Treatment and removal of gynecomastia in men
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What is gynecomastia?
Gynecomastia is a condition characterized by enlargement of the male mammary glands due to the growth of glandular or fatty tissue. It can cause pain and psychological discomfort.
At the first signs of breast enlargement in men, it is important to consult a doctor for diagnosis and treatment.
Types of Gynecomastia
True gynecomastia is the growth of glandular tissue in the male mammary gland caused by hormonal imbalance (most often excess estrogen). The breasts become dense and often painful to the touch. Surgical removal (excision) of the growth may be indicated for treatment.
False gynecomastia (lipomastia) is breast enlargement due to fatty tissue. It occurs with obesity, is not related to hormonal status, and does not necessarily require surgical removal.
Causes of Gynecomastia
The main causes of gynecomastia are:
- Hormonal imbalances
- Tumors: hormone-producing tumors of the testicles, adrenal glands, or pituitary gland
- Obesity: excess adipose tissue promotes increased aromatization of testosterone into estrogen
- Age-related changes: physiological gynecomastia can appear in adolescents due to pubertal hormonal fluctuations or in older men as a result of decreased testosterone
The condition can also develop as a result of long-term medication use, liver disease, or thyroid disease.
What is gynecomastia?
Gynecomastia is a condition in which one or both breasts in men enlarge due to fatty deposits in the chest area.
In 30-60% of cases, the condition develops in young adults. In 10% of cases, symptoms appear after age 50.
The condition is primarily treated conservatively. If drug therapy is ineffective, the doctor may refer the patient for surgical removal of gynecomastia.
Here are the main types of this pathology:
- True gynecomastia in men. Characterized by breast enlargement due to hypertrophy
- Pseudogynecomastia in men (lipomastia). In this case, breast enlargement occurs due to excess fat tissue unrelated to breast growth. This type of condition is more common in obese men
Common causes
Gynecomastia in men is a condition caused by hormonal imbalance, which in 90% of cases is due to dysfunction of the hypothalamus and pituitary gland. Hormonal imbalances are also disrupted by tumors in the lungs, adrenal glands, and testicles, as well as by Klinefelter's syndrome and Reifenstein's syndrome.
Physiological factors also play a role. The condition develops with rapid weight loss or obesity. Its symptoms also appear with lifestyle changes (for example, stopping intense physical exercise).
Additional reasons for the development of pathology include:
- Injuries and illnesses These include chest injuries, liver problems (chronic hepatitis and cirrhosis), and disruption of the brain structures responsible for hormonal regulation
- Medication factors Gynecomastia progresses with the use of medications that can affect hormonal balance and certain narcotics, such as marijuana or opiates
Indications and contraindications
Indications for gynecomastia removal:
- Increased tumor size
- Significant cosmetic defect causing psychological discomfort
- Fibrofatty form not amenable to conservative treatment
Contraindications for which surgical treatment is not performed:
- Acute infections and chronic diseases in the decompensation stage
- Bleeding disorders
- Age under 18: except in cases of malignant processes
Surgery is performed only after examination by an endocrinologist.
Types of surgery
Gynecomastia removal in men is one of the most effective treatments, especially when conservative methods fail to produce the desired results. The choice of correction method depends on the severity of the condition and the patient's anatomical features.
In cases where the problem is limited to excess fat deposits without breast enlargement, liposuction is the only reliable method for correcting gynecomastia in men.
The main types of surgical intervention:
- Endoscopic method. This is a high-tech method for treating gynecomastia in men, avoiding the formation of noticeable scars. Using a specialized instrument, an endoscope, the doctor makes minimal incisions and removes excess tissue. This method is suitable for those with minor breast changes and no issues with sagging skin
- Trans-areola correction. The surgeon makes an incision around the nipple, allowing for a concealed scar. This approach is recommended for significantly enlarged breasts, when excess tissue must be removed and the breasts repositioned naturally
- Combination method with liposuction. This method combines traditional mastectomy with liposuction to remove excess breast tissue. This method achieves a better breast shape while simultaneously removing fat deposits
General information
Gynecomastia Diagnosis
The initial consultation is conducted by a general practitioner. They examine the patient and refer them for blood tests and a chest ultrasound. The key here is to distinguish true gynecomastia, which is characterized by glandular tissue growth, from pseudogynecomastia, which is associated with fatty tissue accumulation.
The patient is then referred to an endocrinologist or urologist, as these doctors specialize in studying and managing hormonal imbalances.
The specialist recommends additional testing. This includes identifying chronic thyroid, kidney, or liver diseases, as well as developmental abnormalities of the genitals. For example, a genital examination may reveal changes in testicular size or atrophy.
Based on the test results and symptoms, the specialist determines the appropriate course of treatment.
Preventive measures
Physical activity not only helps control weight but also stimulates testosterone production. This hormone, in turn, controls breast growth in men.
It's also important to monitor your diet and choose whole, natural foods. Avoid foods high in simple carbohydrates and fats.
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About the service
Gynecomastia is characterized by unusual enlargement of the mammary glands. Pathological growth of glandular or adipose tissue leads to discomfort, a feeling of heaviness or even pain when touched.
In some cases, this condition resolves on its own. If symptoms persist for a long time, it is recommended to consult a doctor - timely treatment helps to neutralize the risk of developing breast cancer.