What to do about man boobs

Gynecomastia is a common condition in men, and may negativelyaffect one’s self esteem. Many factors may contribute to thiscondition. Hormonal changes, heredityconditions, health issues, or the use of prescription or recreational drugs mayincrease the risk of male breast enlargement. Up to 70% of men are affected by gynecomastia at some point in theirlives. In many, the condition willresolve on its own. In other men, symptomsmay continue despite weight loss and exercise. This is because gynecomastia is more than just fat on the chest. It is enlargement of the actual breastgland.

Gynecomastiamay adversely affect one’s appearance and mental health. Adolescents with this condition may limittheir social or sporting activities. Rarely, gynecomastia is an outward sign of aninward hormonal or other health issue. Often, there is no identifiableunderlying cause of gynecomastia.

What are the causes of gynecomastia?

Prescription drug use

Cimetidine

TricyclicAntidepressants

Diazepam

High bloodpressure medications including:

Calciumchannel blockers

ACEInhibitors

Spironoloctone

Furosamide

Metronidazole

Ketoconazole

Cisplatin

Recreational Drug Use

Marijuana

Alcohol

Cirrhosis

Thyroid disease

Renal disease

Hormonal imbalance

Testicular tumors (Rare)

Pituitary or adrenal tumors (Rare)

In most cases, there is no underlying cause.

Symptomsof Gynecomastia

Excessive breast glandular tissue may feel like a firm nodulebeneath the nipple that is sometimes tender. Pain may wax and wane. Lumps inthe breast, ulceration of the nipple, and tenderness or lumps in the armpit arenot symptoms of gynecomastia. Theseconditions should prompt a doctor visit and a physical exam.

Pseudogynecomastia is similar to gynecomastia, but really onlyinvolves excess chest fat, not breast glandular tissue. A combination of excessive fat and breast glandulartissue is sometimes present.

Whattreatment options are available for gynecomastia.

Aphysician should first perform a history and physical exam. Sometimes watchful waiting for resolutionwith time is an option. Pseudogynecomastia will improve with diet and exercise, but truegynecomastia will not.

Surgeryis not for everyone. However, if breasttissue is tender, an underlying cause should be investigated. If gynecomastia causes embarrassment and alow self esteem, surgery can provide a safe and lasting solution.

If you meet the following criteria, this procedure may be anoption:

You are in otherwise good health

The development of your breast tissue has stabilized

You feel your breasts are too large

Other causes of gynecomastia have been ruled out (medicationuse, hormonal factors, etc.).

Adolescents may benefit from surgery, but secondary proceduresmay be needed if breast development continues. Surgical correction of gynecomastia is best performed whenalternative medical treatments have failed and the individual is healthy withno life-threatening illnesses or conditions.

Howis corrective surgery performed?

Plastic surgery to correct gynecomastia is known as male breastreduction surgery. The surgery reduces breast size yielding a masculine chestappearance. In extreme cases ofgynecomastia, the skin may stretch and the breast may droop. Areolar diameter may also be affected bybreast enlargement. Mild cases ofgynecomastia are generally completely corrected by liposuction alone. More severe cases require removal of bothexcess skin and fat. The goal of malebreast reduction surgery is to restore the chest to a normal masculinecontour.

Liposuction

If the gynecomastia is caused by excess fatty tissue alone,liposuction is the treatment of choice. This surgery requires insertion of acannula, a thin hollow tube, through one or multiple small incisions. The cannulaitself has several small holes that facilitate fat removal when applied tosuction. Liposuction is applied to thedeep plane of fat beneath the skin. Thiswill yield a smooth, even contour.

Breast Reduction Surgery

In moderate to severe cases of male breast enlargement,reduction of both skin and fat may be necessary to achieve the desiredoutcome. An incision may be place aroundthe areola to conceal the final scar. Insevere cases, additional incisions may be required to maximize removal of excessiveskin. These incisions are generallyconcealed in the arm pit. The ultimategoal of gynecomastia surgery is to produce a natural appearance withoutevidence of surgery.

Whatto expect following surgery

Immediately following surgery, a dressing is placed just on topof the chest and an elastic binder is placed around the chest and torso. This garment compresses chest tissue as itheals. Immediately following surgery, itis typical to experience drainage from wounds for 24-48 hours. The best results are achieved with the use ofa compression garment for approximately 4 weeks following surgery.

The final results of male breast reduction are permanent in mostmen.

Surgery is a big decision and should be reserved for issues thataffect function and or self esteem. Results can be dramatic and life changing in the appropriatecandidate. Male breast reduction surgeryis safe and may be performed under local anesthesia with sedation or generalanesthesia.