Gynecomastia (male breasts) is a common condition that is usually a result of an imbalance of hormones in the body. The condition may occur in one or both breasts.
The enlarged breast consists of two types of tissue: breast glandular tissue and fatty tissue. All men have the male sex hormone testosterone as well as low levels of the female sex hormone oestrogen, which controls breast tissue growth. When the testosterone to oestrogen ratio changes and more oestrogen is present, breast tissue can grow. Some men with gynecomastia have naturally higher levels of oestrogen in their body. In older men, testosterone production naturally decreases and a relative increase in oestrogen may occur, which can also lead to gynecomastia.
Although gynecomastia often develops from hormonal changes during puberty, other causes include:
• Chronic liver disease
• Exposure to anabolic steroid hormones
• Exposure to the oestrogen hormone
• Genetic disorders
• Kidney failure
• Marijuana use
• The side effects of some medications
• Testosterone deficiency
The technique used to treat gynecomastia depends on the size and composition of the male breast. Excess fatty tissue is usually removed with liposuction. If the problem is breast glandular tissue, it is treated by excision.
When removing breast glandular tissue, the surgery is performed under general anaesthetic and resultant scars are usually barely visible. An incision is made around the areola, the gland is then cut and removed, and stiches are put in place under the nipple. The stitches are normally removed after about 10 days and recovery time is approximately two weeks, during which the patient must wear a compression garment. Swelling and bruising is likely to occur over the first three or four days, but soon diminishes as the first week progresses.
Scarring is relatively minimal, however, scars tend to be more prominent if a large amount of tissue is removed.
Side effects of gynecomastia surgery are rare, though may include:
• Skin injury
• Excessive bleeding
• Excessive fluid loss or accumulation under the skin
• Itchiness or dry skin
• Slightly asymmetrical breasts or nipples
• Altered nipple sensations
