Gynaecomastia Surgery :

GYNAECOMASTIA VERSUS CHEST FAT

You can differentiate between gynecomastia and chest fat by examining the texture of your chest. Fat in the chest area is soft, just like body fat in other areas of your body, such as arms and abdomen. On the other hand, gynaecomastia feels firmer to the touch and can also appear as a hard lump under your skin.

GYNAECOMASTIA SYMPTOMS

Symptoms of gynecomastia can include:

• Pain, especially experienced by teenage boys
• Swollen and tender breast tissue
• Nipples that become sensitive when they rub against clothes

GYNAECOMASTIA CAUSES

Generally, an imbalance between the estrogen and androgen hormones results in the enlargement of breasts in males.

• During Infancy : Gynaecomastia can occur in male infants due to the effects of estrogen during pregnancy.
• At the time of Puberty : Teenage boys are affected by this condition due to hormonal changes during puberty.
• In Advanced Age : Even adult men between the ages of 50 and 80 years can get gynecomastia.
• Other Contributing Factors : Other than hormonal changes, various causes contribute to developing gynecomastia. Some of these reasons are:

1. Health Conditions : Some health conditions can cause an imbalance in hormones, which can either cause or are associated with gynecomastia. These include hypogonadism, hyperthyroidism, kidney failure, liver failure, and cirrhosis, as well as obesity.

• Hypogonadism : Certain conditions lower the amount of testosterone in the body, e.g., Klinefelter's syndrome and pituitary insufficiency.
• Hyperthyroidism : This condition is marked by the thyroid gland producing excess thyroxine.
• Kidney Failure : Men who receive dialysis treatment often develop gynecomastia due to hormonal changes.
• Liver Failure and Cirrhosis : Liver problems and cirrhosis medications bring about changes in hormone levels, which can lead to gynecomastia.
• Obesity :Obese people sometimes develop enlarged breasts due to excess fatty tissue. This is called pseudo-gynecomastia.

2. Medications : Gynaecomastia very often occurs as a result of taking medications for:

• Male infertility
• Anxiety and depression
• Prostate enlargement
• Bacterial and fungal infections
• Heartburn and peptic ulcers
• High blood pressure and heart failure

3. Alcohol, Recreational Drugs, and Illegal Drugs : Marijuana, heroin, amphetamines, and anabolic steroids used by athletes to improve performance and build muscle mass are possible triggers for gynecomastia. Excessive alcohol consumption can also cause gynecomastia.

4. Herbal Products : Shampoos, soaps, and lotions containing plant oils are known to cause gynecomastia. Examples are tea tree and lavender oils. Both these oils contain certain compounds that have the same effect as estrogen hormones or can even affect testosterone.

STAGES OF GYNECOMASTIA

Plastic surgeons have developed a system of grading gynaecomastia into stages that helps them determine a suitable surgical intervention to treat your symptoms. This system uses Grades 1 through 4 for classifying gynecomastia. While Grade 1 implies that you have a mass of tissue beneath the skin that hasn't stretched the skin yet, Grade 4 means that the mound of tissue protrudes out of your skin and hangs down, giving it a look similar to the female breast.

GYNAECOMASTIA DIAGNOSIS

As part of the diagnosis, your healthcare provider will conduct a physical examination and ask questions about your past health and medical history. You may also be required to undergo a few evaluations, such as:

Physical Examination : A routine physical examination will be done manually.

Medical History : Your health care provider will conduct a ask few questions related to your past health and medical history.

Diagnostic Tests : The following tests are done as part of the diagnosis procedure:

• Blood tests (e.g., liver function tests and hormone tests)
• Mammogram (low-dose X-ray of your breast)
• Urine test
• Biopsy (removal of a small breast tissue sample for detection of cancer cells)

GYNECOMASTIA TREATMENT

Most of the cases of gynecomastia occur during puberty and require no treatment as they tend to resolve on their own within six months to 2 or 3 years. If the cause of enlarged breasts is medicine, it should be stopped immediately. That will take care of the problem. Very rarely, gynecomastia surgery may be done to remove the extra tissue.

GYNAECOMASTIA SURGERY PROCEDURE

A person undergoing male breast reduction surgery is usually administered general anesthesia. Very rarely, local anesthesia may be given. During the surgery, a small cut is made around the nipple. Excess fatty tissue is removed using a surgical knife or scalpel.

Sometimes, liposuction may be carried out or a combination of both. Repositioning of the nipples may be required if a lot of tissue needs to be removed.

Finally, the wound is bandaged using dressings. The entire surgical procedure takes approximately 1.5 hours. Post-surgery, you need to stay overnight in the hospital.

GYNAECOMASTIA SURGERY RECOVERY

It can take up to 6 weeks to fully recover from a breast reduction surgery. You may be required to take a few days leave from work.

AFTERCARE

For a few weeks following the surgery, you may experience bruised, swollen, and sore breasts. To support your chest, you may be recommended to wear an elasticated compression garment throughout the day.

The wound dressings must be kept in place until the wounds heal. After 1 or 2 weeks, your stitches will dissolve or be removed at the hospital. Avoid indulging in strenuous exercises or lifting heavy objects for about three weeks.

POSSIBLE COMPLICATIONS

Some of the occasional complications arising after a breast reduction surgery include:

• Thick, evident scarring
• Problems in wound healing
• Loss of sensation in nipples
• Uneven appearance of breasts or nipples
• Bleeding inside the breast tissue (hematoma)

HOW TO CHOOSE THE SURGEON

While seeking to find the best plastic surgeon for yourself, check if they have a certified degree that allows them to carry out gynecomastia surgery. Apart from a relevant degree, the surgeon should have a proven track record of successfully operating several patients.

With most information available on the internet, you can also check for patient reviews and whether the hospital under consideration has a good reputation. Considering all these factors can give you assurance before zeroing in on the right surgeon and hospital for your gynecomastia surgery.