The term ” gynecomastia ” is used to indicate the presence of an unusually developed mammary gland in humans. Although little is said about it, it is, however, a cosmetic defect frequently found in the male population, which can be a source of embarrassment in interpersonal relationships and a cause of profound insecurities. Although there are correlations with the use of some types of drugs, in most cases the origin of gynecomastia is unknown.
GYNECOMASTY: CAUSES AND SYMPTOMS
The causes of the increase in male breast volume can be:
- in the case of true gynecomastia : the cause lies in the excessive development of the glandular tissue;
- in the case of mixed gynecomastia : the cause is represented by the excessive development of the glandular and adipose tissues ( mixed gynecomastia is the type most frequently found among patients);
- in the case of false gynecomastia : the cause is the excessive development of adipose tissue in the male breast.
WHICH THERAPY IS MOST INDICATED TO CORRECT GYNECOMASTY?
Gynecomastia therapy is surgical and consists in the removal of breast tissue, adipose tissue and sometimes excess skin. With this type of surgical therapy it is possible to give the chest a more toned and natural appearance.
ARE THERE ANY AGE LIMITS FOR GYNECOMASTY INTERVENTION?
There are no age limits to undergo this type of intervention, but it is preferable to wait until the pubertal phase is definitively concluded during which, also in humans, a certain increase in the size and consistency of the mammary gland is normal. The intervention is not recommended for obese men before a serious attempt to lose weight through an adequate diet and in those subjects who abuse substances such as anabolic drugs, alcohol or light drugs, which can determine the onset of gynecomastia.
WHAT OTHER INTERVENTIONS CAN BE CARRIED OUT TOGETHER WITH THIS SURGICAL PROCEDURE?
Surgical therapy of gynecomastia can be done alone or in combination with other cosmetic surgery interventions (e.g. liposuction, rhinoplasty, etc.) as long as they are not too demanding for the patient.
WHAT ARE THE RISKS AND COMPLICATIONS OF THIS TYPE OF INTERVENTION?
Surgical treatment of gynecomastia is a relatively simple surgical procedure that generally gives excellent results, of great satisfaction both for the patient and for the surgeon who performs it. When this type of surgery is performed by a specialist in plastic surgery, experienced in breast modeling and authorized facilities, the results are generally very good. However, this is a real surgery where complications (bleeding, infection) are rare but can happen and be easily resolved only if the intervention is performed by a specialist within duly authorized facilities. To decrease the risk of complications, however, it is important to carefully follow the advice and instructions that the surgeon will give you before and after the operation.
HOW IS THE PRE-OPERATIVE VISIT DONE?
The surgical treatment of gynecomastia is a very personalized intervention which, as such, requires an accurate specialist visit. During the first visit, the surgeon will have to evaluate the shape and size of the breast, areola and nipple and illustrate the possible aesthetic changes that the most modern surgical technique makes available for your case. The surgeon will also have to evaluate your health conditions to exclude the presence of alterations (high blood pressure, clotting or scarring problems) that could affect the final result of the surgery. Before the operation you will receive precise instructions on pre and post-operative nutrition, on the intake of drugs, alcohol and cigarettes.
WHAT TYPE OF ANESTHESIA IS PRACTICED?
Male breast reduction surgery is generally performed under local anesthesia with sedation (this means that you will be awake but relaxed and insensitive to pain) in a day-hospital regime. In the case of important gynecomasts, the operation is performed under general anesthesia without intubation (i.e. only with the aid of the laryngeal mask) and requires one or two nights of hospitalization in the clinic. Before the operation, the anesthesiologist will proceed to a careful pre-operative visit and prescribe a list of routine tests such as: electrocardiogram Blood count PT, PTT, fibrinogen Electrolytes Glycemia, nitrogen, creatinemia Serology (hepatitis B, C and HIV virus) Visit breast with breast ultrasound and / or mammography
WHERE ARE THE ENGRAVINGS MADE?
Depending on whether they are small, medium or large gynecomastie, the incisions can be made only around the areola or descend vertically up to the submammary sulcus and along the lower fold of the breast (so-called anchor-shaped or inverted T incision). Liposuction of the breast region is also often associated.
HOW LONG DOES THE GYNECOMASTY INTERVENTION LAST?
The operation lasts 1-2 hours, is absolutely painless and ends with a small compression dressing.
WHAT IS THE POST-OPERATIVE COURSE?
In the 48 hours following the gynecomastia operation you will have to rest. In the first two days, swelling and bruising may appear around the treated region. Bleeding, infection, keloid scars and changes in the sensitivity of the areola and nipple may rarely occur.
Starting from the third day, you can resume a normal life while avoiding strenuous activities, saunas, Turkish baths and sun exposure. After 7-10 days you can resume your work if not too tiring. Two weeks after surgery, you will gradually resume all normal activities including sports.
WHAT TYPE OF RESULT CAN BE OBTAINED WITH A GYNECOMASTY INTERVENTION?
The aesthetic result that can be achieved with this type of intervention is generally very satisfying and long-lasting, but it will still be conditioned by your lifestyle (increase and weight loss).
Q. I am a 30 year old boy in good physical shape but I am ashamed to go to the beach because I have very developed breasts for being a man. What can I do?
A. The only therapy to correct this defect called “gynecomastia” is surgical and consists in removing the excess mammary gland and aspirating the adipose tissue which is often present on the thoracic region.
Q. What is Puberal Gynecomastia?
R. Puberal gynecomastia is what is normally called true gynecomastia. Puberal gynecomastia is essentially glandular because, in these patients, there is an excessive development of the glandular tissue due to an excessive hormonal stimulus (estrogen and the like) of the male gland. In this type of gynecomastia, it is generally the attending physician who asks the young patient to take a blood sample to evaluate an excessive presence of hormones and a breast ultrasound that documents a glandular hypodevelopment. The symptoms of puberal gynecomastia, from a clinical point of view, are the pain and tenderness of the mammary region to the touch (discomfort similar to that of the woman during the menstrual cycle) and with an increase in the volume of the male breast.
Q. Are there pharmacological treatments or natural remedies to correct gynecomastia?
The only true, definitive and permanent remedy for gynecomastia is surgical. Only in cases of true gynecomastia due to hormonal alterations there are drugs that can block or modify this imbalance of hormones such as tamoxifen, raloxifene and anastrozole and make the gynecomastia regress partially or totally. There are no documented improvements with natural remedies in the literature.