Gynecomastia is a medical term that refers to abnormally large breasts in men. The term comes from the Greek words gyne meaning "woman" and mastos meaning "breast." This condition, though rarely discussed, is fairly common as it affects an estimated 40 to 60 percent of men. The condition is relatively common in adolescent boys, and 90% of the time symptoms disappear in a matter of months. It may affect only one breast or both. Abnormally large breasts in men may cause the individual to feel self-conscious about their appearance.

There are several potential causes:

• Puberty
• Steroid abuse
• Obesity
• Tumors
• Genetic disorders
• Chronic liver disease
• Side effects of many medications
• Castration
• Klinefelter Syndrome
• Gilbert's Syndrome
• Aging
• Various drugs are implicated in gynecomastia and can be classified into the following categories:
  
  
  1. Estrogens or drugs with estrogen-like activity such as diethylstilbestrol, digoxin, phytoestrogens, estrogen-contaminated food and estrogen-containing cosmetics.
     
     
  2. Drugs that enhance estrogen production such as gonadotropins, clomiphene, phenytoin, and testosterone.
     
     
  3. Drugs that inhibit testosterone synthesis or action such as ketoconazole, flagyl, cisplatin, spironolactone, zantac, flutamide, finasteride, and etomidate.
     
     
  4. Drugs that act by unknown mechanisms such as isonicotinic acid hydrazide, methyldopa, busulfan, tricyclic antidepressants, valium, penicillamine, omeprazole, phenothiazines, calcium channel blockers, ACE inhibitors, alcohol, marijuana, and heroin. More Male Breast Reduction Facts...

The Remedy

In cases of obesity, weight loss can alter the condition and in the case of drugs and medications, cessation of medication may or may not cause reversal of gynecomastia. For all other causes, surgery is the only known physical remedy. The procedure, called male breast reduction, removes fat and or glandular tissue from the breasts, and in extreme cases removes excess skin, resulting in a chest that is flatter, firmer, and better contoured. More Male Breast Reduction Facts...

Who is a candidate for male breast reduction?

Surgery to correct gynecomastia can be performed on healthy, emotionally stable men of any age. The best candidates for surgery have firm, elastic skin that will reshape to the body's new contours.

Surgery may be discouraged for obese men or for overweight men who have not first tried exercise or weight loss. Also, individuals who drink alcohol beverages in excess or smoke marijuana are usually not considered good candidates for surgery. These drugs, along with anabolic steroids, may cause gynecomastia. Therefore, patients are first directed to stop the use of these drugs to see if the breast fullness will diminish before surgery is considered an option. More Male Breast Reduction Facts...

What are the risks and complications of the procedure?

Risks include infection, skin injury, excessive bleeding, adverse reaction to anesthesia, and excessive fluid loss or accumulation. The procedure may also result in noticeable scars, permanent pigment changes in the breast area, or slightly mismatched breasts or nipples. If asymmetry is significant, a second procedure may be performed to remove additional tissue.

The temporary effects of breast reduction include loss of breast sensation or numbness, which may last up to a year. More Male Breast Reduction Facts...

Preparing for Surgery

The initial consultation with your surgeon is very important. Your surgeon will need a complete medical history, so check your own records ahead of time and be ready to provide this information. First, your surgeon will examine your breasts and check for causes of the gynecomastia, such as impaired liver function, use of estrogen-containing medications, or anabolic steroids. If a medical problem is suspected, you'll be referred to an appropriate specialist.

Your plastic surgeon may, in extreme cases, also recommend a mammogram, or breast x-ray. This will not only rule out the very small possibility of breast cancer, but will reveal the breast's composition. Once your surgeon knows how much fat and glandular tissue is contained within the breasts, he or she can choose a surgical approach to best suit your needs.

Smokers should plan to stop smoking for a minimum of one or two weeks before surgery and during recovery. Smoking decreases circulation and interferes with proper healing. Therefore, it is essential to follow all your surgeon's instructions. More Male Breast Reduction Facts...

THE SURGERY

If excess glandular tissue is the primary cause of the breast enlargement, it will be excised, or cut out, with a scalpel. The excision may be performed alone or in conjunction with liposuction. In a typical procedure, an incision is made in a barely visible location--either on the edge of the areola areola--the dark skin that surrounds the nipple, or in the under arm area. Working through the incision, the surgeon cuts away the excess glandular tissue, fat and skin from around the areola and from the sides and bottom of the breast. Major reductions that involve the removal of a significant amount of tissue and skin may require larger incisions that result in more obvious scars. If liposuction is used to remove excess fat, the cannula is usually inserted through the existing incisions.

If your gynecomastia consists primarily of excessive fatty tissue rather than glandular tissue, liposuction may be all that's needed to remove the fat. A small incision, less than a half-inch in length, is made around the edge of the nipple or in the underarm area.

Sometimes, a small drain is inserted through a separate incision to draw off excess fluids. Once closed, the incisions are usually covered with a dressing. The chest may be wrapped to keep the skin firmly in place. More Male Breast Reduction Facts...

What is my recovery like?

Whether you've had excision with a scalpel or liposuction, you will feel some discomfort for a few days after surgery. However, discomfort can be controlled with medications prescribed by your surgeon. In any case, you should arrange to have someone drive you home after surgery and to help you out for a day or two if needed.

You'll be swollen and bruised for a while--in fact, you may wonder if there's been any improvement at all. To help reduce swelling, you'll probably be instructed to wear an elastic pressure garment continuously for a week or two, and for a few weeks longer at night. Although the worst of your swelling will dissipate in the first few weeks, it may be three months or more before the final results of your surgery are apparent.

In the meantime, it is important to begin getting back to normal. You'll be encouraged to begin walking around on the day of surgery, and can return to work when you feel well enough--which could be as early as a day or two after surgery. Any stitches will generally be removed about 1 to 2 weeks following the procedure.

Your surgeon may advise you to avoid heavy exercise for about three weeks. You'll be told to stay away from any sport or job that risks a blow to the chest area for at least four weeks. In general, it will take about a month before you're back to all of your normal activities.

You should also avoid exposing the resulting scars to the sun for at least six months. Sunlight can permanently affect the skin's pigmentation, causing the scar to turn dark. If sun exposure is unavoidable, use a strong sunblock.

The results of the procedure are significant and permanent. If your expectations are realistic, chances are good that you'll be very satisfied with the appearance of your chest. More Male Breast Reduction Facts...

Disclaimer:
This information is intended only as an introduction to this procedure. This information should not be used to determine whether you will have the procedure performed nor does it guarantee results of your elective surgery. Further details regarding surgical standards and procedures should be discussed with your physician