Procedures > Hair Loss

What Is Gynecomastia?

Gynecomastia is swelling or enlargement of the breast tissue in boys or men, caused by an imbalance of the hormones estrogen and testosterone. Gynecomastia can affect one or both breasts, sometimes unevenly.

Generally, gynecomastia isn’t a serious problem, but it can be tough to cope with the condition especially when there is pain involved. Embarrassment is extremely common in men and boys with gynecomastia.

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The hormones testosterone and estrogen control the development and maintenance of sex characteristics in both men and women. Testosterone controls male traits, such as muscle mass and body hair. Estrogen controls female traits, including the growth of breasts.

Most people think of estrogen as an exclusively female hormone, but men also produce it — though normally in small quantities. However, male estrogen levels that are too high or are out of balance with testosterone levels can cause gynecomastia.

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What Are the Symptoms of Gynecomastia?

The primary symptom of gynecomastia is enlargement of the male glandular breast tissue. It is typically symmetrical in location with regard to the nipple and may have a rubbery or firm feel. Gynecomastia usually occurs on both sides but can be unilateral in some cases. Tenderness, sensitivity or pain may be present.

The most important distinction with gynecomastia is differentiation from male breast cancer, which accounts for about 1% of overall cases of breast cancer. Cancer is usually confined to one side, is not necessarily centered around the nipple, feels hard or firm, and can be associated with dimpling of the skin, retraction of the nipple, nipple discharge, and enlargement of the underarm (axillary) lymph nodes.

Treatment for enlarged prostate, hair loss and prostate cancer therapy [Flutamide, Finasteride (Proscar, Propecia) and spironolactone (Aldactone)].

Bodybuilding – Anabolic steroids and androgens.

Tricyclic antidepressants.

Certain Antibiotics.

Plant oils, tea tree or lavender.

Ulcer medications, such as cimetidine (Tagamet).

AIDS medications. Efavirenz (Sustiva) is more commonly associated with gynecomastia than are other HIV medications.

Heart medications, such as digoxin (Lanoxin) and calcium channel blockers.

Alcohol

Amphetamines

Marijuana

Heroin

After surgery, dressings, bandages, or support garment may be used to minimize swelling and support your new chest contour as it heals. Typically drains are not used.
The final results of gynecomastia surgery are permanent in many cases. However, if gynecomastia resulted from the use of certain prescription medications, drugs (including steroids), or weight gain you must be fully free from these substances and remain at a stable weight in order to maintain your results.

Who Is a Candidate for Gynecomastia Surgery?

  • Is in good physical and mental health.
  • Is looking to improve appearance and boost self-confidence.
  • Has good skin elasticity.
  • Is not currently taking any medications known to cause gynecomastia.
  • Does not have any life-threatening medical conditions that could compromise recovery (e.g., cardiovascular disease or an uncontrolled illness).
  • Does not smoke, or plan to quit at least 2-3 weeks before surgery.
  • Is of a relatively normal weight.
  • Has specific and reasonable expectations of the surgical outcome.
  • Is not experiencing fluctuation in breast development.
  • Experiences negative psychological effects from having excessive breast tissue (e.g., embarrassment in social situations, self-doubts).

Most cases of gynecomastia regress over time without any treatment. However, if gynecomastia is caused by an underlying condition, such as hypogonadism, malnutrition or cirrhosis, that condition may need treatment. If you’re taking medications that can cause gynecomastia, you may have your doctor stop them or substitute with another medication.

In adolescents with no apparent cause of gynecomastia, the doctor may recommend periodic re-evaluations every three to six months to see if the condition improves on its own. Gynecomastia often goes away without treatment in less than two years. However, treatment may be necessary if gynecomastia doesn’t improve on its own or if it causes significant pain, tenderness or embarrassment.

  • Testosterone replacement has been effective in older men with low levels of testosterone,
  • Estrogen receptor modulator (SERM)Tamoxifen or Raloxifene have been shown to reduce breast volume in gynecomastia,
  • Danazol is a synthetic derivative of testosterone that decreases estrogen synthesis by the testes.
  • Liposuction – This surgery removes breast fat, but not the breast gland tissue itself.
  • Mastectomy – This type of surgery removes the breast gland tissue. Complications of mastectomy may include hematoma, surgical wound infection, breast asymmetry, changes in sensation in the breast, necrosis of the areola or nipple, seroma, noticeable or painful scars, and contour deformities.

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