Gynecomastia refers to breast tissue swelling in boys or men due to an imbalance of the hormones estrogen and testosterone. It can affect either one or both breasts, at times unevenly. Because of normal change in hormonal level, gynecomastia can develop in newborns, boys during pubertal age and older men. It should also be understood that apart from this, there are other causes as well for developing gynecomastia.
Usually, gynecomastia is not a serious medical condition, though it can be challenging to cope with the condition. Pain in the affected breast can be experienced. More than a medical issue, often men and boys consider gynecomastia as something that lets down mentally. Fortunately, gynecomastia may go away on its own. If not, medication and surgery may be considered to get rid of it.
Signs and symptoms of gynecomastia include swelling in the breast tissue and breast tenderness. It is advisable to seek a medical opinion if there is swelling, pain, tenderness, nipple discharge in one or both breasts.
Gynecomastia occurs when the level of testosterone goes down compared with estrogen. The trigger of this reduction can be conditions that block the production of testosterone or something that causes an increase in the production of estrogen. There are numerous things that influence hormone balance, some of them are the following.
The hormones estrogen and testosterone play a vital part in the development and maintenance of sex characteristics in both men and women. Testosterone influences male traits such as muscle mass and body hair, whereas estrogen controls female traits such as growth of breasts.
Generally people associate estrogen exclusively with females, but men also produce it in small quantities. However, if male estrogen level outweighs the level of testosterone, it can lead to gynecomastia.
Gynecomastia in infants: Incidentally, more than half of baby boys are born with enlarged breasts owing to the effects of their mothers’ estrogen. Generally, the swollen tissue of the breast will disappear within two to three weeks after birth.
Gynecomastia during puberty: Gynecomastia arising out of hormonal change during puberty is the most common form of this condition. Swollen breast tissue tends to go away within six months to two years. If it persists after this time period, it is better to get a medical opinion.
Gynecomastia in men: The incidence of having gynecomastia goes high again between the ages of 50 and 69. At least 1 in 4 men in this age bracket is likely to have this condition.
Apart from hormonal change, gynecomastia can occur as a result of a host of medications. These include:
- Anti-androgens used to treat prostate enlargement, prostate cancer and some other conditions.
- Anabolic steroids and androgens
- AIDS medications. Gynecomastia can develop in HIV-positive men who are receiving a treatment regimen called highly active antiretroviral therapy (HAART)
- Anti-anxiety medications, such as diazepam
- Tricyclic antidepressants
- Ulcer medications
- Cancer treatment (chemotherapy)
- Heart medications, such as digoxin and calcium channel blockers
- Gastric motility medications, such as metoclopramide
Street drugs and liquor are two things that fuel the progression of gynecomastia. Substances that increase the chance of gynecomastia include alcohol, amphetamines, marijuana, heroin and methadone.
Some health conditions that cause hormonal imbalance in the body can also lead to gynecomastia. Some are:
Hypogonadism: Medical disease or disorders that interferes with the production of testosterone, such as Klinefelter’s syndrome or pituitary insufficiency can be a cause for gynecomastia
Aging: As we age, our body is bound to have some hormonal changes that may lead to gynecomastia, especially in men who are obese.
Tumors: Tumors affecting adrenal glands, pituitary gland, testes can produce hormones that change the equilibrium of testosterone and estrogen.
Hyperthyroidism: Due to hyperthyroidism, thyroid gland produces too much of the hormone thyroxine.
Kidney failure: About half of the folks undergoing regular hemodialysis experience gynecomastia owing to hormonal imbalance.
Liver failure and cirrhosis: Hormonal changes due to liver diseases as well as drugs taken for cirrhosis can alter the male-female hormone balance
Malnutrition and starvation: Testosterone level goes down when the body is starved of adequate nutrition, whereas estrogen level remains the same leading to hormonal imbalance.
Herbal products: Herbal products may contain plant oils. Plant oils such as tea tree or lavender used in shampoos, soaps and lotions are believed to cause gynecomastia.
Risk factors for gynecomastia are adolescence, older age, use of steroids or androgens to enhance performance in sports.
Liposuction in gynecomastia
Of all the treatments for gynecomastia, liposuction is often discussed as a “minimally invasive’ surgical option. Minimally invasive surgery means procedures that don’t leave large and unsightly scars. In liposuction a cannula (thin hollow tube) is inserted through several small incisions and the fatty tissue is broken down before the probe sucks it out of the breast area. The main advantage of this procedure is the scar can be sited away from the treatment area and is therefore hidden, for example under the arm. Moreover, liposuction deals with fatty tissue and it will not remove breast tissue.
There are number of liposuction techniques, the one that suits you will be defined prior to your procedure.
As the name indicates lipoexcision involves liposuction with excision of breast tissue through a semi areolar incision. Excision along with lipo is often done if glandular breast tissue or excess skin must be removed to correct gynecomastia. Excision is also required if the areola is to be reduced or the nipple is to be repositioned to a more natural male contour. Incision pattern vary depending on the specific conditions and surgical preference.
Prevention is better than cure
There are a few things that you can do to control or reduce the risk of gynecomastia. First is not to use illegal drugs. Make sure you stay away from alcoholic drinks. If you cannot, drink in moderation. Last but not the least, review your medication. If the medications you take increase the risk of gynecomastia, consult your doctor and request if there are other choices.