Gynecomastia is the benign enlargement of breast tissue in men with an imbalance in testosterone and estrogen hormones. As a result of this discomfort, breast size in men can increase to an uncomfortable level. Sometimes it occurs as a side effect of a disease or a drug used, and sometimes it can be due to natural hormone imbalance. The problem of drug or disease-induced gynecomastia may resolve spontaneously when the conditions disappear.
WHAT IS GYNECOMASTIA
Gynecomastia is the abnormal growth of male breast tissue due to an imbalance in testosterone and estrogen hormones. Due to the weight gained in adolescence, breast tissue growth occurs. This growth in breast tissue is generally benign. While it affects only one breast in some people, it affects both breasts in some patients. At the same time, both breasts do not grow at the same rate. It can be seen more frequently in newborn babies, adolescence and elderly men, as homonal balances change during these periods.
Gynecomastia is not a serious disease in general terms. However, many people may have difficulty coping with this situation. In most cases, only visual discomfort is felt, but sometimes a feeling of pain can also be experienced. Depending on the cause, it sometimes heals spontaneously, but many patients require drug therapy and surgical intervention.
WHAT ARE THE CAUSES OF GYNECOMASTIA?
During adolescence; It is natural for men to have enlargement, fullness and tenderness in their breasts due to hormonal reasons. Because the body is in a hormonal mess. This situation, which should be temporary, is called gynecomastia if it becomes permanent for various reasons.
During this period, men with excess weight are more likely to develop gynecomastia. Young people with gynecomastia try to hide it by wearing loose clothes and walking hunched over. Especially in summer, they don't even go into the sea just to hide it.
Although gynecomastia is mostly encountered as described above, unilateral or bilateral gynecomastia can sometimes be encountered depending on hormonal, tumoral causes (testicular tumor) or the drugs used.
Gynecomastia is divided into 4 groups according to its size and abundance in the skin ;
In the first stage, its size is limited, there is no laxity or sagging in the skin.
In the second stage, it is like a large female breast, but no sagging of the skin has occurred.
In the third stage, there is additional skin laxity that requires surgical treatment.
The fourth stage breast is like a real female breast.
WHAT ARE THE SYMPTOMS OF GYNECOMASTIA?
The most prominent among the symptoms of gynecomastia is the naturally swollen breast tissue. The breast tissue can visibly enlarge. Of course, the growth rate and the imbalance between the two breasts vary from person to person. In addition to physical growth, there is also tenderness in the breasts. While normal growths do not cause any problems, in some cases the problem can be serious. In the following situations, you will need to contact your doctor as soon as possible. These situations are;
Pain with swelling in the chest
Hypersensitivity in the chest
To diagnose gynecomastia, you must first consult your doctor and have a physical examination. After your doctor performs a physical examination, he or she will ask you questions about your family health history. In this process, you should report all the symptoms you observe to your doctor. The more clear information you give, the better the treatment process will go. Beyond these, a blood test will be requested from you for diagnosis. This is necessary to learn the cause beyond the diagnosis. According to the test results, tests such as computed tomography, testicular ultrasound, MRI and tissue biopsy can also be performed.
Breast enlargement is not always associated with gynecomastia. In some cases, breast structure enlargement occurs in people similar to gynecomastia. In other words, the person only has excessive lubrication in the breast. In this case, since there is no gynecomastia, different tests are applied and additional evaluations may be requested from the person.
Although very rare, breast cancer can occur in men as well. You may think that male breast cancer will occur, but there is such a possibility, although it is very low. A hard nodule in the chest area of men can cause breast cancer. Therefore, not every man with an enlarged breast is directly diagnosed with gynecomastia.
HOW IS GYNECOMASTIA TREATED?
Surgical methods are not always considered for the treatment of gynecomastia. Because in some patients, this tissue passes by itself, and in some patients, even drug treatment may be sufficient. In cases that do not go away on their own, drug therapy and surgical interventions may be considered. There are two important methods preferred as gynecomastia surgery. These;
Surgical intervention to remove excess fat from the breast area with liposuction is the first method. Only breast fat can be removed during this procedure. The mammary gland tissue remains in the area.
In the mastectomy operation, both mammary gland tissue and excess adipose tissue are removed. It is sufficient to make only one incision in the region during the operation process.
