By Betul Yurekli • Medical review by Tamer Sakrak, MD on September 11, 2023

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Gynecomastia

It is the result of a gynecomastia performed by Ekrem Keskin, MD. For reference purposes only, results may vary.

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& All About Gynecomastia

When an imbalance occurs between androgen and estrogen, male breasts enlarge, and this is called gynecomastia. It is the most common breast issue of men.

Gynecomastia may occur during early childhood, puberty, or older age. Most of the male babies and boys have enlarged breasts due to hormonal changes.

And, men older than 60 may also suffer from gynecomastia for the same reason as babies and young boys at puberty. Other than these age groups, gynecomastia can be observed in adult men because of many reasons.

There is another situation which is called pseudogynecomastia that causes enlarged male breasts. This situation is a result of obesity and before maintaining a healthy weight, surgery is not recommended. 

Men who are unhappy with their feminine looking breasts wants to get gynecomastia surgery. Having large breasts cause men to be embarrassed in removing their shirts in public.

gynecomastia surgery

Since this situation put emotional and psychological distress on them, they might not feel confident in engaging outdoor sports or exercising in a gym.

If you are seeking to gain your self-confidence back and get a masculine chest appearance, you might consider gynecomastia surgery.

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A good candidate for gynecomastia has to be:
 

  • At least 18 years old, so that their body is completely developed.

  • Experienced extreme discomfort due to large breasts

  • Suffered from a lack of confidence

  • Tried medical treatments but didn’t get any respond

  • Who have realistic expectations from surgery

Below are some of the things you should need to do in preparing for gynecomastia surgery:

jinekomasti

 

  • Get lab testing or a medical evaluation

  • Take certain medications or adjust your current medications

  • Stop smoking

  • Avoid taking aspirin, anti-inflammatory drugs or herbal supplements to prevent increased bleeding during and after the operation.

Be sure to arrange for someone to drive you to the hospital and to your home afterwards. You will also need an companion to stay with you for at least the first night following surgery.

The first step before gynecomastia surgery will be a preliminary meeting with your doctor. Remember that this consultation will determine your gynecomastia treatment process.

You should clearly answer all the questions your doctor will ask you, and you should not skip in detail about your medical history.

Your doctor should find out what causes gynecomastia in order to decide which treatment to apply. For this, a number of tests may be requested after the physical examination.

There are two methods for removing the unwanted tissue and excess fat in the chest area: liposuction and mastectomy. Both of the options require a short recovery time because they are less invasive.

Before the surgery, your doctor plans which of the methods will be performed on your breasts. Depending on the type of the procedure, the surgery takes 1 to 3 hours.

gynecomastia treatment

Liposuction: Performed under local anesthesia. Excess breast fat is removed by liposuction. No need to stay in the hospital. Patients can go back home on the same day.

Mastectomy: Performed under general anesthesia. The doctor makes small incisions to remove excess glandular tissue. The incisions are traditionally oval-shaped surrounding the areola and the skin near to armpit.

After removing the tissues, the doctor may change the position of the nipples if it is necessary. The incisions are closed with stitches and surgical drain tubes are placed near the incisions to remove blood or other fluids.

After gynecomastia surgery is done, dressings or bandages will be applied to your incisions and an elastic bandage or support garment may be used to minimize swelling and support your new chest contour unil it completely heals.

A small, thin tube (drainer) may be temporarily placed under the skin to drain any excess blood or fluid that may collect.

You will be given specific instructions about how to care for the surgical site and drains, medications to apply or take orally to aid healing and reduce the potential for infection, specific concerns to look for at the surgical site or in your general health.

The price of gynecomastia surgery varies due to the type of procedures. The location of the health facility and most importantly, the experience level of the doctor will also affect the cost of the surgery.

Although gynecomastia (male breast reduction surgery) is a simple procedure, it should not be forgotten that it is a surgical operation. As with any surgical operation, it is important for patients to rest well for a while after gynecomastia surgery.

Depending on the degree of gynecomastia surgery, the length of the healing process may vary. In general, the first two weeks are critical. In this process, patients should stay away from strenuous physical activities and should not tire themselves.

jinekomasti ameliyatı

Patients who are discharged after the necessary examinations are made after the operation should take a 2-week leave from their workplace.

From the second week, it is possible to return to daily activities that are not too tiring. Full recovery and return to social life takes between 3-6 weeks.

Gynecomastia surgery is an operation with permanent results. For this reason, it is useful to evaluate the pros and cons of the operation before deciding on surgery.

