This is about enlarged male breasts. It is frequently seen in men in puberty period. While it regresses in a majority of them, this becomes permanent in 10 % of them. The one seen in puberty period is generally two sided. Before intervention you should wait for one or two years. Some of the factors causing male breast enlargement are aging, being overweight, using steroid, addiction to marihuana, chronic liver disease, tumours secreting hormone, some genetic diseases. Weight loss does not usually solve the problem in gynecomastia depending on being overweight.

The most significant problem gynecomastia brings about is feeling of embarrassment of the patient. It creates feeling of embarrassment of a man to have a secondary sex organ which is adopted to belong to the opposite sex. This influences that person in many terms varying from wearing, participating in social medium to private life. The only solution of gynecomastia is surgery. If fat tissue is more excessive in the enlarged breast, only liposuction procedure is adequate; however, if enlargement of breast tissue is highlighted, then breast tissue is removed by penetrating through semi-circular incision which is made around the nipple.

This operation can be performed solitarily or in combination with liposuction. If there is excessive amount of skin, some of this skin may need to be removed. The operation is performed under general anaesthesia at hospital.

The operation takes 1-2,5 hours on average. The patient can be released from hospital same day or next day, can go back to her normal life within 2-3 days. It is recommended to wear a stretch corset for 3-4 weeks. Bruises will disappear within 10-15 days, swelling will have disappeared totally within 2-3 months. Early complications may be bleeding and infection while late complications are asymmetrical breasts.

Gynecomastia with Questions and Answers

1. What is Gynecomastia?

Gynecomastia is enlargement of male breast tissues, which can be recognized visibly and even under clothes. Men feel uneasy aesthetically. This generally occurs in infancy, puberty or aging periods when they are exposed to hormonal changes.

2. Why does it occur?

Gynecomastia is a situation which can be caused by many hormonal changes or with no reasons, is harmless in terms of physical health of the patient but making him uneasy aesthetically. Hormonal changes, the increase of oestrogen in males or decrease of testosterone may result in gynecomastia. This situation may sometimes occur in liver diseases, breast cancer, lung cancer, suprarenal glands or pituitary tumours due to testicular cancer, drug use, birth anomalies, thyroid diseases and trauma. Still reasons of a great amount of cases are not known.

3. Statistics regarding gynecomastia;

• A great majority of gynecomastia cases occur in puberty period. It breaks out in this period and the breast continues to grow constantly for a few years. 65% of 14-year-old boys have gynecomastia.

• Gynecomastia may occur in the new-born because of hormones transferred from mother.

• In 90% of the men with gynecomastia in puberty period, breast tissue reduces on its own without any need for treatment. For that reason, it is better to wait for minimum two years to let gynecomastia starting in puberty period disappear on its own.

4. What are the symptoms of gynecomastia?

Gynecomastia is enlargement of male breast tissue, which causes an unfavourable appearance. Classification of gynecomastia is made differently in world of medicine. One of those classifications is indicated below;

1st grade gynecomastia – very mild breast enlargement, no excessive skin.

2nd grade gynecomastia – moderate breast enlargement, excessive skin may be existing or no excessive skin.

3rd grade gynecomastia – severe breast enlargement  and excessive skin is existing.

Symptoms of gynecomastia may occur in relation to other diseases. Definitely consult your physician for a health and definite diagnosis.

5. How is gynecomastia diagnosed?

After the patient’s background is reported and physically examined, steps of a definite diagnosis may include the following procedures;

• Blood tests (liver and hormone examination)
• Urinary tests
• Endocrinologist’s examination (An endocrinologist is a physician specialized in functions of hormones and their effects on organs.)
• Mammography

6. What are the methods used in treatment of Gynecomastia?

About the Surgical Technique:

In order to solve the problem about gynecomastia, characteristics and grade of gynecomastia is considered. The physician decided which of these techniques can be used according to the examination findings.

• Liposuction

Liposuction is used in first or second grade gynecomastia where breast tissue consist of mostly fat.

• Open surgery;

Since the skin will be more stretched and it will be less likely for it to put itself together on its own in third grade gynecomastia, excessive skin may need to be removed in addition to other procedures. In such case, open techniques is used. The surgeon decides if the skin will be removed or not by assessing the elasticity of the skin. In this case, there might occur a scar depending on the amount of excessive skin to be removed.

7. How is gynecomastia surgery planned?

The physician makes decision about how gynecomastia will be treated by assessing the following:

• Age, status of general health, medical background
• Grade of gynecomastia
• Patient’s expectation about the correction of appearance
• Patient’s wishes or preferences

Operation may be a good option to remove the excessive tissue which causes the unaesthetic appearance. However, if symptoms of gynecomastia has first begun during puberty, it is better to wait to let it disappear on its own and to consider operation in case it hasn’t gone away two years later.