It is recommended that the patient pay attention to some conditions before gynecomastia surgery. Positive results are obtained as a result of paying attention to some conditions before any kind of surgical intervention. Conditions to be considered before this operation;
It is recommended not to be exposed to the sun during the two weeks before the operation. Sun rays can prevent the operation as they cause permanent scars and sunburns on our skin.
As of 1 week before the date of the procedure, you should not have any cold, flu, urinary tract infection. In case of passing, the doctor should be informed about this issue.
Smoking should be stopped at least 3 weeks before the surgery. Alcohol intake should be stopped 48 hours before.
Consumption of food and drink should be stopped at least 5 hours before the surgery.
As in any surgical intervention, the use of aspirin-like drugs should be discontinued at least 10 days before the surgery.
FREQUENTLY ASKED QUESTIONS
Can gynecomastia be treated with drugs?
Gynecomastia is a disease that has a cure, but the treatment is surgery. Although it is very unnecessary and meaningless, a very partial change can be achieved with estrogen antidote, namely estrogen-reducing drugs such as testosterone, clomiphene and tamoxifen, and danazol in men who resist gynecomastia surgery and do not want to undergo it. However, it should be kept in mind that this medical and heavy treatment has side effects. There is also the problem of aesthetic appearance, even if the drug treatment reduces the breast tissue a little, it does not have an effect on the adipose tissue and the skin. In general, there is no change in the gynecomastia appearance of the distressing patient.
Does gynecomastia increase the risk of breast cancer?
Only 1% of all breast cancer types occur in men. Having gynecomastia does not increase the risk of developing breast cancer. Only in Klinefelter's syndrome, the risk of breast cancer increases 60 times. As a result, gynecomastia does not increase the risk of breast cancer.
What are the risks of gynecomastia surgery?
Bleeding and related blood collection may occur after gynecomastia surgery as in every surgical intervention. This risk can be reduced with the use of drains.
The possibility of infection is considerably reduced with the antibiotics used.
Irregularities may occur in the thorax. This situation can be eliminated to a great extent with massages. If there is a permanent situation, this situation can be corrected with oil injection.
Long-lasting numbness, tingling and color changes can be seen in gynecomastia surgeries performed with liposuction. These usually improve over time.
Does gynecomastia progress?
If gynecomastia is mainly due to weight gain, the breasts continue to grow as the patient continues to gain weight. It has no specific limit. Skin cracks may occur, especially in rapidly occurring gynecomastia. After weight loss, these skin cracks cause sagging in the skin.
Even though the breast is massively smaller, it sags due to excess skin and patients still need surgery. In such cases, it is necessary to be careful from the beginning of the weight gain and to reduce the weight gain as much as possible.
If cracks occur in the skin and the quality of the skin is not deteriorated at these stages, the gynecomastia problem can be solved only with liposuction without leaving too many scars.
Can gynecomastia surgery be performed with local anesthesia?
If the patient's breast is not very large and will not be operated in a large area, the operation can be performed under local anesthesia. General anesthesia is preferred in other cases or in combined surgeries with other regions.
It is recommended that patients use a corset for 6 weeks after this surgery. The use of a corset not only prevents the accumulation of blood and body fluids in the surgical field, but also allows the skin to adapt to the underlying tissues more easily. The use of the corset should be as continuous as possible, especially during the first 2-3 weeks. In the next 3 weeks, it is sufficient to use a corset only during sleep.
How long after gynecomastia surgery can one return to normal life?
This surgery is not very painful. Male patients do not experience much pain after liposuction, so patients can move freely after surgery. Patients who have enough rest for a week can return to their normal lives 1 week after the operation.
After returning to normal life, patients may feel pain in the chest area if they use their arms too much for 2-3 weeks. Apart from this, gynecomastia surgery does not cause much restriction in the lives of patients.
Why Isn't Gynecomastia Treatment Applied to Teenagers in Adolescence?
For the treatment of gynecomastia, hormones should be balanced in general and some periods should be skipped. People who still have an imbalance in their hormones during puberty may experience breast enlargement again. Therefore, it is recommended to postpone the treatment during this period.
When the body and structure development in adolescence is completed, the problem of breast size in men can be treated much more successfully. At the end of the adolescence period, this breast size problem that the person experiences can also go away on its own. Therefore, before undergoing a surgical operation, it is recommended to wait until the problem will go away on its own.