INVITE YOU TO CALL OUR NEW JERSEY OFFICE AT 973-942-6600.


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