Gynecomastia: Causes, Treatment, and Surgery

Gynecomastia before after

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Gynecomastia is a condition where a man’s or boy’s breast tissue becomes swollen or enlarged. It is not the same as chest fat caused by carrying too much weight. Gynecomastia occurs due to an imbalance between testosterone and estrogen production and can appear during puberty or later in life.

Difference Between Breast Tissue and Pseudogynecomastia

Excess chest fat can lead to what looks like breast enlargement. However, if you are carrying excess weight around your tummy, your chances of breast fat development are not uncommon. Gynecomastia can become a serious concern if it is tied to a hormonal imbalance. This could indicate:

  • testicular illness or injury
  • thyroid imbalance
  • pituitary or adrenal tumors
  • kidney and liver disease
  • illegal steroid use

While the male body does produce some estrogen, which leads to breast tissue development, testosterone production should override or suppress this symptom. If your hormones are out of balance due to testosterone suppression, it is time to talk to your physician.

Gynecomastia: Causes, Treatment, and Surgery

Medications May Impact Male Breast Development

If you are on any medications and are noticing breast tissue development, carefully study the side effects. For example, it makes sense that anti-androgen drugs, such as those that treat prostate cancer, could lead to breast development. However, some anti-anxiety drugs can also lead to breast tissue development, as can some heart medications.

Nutritional Impact

If you have been working hard to lose weight or are on a stringent fitness plan, check your breasts. Severe caloric restriction and malnutrition can impact your testosterone production, but estrogen levels will remain steady. See your doctor if you notice any swelling below the nipple, breast tenderness, or discharge. Bloodwork will show where if malnutrition is affecting testosterone levels. Bringing your nutrition levels up may allow your testosterone production to come back to normal levels, but if it does not, you may need supplementation.

Additionally, liver damage can lead to male breast growth. Men struggling with alcohol abuse or addiction may want to have their liver function checked if new breast tissue growth appears. Alcohol is doubly hard on your hormone levels. A healthy liver suppresses the action of estrogen in the male body and alcohol suppresses testosterone production.

Treatment Options

For many men, particularly young men going through puberty, testosterone production over time will overcome the effects of estrogen and breast tissue will naturally reduce. For other men, treating the underlying endocrine disorder, or changing up the medications that have contributed to breast tissue growth, will correct the problem in time.

However, there are men who require an operation to correct the condition. The two most common surgeries are:

  • liposuction, to remove chest fat
  • mastectomy, to remove breast tissue

It is critical that surgery candidates be of good health and not be using any drugs or alcohol. The conditions that lead to male breast tissue overgrowth can include illegal steroid use and excessive alcohol use, so getting to a healthy state that is free of these products is critical to a successful long-term outcome.

An adolescent boy with excessive breast tissue growth may be a good candidate, but only if their breast tissue has stabilized. However, it is important that their testosterone production is stable to be sure that future treatments will not be needed.

Costs and Long-Term Considerations

Liposuction and mastectomy are considered cosmetic surgeries. If your need for this surgery is related to endocrinological cancer or another serious illness, you may be able to work with your cosmetic surgeon to present a case for insurance coverage. However, chances are good that you will need to be able to pay for your surgery out of pocket.

For many men, excess breast tissue is a source of great frustration and embarrassment. Losing weight and working out may actually make male breast tissue stand out even more because:

  • tummy fat is reduced
  • pectoral muscles push the breast tissue out even more
  • the nipples become more prominent

If the breast tissue does not reduce over time on its own, many men struggle with psychological and social challenges.

Emotional Considerations

For some men, gynecomastia and the inability to reduce breast tissue growth on their own can lead to isolation, a severe loss of self-esteem, anxiety, and depression. The risks of a limited life and loss of confidence are especially concerning for adolescent boys who have excessive breast tissue growth.

The decision to seek out a surgical correction for this condition is a big step. However, the long-term risks of leaving the condition untreated can be even more dangerous. Once the underlying conditions have been determined and treated, a surgical consult could give hope to a man who has lost confidence in his physique.

Looking for Gynecomastia Surgery in South Florida?

Get in touch today to book your complimentary consultation with Dr. Castrellón. As a Double Board-Certified Plastic and Reconstructive Surgeon, Dr. Castrellón can discuss your condition with you in greater detail and determine the best treatment plan to suit your unique needs and goals. Call us today!

Frequently Ask Questions

Strenuous activity (anything that increases blood pressure) should be avoided for the first two weeks after surgery. Increased cardio and lower body activity can resume after the first two weeks. Most importantly, upper body or chest workouts may resume incrementally after four weeks unless otherwise instructed.

Initial male breast reduction recovery time takes about 1-2 weeks on average. During this time, patients will want to take it easy, and must avoid strenuous activity to facilitate healing and prevent complications.

Showering is allowed on the first day after your surgery. You should shower daily. You need to gently pat the incisions dry. Don’t take a bath or soak the surgical incisions until your incisions are completely healed.

The vest should be snug but not to tight to cause discomfort. Each surgeon has their own instructions for the length of time to wear the vest. For my patients, I want them to wear it for 6 weeks, and then they can resume all normal activities.

Some men may bruise very little while others observe significant bruising. Some men develop a rash around the nipple or breast and some feel itching but no rash. Some men’s nipples seem to invert after gynecomastia surgery and others look asymmetrical with swelling.

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