Pros of Gynecomastia Surgery

It will boost your confidence: Having masculine and defined chest is the biggest pro of the surgery. Thus, you will rebuild your confidence and won’t ashamed to remove your shirt in front of anyone.
It will improve your physical discomfort: Unfortunately, gynecomastia can cause physical pain and discomfort in some patients. You can improve your quality of life by solving them permanently with surgery.

It is a relatively low-risk procedure: If performed by a competent specialist surgeon, gynecomastia surgery is safe and risk-free.

It gives permanent results: As long as you do not gain excessive weight after gynecomastia surgery, the results of the surgery are permanent. The surgery does not need to be repeated.

gynecomastia

Cons of Gynecomastia Surgery

Scarring after surgery: A slight scar after the operation can be counted among the disadvantages of gynecomastia. However, this scar, which is well hidden by the surgeon, is not very noticeable after healing.

After the surgery, side effects such as swelling, mild pain, redness and bruising are seen. However, these are the expected side effects that we encounter after all plastic surgery operations. All pass in a few days.

Male breast reduction surgery is generally not painful. Most of the patients rate the pain they experience after surgery as mild to moderate.

Many complain of a feeling of tightness in their breasts rather than pain after surgery. These are easily controlled with the painkillers given.

The season in which gynecomastia surgery will be performed is an important issue. When it comes to most of the aesthetic operations, patients prefer the winter months to get through the healing process more easily and to be ready for summer.

gynecomastia before after

This is especially important in gynecomastia surgery. Experts recommend that the surgery be performed in colder weather if possible. Since there is less exposure to the sun in winter, the surgical site heals more easily. In terms of the comfort of the patient, it is much better to perform the operation in winter.

Fat tissues are removed permanently by liposuction fat removal technique during gynecomastia surgery. These fat tissues cannot come back again, and therefore gynecomastia surgery is a permanent solution. However, if patients gain excessive weight after surgery, these fat tissues can expand again in time.

Experiencing some degree of breast enlargement is common for both adult men and adolescent boys. Although gynecomastia can occur at any age, the causes of the condition and the recommended treatment options may differ according to the age of the patient. Likewise, the patient's age and degree of gynecomastia can affect his body in different ways.

According to public statistics from the National Institutes of Health (NIH), between 50 and 60% of adolescent boys suffer from gynecomastia. Adolescent gynecomastia is almost always due to higher than normal estrogen levels.

This situation affects the psychology of men especially in adolescence. In fact, if the gynecomastia is severe, it can even lead to adolescent bullying.

man big breast

By the age of 21, with the completion of puberty, most people's chest contours naturally flatten. Gynecomastia that does not resolve spontaneously after the age of 20 should be treated with surgery.

The same NIH study reveals that gynecomastia is even more common in adult men. It's estimated that roughly 65% of men aged 30 to 75 experience mild to moderate gynecomastia.

Although it may present with similar symptoms at any age, the causes of gynecomastia in adolescents and adults are often different.

Besides hormone imbalances that develop over time, male breast enlargement in adults can also indicate serious medical problems, such as thyroid problems or pituitary gland cancer.

Gynecomastia occurs as a result of an imbalance between the two of the major hormones: estrogen and androgen.

Other than the imbalance between hormones, some health problems such as liver disease, testicular tumors, and hyperthyroidism, or drugs like steroids and amphetamines can cause breast growth in males. Even overuse of alcohol can be the reason for gynecomastia.

Gynecomastia isn’t always caused by hormonal imbalance or weight gain. Some certain medications can also invite gynecomastia.

fit man

Some drug groups that cause gynecomastia are:

  • Anabolic steroids and androgens

  • Anti-androgen drugs used in prostate treatment

  • Tricyclic antidepressants

  • Antibiotics

  • Ulcer medications

  • Antiretroviral drugs used to treat AIDS

  • Heart medications

If you are using one or more of these drugs and you have comlaints about the size of your breasts, consult to your doctor.

To diagnose gynecomastia, doctors give a physical exam to their patients. And then, patients tell about their medical history for an evaluation in detail.

After these, some tests need to be done to have a certain diagnose:

 

  • Blood tests

  • Urine tests

  • Mammography

In some cases, patients are recommended to visit an endocrinologist to see how their hormones work.  

Even though there are some medications including breast cancer drugs to treat gynecomastia, the most effective solution is obtained with surgery.

Gynecomastia Surgery

Generally, gynecomastia doesn’t require treatment since it is a benign enlargement of male breast glandular tissue. But in some cases, breast growth can cause anxiety and discomfort.

If the medication doesn’t fix the problem, patients should consider surgery after consulting a doctor. Gynecomastia surgery consists of removing the excess fat and glandular breast tissue by using surgical techniques and, liposuction if needed.

Written on 01/01/2018

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Last Update: 20/10/2023

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