GYNECOMASTIA



The term Gynecomastia comes from the Greek words gyne meaning "woman" and mastos meaning "breast".  In the vernacular of the day, we call it “man boobs.”  In practical terms, it means the breast-like growth of male chest area.  Men experiencing this condition often suffer from significant psychological stress.

Men are most aware of this condition when wearing certain clothing like T -shirts. Any activity involving the potential to expose their chests become extremely uncomfortable and anxiety producing.

There are many potential causes of this condition, the most common being related to adolescent hypertrophy of the glandular material (puberty) that persists into adulthood or the idiopathic variety (which basically means we don’t know why it exits). Less common causes include hormone imbalances and medications or underlying medical disorders. Pseudogynecomastia refers to a condition when excess fat exists around the chest area without the involvement of actual breast tissue.

Regardless of the cause, it is a benign condition. The evaluation of gynecomastia usually entails an accurate history and physical examination. The doctor will ask questions about your use of medications, drugs and alcohol as well as inquiring about symptoms of liver dysfunction, decreased libido or impotence or pulmonary symptoms suggestive of lung cancer. An extensive laboratory work up is generally unnecessary.

The most successful treatment outcomes usually involve surgery. Medical therapies are not likely to improve gynecomastia. Most patients don’t need treatment for the condition unless the enlarged breast tissue causes sufficient pain, embarrassment or emotional discomfort that interferes with the patient’s daily life.

Surgical alternatives consist of liposuction and/or direct excision of breast tissue. Most patients have a discrete area beneath their areolas that consists of dense breast tissue that cannot be removed with liposuction. An incision is made around the areola and this dense breast tissue is directly removed.  If there is a large amount of loose and saggy skin, a surgeon may recommend removal of excess skin with a horizontal scar. Recovery time is brief, with the use of a compression garment for about four weeks.

Complications from gynecomastia procedures are uncommon. As with any surgery, infection and bleeding can occur. I have seen instances where surgeons have not removed enough tissue and continued fullness exists, or inexpert surgery has resulted in divots and contour irregularities of the skin. This reminds all patients to choose their surgeons wisely.  Time spent researching a doctor’s favorable track record, stellar reputation and proven results is time well spent.

Gynecomastia treatment is extremely rewarding to both patient and surgeon. It is a relatively straight -forward surgical endeavor that results in a dramatic improvement in the appearance of the chest area. I often hear patients say that they are very pleased with their results and only wished they had performed the treatment sooner.


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