Gynecomastia is breast enlargement in men due to various reasons. This breast enlargement is usually benign. Although it usually happening in adolescence, it can also happen in infancy or old age. This condition is seen in almost one out of every three men. The enlargement occurring during puberty usually go away by itself. In the long-term cases, medical treatment or surgical intervention can be done.
Although it is a benign breast enlargement, it can cause psychological discomfort and anxiety. This is the reason why most patients take decision for treatment. The most basic reason is hormonal disorder and it is related to the balance of testosterone and estrogen hormones in men. Irregularity and imbalance in the appearance of the breast can also cause an overly sensitive personality development.
Gynecomastia seen in puberty is caused by excessive hormonal irregularities. It goes away itself within six months to two years. In adults, it may occur due to usage of medicines, drugs, alcohol, and serious liver damage. Drugs that can cause gynecomastia are some antibiotics, stomach drugs, chemotherapy, some antiviral drugs and tricyclic antidepressants. Although not very often, some herbal products also can cause it. Even small amounts of estrogen contained in tea tree and lavender oils in soaps or lotions can cause gynecomastia.
The most common symptom of gynecomastia is the swelling observed in the breasts. Pain and tenderness may also develop in the breasts. Fluid coming from one or both nipples is also a sign of gynecomastia. Some other symptoms may also be signs of gynecomastia such as lack of sexual desire. With the deterioration of the hormonal balance, sexual desire in men decreases. The visual disturbance caused by gynecomastia further increases this reluctance. In case of observing these conditions, it is necessary to be examined by a specialist doctor.
A specialist doctor’s examination is essential for diagnosis. There may be a palpable hardness or mass in the breast. In gynecomastia, the breasts are usually large and hard. After examining the breasts, a breast ultrasound is getting done to confirm the diagnosis of gynecomastia.
Since gynecomastia is caused by the imbalance of hormones, first of all, hormone-balancing drug therapy is applied. Doctors tries the Estrogen and testosterone balance in men to be regulated with drugs. In the meantime, the underlying causes of the disease should be investigated. If the specialist doctor has diagnosed gynecomastia, treatment can get started. In adolescents, the mechanism and response to treatment are different. Doctor follow up with the patient to check if their gynecomastia will be recovered itself or not. generally medical treatment is arranged according to the age of the patient and according to the test results. The best-known drug used in medical interventions is Tamoxifen. Drug therapy may not be beneficial in patients who have been ill for more than one year. In this case, surgical intervention comes into play.
After determining the type of gynecomastia, the treatment method will be decided. The treatment with the highest success rate is surgery. However, the surgery is getting performed according to the type of gynecomastia and it may have technical differences. Gynecomastia surgeries are performed under anesthesia. Anesthesia can be applied general or regionally. In the operation, a cut is made where the nipple meets the skin, and the fatty tissue is getting removed. Laser liposuction techniques used in the surgery allow the patient to spend the healing process comfortably. It is normal to experience edema or mild muscle pain in the area with gynecomastia after surgery. Those who have surgery can be discharged on the same day. However, it would be a better decision to be under the supervision of a doctor overnight. Adolescents, the elder people, and those who use performance-enhancing anabolic steroids are at risk. In addition, those with Klinefelter Syndrome, liver, kidney and thyroid problems are in the risk group. Resting for three days after the operation is very important in order to the limiting arm and shoulder movements. In this period, it is usually possible to decrease pain with simple painkillers.
Gynecomastia corset is a medical product used for the comfort of the patient after surgery. This product, which is simple to use and is worn immediately after gynecomastia surgery and should be used for a period to be determined by the doctor. This period is usually three weeks. This period can be extended if the doctor deems it necessary. The corset should also be worn while performing simple physical activities day and night. The corset can be removed at night.
If patient after the surgery starts to gain weight, an increase in breast fat may occur as a result of obesity. This does not mean that the disease has returned. Patients who have undergone surgery should strengthen their chest muscles with sports so that they do not gain weight.
In cases happening in adolescence and newborns, it is often temporary and needs to be followed up. But in adults, it gets progressively worse over time. In these patients, surgical intervention methods with laser liposuction or surgery may be preferred.
Breast enlargement can be seen with the increase of adipose tissue in the breasts. A diagnosis of false gynecomastia can be made if there is no mass in the breast following examination and evaluation with breast ultrasound, the medical name of fat tissue in men’s breast is “Pseudogynecomastia”. For treatment the accumulated fat is removed by liposuction and the breast tissue is corrected. It will be beneficial to do sports after this procedure. Working especially on the chest area will prevent the accumulation of fats that have the potential to accumulate there. The most effective treatment is surgery, but it should be decided under the supervision of a specialist doctor.
If the surgery is performed with laser liposuction, this procedure is performed with a 2-3 millimeter incision close to the armpit line. Through this incision, the area where gynecomastia occurs is entered. The mass or tissue inside is cleaned from the incision. The incision scar heals very quickly after the surgery. If this incision is stitched by a specialist plastic surgeon, it heals within three to six months without a trace. The risk is as low as a nose correction operation.
If the treatment method chosen after the diagnosis is surgery, then the surgery will be performed by removing the masses and removing the excess fat tissues. In the rare cases of very large breasts during the operation, it may be necessary to remove the skin as well. However, there is usually no need for such surgery.
Depending on the type of surgery, it is performed by plastic surgeons or general surgeons. In our institution, aesthetic and general surgery specialists perform this procedure together.
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