Gynecomastia is the benign hypertrophy of the mammary gland. In fact, it is an endocrine disorder in which the male breast swells and resembles a female, with the consequence that male psychology suffers a strong blow.

What happens during gynecomastia?

The swelling of the male breast is responsible for the imbalance of estrogen and androgens. In Gynecomastia the androgens grow and outweigh the androgen. Female hormones, that is, are more than testosterone. Gynecomastia resulting from hypertrophy of the mammary gland is characterized as true while the increase in breast volume due to accumulated fat due to obesity is characterized as pseudogynecomastia. According to statistics more than 95% of cases relate to pseudogynecomastia and only 5% gynecomastia.

Male breast and Gynecomastia

The male breasts are the corona alos, the nipple, the mammary gland and the adipose tissue. The swelling of the mammary gland causes the phenomenon of gynecomastia. Gynecomastia involving one breast is called heterolateral, while gynecomastia involving both breasts is called bilateral.

Why is Gynecomastia presented?

Gynecomastia may be idiopathic, which is the case of a reason we cannot identify. However, it may occur due to genetic abnormalities or as a result of certain conditions or to be presented after receiving a specific medication. It may even be the result of certain habits such as alcohol abuse, drug use and poor nutrition.

In detail, the causes that are considered responsible for gynecomastia

Patients are characterized in 1/4 of cases of gynecomastia. If gynecomastia arises due to pathological causes it is likely to be liable:

  • Hereditary predisposition
  • The absence of testicles
  • Renal insufficiency

For gynecomastia resulting from an increase in estrogen levels may be liable:

  • Cirrhosis of the liver
  • The hyperthyroidism
  • Congenital adrenal hyperplasia
  • Tumor in the testicular region

If gynecomastia arises as a result of a specific medication, it is responsible:

  • Treatment with clomiphene or phenytoin
  • Treatment with Spiroolactone, ketoconazole etc.
  • Anabolic use
  • Treatment with antiretrovirals
  • Anti-depressants treatment
  • Treatment with antipsychotics

For gynecomastia resulting from specific diseases is likely to be liable:

  • Diabetes mellitus
  • Spinal cord Damage
  • Other chronic diseases

The usual is gynecomastia due to a simple hormonal imbalance. However, since there is a potential for more serious causes, thorough examinations should be carried out in order to exclude any other possibility

When is gynecomastia presented?

Gynecomastia employs approximately 40% of the male population. If it is idiopathic and does not result from a hormonal or pathological cause it may occur during neonatal, adolescent or adult life.

Gynecomastia during neonatal age can occur due to the mother’s estrogen being transported through the placenta, which subsides a little while after the infant is born.

During adolescence arises due to the increased level of hormones, which subsides a few years after adulthood.

During adulthood, gynecomastia may occur between 40 and 75 years old. In this case it does not subside and surgery is the only option.

Gynecomastia: How to Diagnose

If you are an adult and you notice an increase in the size of your breasts, you should contact a qualified medical practitioner. Based on your clinical picture and history, the results of ultrasound or mammography will determine whether it is actually gynecomastia.

Gynecomastia: What tests should be performed before surgery?

Before proceeding with surgery, a test should be performed, including:

  • Testosterone and estrogen level
  • LH
  • FSH
  • thyroid hormones
  • Prolactin

In addition you will have to undergo:

  • General and biochemical blood test
  • General Urine Test
  • Electrocardiogram

Gynecomastia: What is the procedure of surgery?

The operation is performed through an incision made around the corona alω. The plastic surgeon removes the massive gland and excess fat. In case there is excess skin performs breast reduction. Another method that can be applied is that of liposuction. During liposuction, the mass gland is not removed but only the excess fat. Liposuction is indicated mainly in the case of Pseydogynaikomastias. Incisions are minimal in size and can be difficult to distinguish over time. Whichever technique is chosen has excellent aesthetic result. After surgery you are relieved of gynecomastia for life.

Gynecomastia: What kind of anesthesia is performed during surgery?

Anesthesia done in case the mass gland is removed is general. If only the excess fat is removed then it becomes local anesthesia with intoxication. In the second case you exit the clinic after a few hours. If there’s a general anesthesia, you’ll stay for one night and get discharged the next.

Gynecomastia: Is there any chance of complications?

Complications during or after this procedure are very rare. However, some have been mentioned, such as:

  • The formation of Hematomas
  • The asymmetry of the nipples
  • Very slow healing rate

These complications are not characterized as serious and are easily treated.

Gynecomastia: When will the results be visible?

You will have a first image after 1 to 2 weeks where the swelling will have subsided completely. The definitive results will be visible after about 4 weeks where the breasts will have acquired its final shape.