A New Chapter: Empowering Men to Overcome Gynecomastia and Reclaim Their Body

Gynecomastia is a benign enlargement of one or both breasts in males due to excess glandular and fibrous tissue. Surgical treatment involves the removal of this tissue through either surgical excision or liposuction techniques, says our plastic surgeon.

Boys with gynecomastia due to hormonal changes usually get better on their own during infancy or adolescence. Adults with gynecomastia related to underlying health problems or drugs usually improve after treatment of the underlying problem.

1. Tamoxifen

Medications that decrease the oestrogen/androgen balance are effective for treating gynecomastia. They include selective oestrogen receptor modulators, SERMs (tamoxifen and raloxifene) and aromatase inhibitors (anastrozole).

Gynecomastia treatment depends on the underlying cause. If gynecomastia is due to puberty, it usually resolves within six months to two years. If it is a side effect of a drug, stopping the drug can often correct the problem.

If gynecomastia occurs with chronic health conditions, such as thyroid disorders and hypogonadism, treatment of the underlying disease can help. Laboratory tests such as hepatic transaminase, creatinine, total and free testosterone, estradiol, dehydroepiandrosterone sulfate and urinary 17-ketosteroid levels should be obtained to assess hormonal imbalance.

A review of the patient’s medications is important to determine if any may be contributing to the gynecomastia. For example, spironolactone, commonly known by the brand name Aldactone, can sometimes cause gynecomastia. Routine testicular ultrasonography is also recommended in patients with gynecomastia, as it can detect nonpalpable tumors.

Tamoxifen is an option for adults whose gynecomastia does not resolve after three months of therapy with another drug. The drug acts by blocking the oestrogen receptors in breast tissue. It can be combined with other treatments, such as liposuction and surgical excision of enlarged breast tissue. A boy with a unilateral gynecomastia was treated with oral tamoxifen for six months, and his gynecomastia regressed to normal. He was able to resume activities that required him to be bare-chested and felt more confident about his appearance.

2. Testosterone Replacement

The male genitalia and other characteristics like muscle bulk, deep voice and hair pattern are controlled by the hormone testosterone. Sometimes it is possible to get gynecomastia because of too little testosterone in the body. This can occur because of illness (like AIDS), injury, certain medicines or genetics. Testosterone replacement therapy is used to help restore the level of testosterone in the body. This can be done with pills or injections.

A blood test can help determine if you have a hormone imbalance and to see what the ratio of estrogen to testosterone is. Estrogen makes breast tissue grow and testosterone stops it from growing. Tamoxifen is a drug that blocks the action of estrogen. It is typically a treatment for cancer, but it can also decrease breast pain and improve the appearance of the chest in men. Aromatase inhibitors are other drugs that can reduce gynecomastia. They are typically treatments for ovarian cancer in post-menopausal women but may also treat gynecomastia in men with low testosterone levels.

Most cases of gynecomastia that are caused by an underlying health problem go away on their own. This can take several months or years to happen. If the gynecomastia is not caused by a medical condition, it can be treated with medications or surgery. If the gynecomastia does not improve after medication, gynecomastia surgery can be used to remove excess fat and reduce the size of the breast glands.

3. Liposuction

Liposuction is a cosmetic surgery used to remove excess fat tissue from body parts such as the stomach, thighs, and hips. It’s also used to treat some health conditions, including gynecomastia. This surgery uses a thin tube called a cannula to transport a saline solution that dissolves and eliminates fat tissue. It’s sometimes performed under local or general anesthesia. People of both sexes can benefit from liposuction.

Liposuction can reduce gynecomastia caused by hormone imbalances and certain medicines or drugs. Medicines that can cause gynecomastia include anabolic steroids, some heart medicines, antibiotics, and some cancer medicines. Alcohol and some recreational medicines can also cause enlarged breast tissue. If gynecomastia is caused by a drug, stopping the medicine may improve the gynecomastia.

Before a person has liposuction, the surgeon should review his or her medical history and ask about any medications he or she is taking. The surgeon should also explain how the procedure works, its risks and benefits, and the costs. The doctor should tell the person about ways to prepare for the surgery, such as avoiding some foods and medicines. The doctor should also teach the person about caring for the area after surgery. Liposuction permanently removes fat cells, so it changes the shape of the body. It can also be painful and leave numbness in the area where the surgeon works.

4. Excision

Excision is a surgical procedure that involves cutting out excess glandular tissue. It may be done in conjunction with liposuction to reduce the size of a man’s breasts. It is also useful if there are multiple glandular lesions. It is important to distinguish gynecomastia from pseudo-gynecomastia (breast tissue that feels rubbery and has a network of ducts) or breast cancer, which is usually on one side and not around the nipple area. The diagnosis is made by physical examination, a breast ultrasound and a mammogram.

Gynecomastia is most commonly caused by a hormonal imbalance involving estrogens and androgens. Both men and women produce these hormones, but estrogen is much more prevalent in girls and women. During puberty, the ratio of the two hormones changes, causing boys’ breast tissue to grow. Normally, this process is harmless and will resolve on its own as the boy grows up. However, the swollen breast tissue can cause emotional distress, and some people avoid intimate activities to hide the condition.

Conclusion

A doctor can help a man determine whether his gynecomastia is a result of a hormone imbalance, drug use or other health problems. If the disorder is a result of drug use, he can suggest medications that affect the balance between the two hormones. If a patient is too self-conscious to participate in normal activities, counseling can be helpful, according to our plastic surgeon in Mumbai.