Under certain circumstances, a man can develop fibro-fatty breast tissue that resembles a woman’s breast. This condition is referred to as gynecomastia. The etiology of this process is not widely understood, however, it is known that certain medical conditions, medications, hormones, drugs and other factors may play a role. In the majority of cases, no direct cause can be determined. Gynecomastia affects an estimated 40 percent to 60 percent of men and it may affect one breast or both breasts. Dr. Tyrone performs a wide array of reconstructive surgery and cosmetic surgery procedures, including male breast reduction at our plastic surgery office in Gainesville, FL.
What Is Gynecomastia?
Gynecomastia is a condition of enlarged or overdeveloped breast tissue in boys or men. It can occur at any age and affect one or both breasts, sometimes unevenly. The condition is usually caused by fluctuations in hormone levels. Although it is not a serious physical problem, it can be tough to cope with the condition because of its potential emotional and psychological effects. Transient gynecomastia generally resolves on its own without treatment after a couple of years. However, if the problem persists, medication and male breast surgery in Gainesville have been successfully used to treat the condition.
Depending on the extent of the problem, gynecomastia may be treated with excision of the breast bud, liposuction of the fatty tissue, or a combination of both procedures. Occasionally, a secondary procedure to reduce excess skin or to return the nipple to a more normal position may be needed. Results can vary but generally, patients have a chest that is flatter, firmer, and better contoured. Additionally, patients feel more comfortable in form-fitting clothing or going without a shirt.
True gynecomastia refers to enlarged glandular tissue rather than just adipose (fat) tissue. Although the condition is not accompanied by severe pain, the enlarged area may feel tender or sensitive. It’s important to note that the breast enlargement of gynecomastia is usually symmetrical in location with regard to the nipple. This is not to confuse it with lumps that could indicate male breast cancer. Pre-cancerous lumps are generally firm, often located only on one side, and not necessarily centered around the nipple. Other symptoms of cancer are dimpling skin, enlargement of the underarm lymph nodes, and nipple retraction or discharge. Gynecomastia can cause severe emotional discomfort and impair self-confidence. Some men even avoid certain physical activities and intimacy to hide their condition.
Natural Hormonal Changes
Both testosterone and estrogen are naturally occurring hormones in the male body. However, if estrogen levels are too high or out of balance with testosterone levels, gynecomastia can occur. Some life stages put boys and men at increased risk of gynecomastia. For example, most male infants are born with enlarged breasts due to their mother’s estrogen. Generally, this swelling goes away within three weeks. Puberty is also a time of hormonal changes during which gynecomastia is common. The swollen breast tissue usually goes back to normal within six months to two years. Finally, the prevalence of gynecomastia peaks among men in their 50s and 60s, especially if they are or have been overweight.
Any condition that interferes with normal testosterone production, such as pituitary insufficiency or Klinefelter’s syndrome, can cause gynecomastia. Thyroid issues, kidney failure, cirrhosis or liver failure, malnutrition and tumors involving the testes, adrenal glands or the pituitary gland are other risk factors.
Some medications can cause or exacerbate gynecomastia. These include anabolic steroids and androgens used to enhance athletic performance; anti-androgens used to treat prostate conditions; anti-anxiety medications, antidepressants; antibiotics; AIDS or HIV medications; ulcer medications; heart medications; and cancer treatments, especially for testicular cancer.
Abusing alcohol and drugs such as marijuana, heroin, amphetamines and methadone can cause gynecomastia. Some plant oils, such as lavender or tea tree, used in shampoos, lotions, and various skin-care products have also been associated with the condition.
Who Is A Candidate For Gynecomastia Surgery?
If you are bothered by the feeling that your breasts are too large, consider surgery for gynecomastia treatment in Gainesville. Good candidates for this surgery include the following.
- Males that are physically healthy and of a stable, normal weight
- Males that do not have life-threatening illness or health conditions
- Males whose condition cannot be corrected through alternative medical treatments
- Males whose breast development has stabilized
- Men with realistic expectations and a positive outlook
Our Gainesville plastic surgeon, Dr. Tyrone, feels that patients should make a conscious, informed decision regarding the surgery. During consultation, all potential risks will be discussed and any questions you have will be answered. Patients should be aware of the following risks: bleeding; breast asymmetry; changes in breast or nipple sensation; improper healing and complications regarding anesthesia.
After an initial consultation with a surgeon to discuss goals, concerns, and the patient’s medical history, intravenous sedation or general anesthesia is administered on the day of the surgery. The extra breast tissue is then removed through liposuction techniques or excision techniques. For the first, a cannula, or a thin and hollow tube, is inserted through several incisions and moved back and forth to loosen excess fat, which is then removed by vacuum suction.
The second method is used when the surgeon needs to remove glandular tissue and/or excess skin, reduce the size of the areola or reposition the nipple. Sometimes both methods are combined. Incision patterns vary depending on individual patients’ conditions and preferences.
Gynecomastia Surgery Recovery
After your Gainesville male breast reduction surgery, dressings or bandages will be applied to the incisions to minimize swelling and support your new chest contour as it heals. A thin tube may be temporarily placed under the skin to drain excess blood or fluid that may accumulate. Your surgeon will provide specific instructions for postoperative care of surgical sites and drains, including required downtime and follow-up visits. Dr. Tyrone may provide oral medications to aid healing, reduce pain and decrease the potential for infection. If you experience shortness of breath, chest pain or an unusual heartbeat, seek medical attention immediately.
Frequently Asked Questions
Gynecomastia can be caused by certain medications, drugs, hormones and metabolic disorders, but most often its cause is unknown and not due to any specific medical condition.
Generally, gynecomastia is triggered by low levels of testosterone compared with those of estrogen. This can be the result of conditions or agents that reduce the levels or block the effects of testosterone or, on the flip side, increase estrogen levels. The following are some of the things that can induce hormonal imbalances.
If gynecomastia is due to a drug or medication reaction, it can often be improved by stopping the offending agent. However, the majority of cases will require surgery to correct the problem. Our plastic and aesthetic surgeon typically uses a combination of liposuction and excision of breast tissue to correct the problem. Rarely a second operation may be required to correct skin laxity if the gynecomastia is severe.
Patients that are healthy and experience discomfort or a lack of self-confidence associated with their breast size or shape are ideal candidates. Note that patients should not be smokers as this can impede healing. Patients should have realistic expectations of their gynecomastia surgery results.