Gynecomastia (Male Breast Growth)
Gynecomastia is a breast enlargement disorder that occurs in men. As a result of this disorder, male patients feel themselves under social and psychological pressure.
For this reason, patients with gynecomastia have to wear loose clothes, are afraid to change their clothes in dormitories and public living areas, cannot swim comfortably on the beach, and cannot move comfortably in gyms.
Just as breast growth affects women sociopsychologically, breast growth in men may be more affected by psychological and social pressure in women.
Why Gynecomastia Occurs?
The most common cause of gynecomastia is the absence of a specific cause, which is called idiopathic. The most common cause following this is physiological conditions classified in general.
If it is necessary to explain;
The main cause of physiological gynecomastia is the increase in testosterone-estrogen hormone balance in favor of estrogen in men. In men, these physiological conditions are seen at the age of 3 years,
- Neonatal period, which develops due to estrogens passed from mother to baby after birth and disappears spontaneously within 1 month.
- Puberty period, which develops due to excessive hormone secretion and imbalance in men during puberty.
- It is senile gynecomastia that develops due to hormone imbalance in men over 65 years of age.
Apart from these reasons, other sepsis causing gynecomastia; It can cause systemic diseases such as ovarian (testicular) tumors, goiter diseases, kidney failure, and cirrhosis. In addition, alcohol-heroin-marijuana addiction and hormonal drug use can also cause gynecomastia.
---- How Many Types of Gynecomastia Are There?
In this type of gynecomastia, breast tissue and adipose tissue are generally found in different proportions. It is mostly seen in the initial stages of gynecomastia.
In this type of gynecomastia, stromal fibrosis, which is called as tight connective tissue in the breast, is predominant. Breast and adipose tissue are very scarce. This type of gynecomastia is seen in patients with many years.
In this type of gynecomastia, breast tissue, adipose tissue and fibrous tissue are equally present in the breast. It is the most common type of gynecomastia.
Stages of Gynecomastia
Gynecomastia is generally divided into 4 stages by Simon according to the amount of breast content and the degree of sagging of the skin;
- Stage 1 - small breast growth and no excess skin.
- Stage 2a - moderate breast enlargement and no excess skin.
- Stage 2b - moderate breast enlargement and excess skin.
- Stage 3 - characterized by significant breast enlargement and significant sagging of the skin.
The main purpose of understanding the stage of gynecomastia is to decide on the treatment procedure to be applied.
Planning of gynecomastia treatment begins at the stage of interview and examination with the patient. During the interview with the patient, the following information is learned;
- How long has it existed?
- Any regression?
- Do you have a regular medication? (The most common cause of gynecomastia is hormonal drugs used for bodybuilding)
The answers to their questions are sought. Later, on examination, the stage of gynecomastia and whether there is sagging of the skin are distinguished. There are 2 main treatment methods in the treatment of gynecomastia;
Fat absorption by liposuction
This operation is generally preferred for patients with fluoride (predominantly fat and breast tissue) type gynecomastia and who do not have sagging skin. Because the breast content is excessively hard, it is not suitable for liposuction treatment. In addition, when liposuction is applied to patients with sagging breast skin, sagging will not be an appropriate treatment method, since sagging will increase. Although the classical liposuction method is used in the treatment of gynecomastia, excellent results in gynecomastia have been achieved with ultrasonic-assisted liposuction in recent years.
Correction of gynecomastia by surgery
Suitable patients for the surgical method are those with excessive skin sagging and advanced gynecomastia with excess breast content. With this method, half-moon or circumferential incisions of varying length depending on the degree of gynecomastia are made between the brown tissue around the nipple (nipple-areola complex) and the skin junction. The desired size of breast tissue is removed. The skin is closed with the appropriate method.
How is Gynecomastia Surgery Performed?
Gynecomastia operation is usually performed under general anesthesia in the operating room under sterile conditions. It can also be performed with sedation + regional anesthesia for patients with small gynecomastia in the initial stage. The operation takes between 1-2 hours, depending on the stage of gynecomastia. Feeding is allowed 6 hours after the operation and the patient stays in the hospital for 1 night. One day after the operation, the patient is checked, the dressing is changed, and if there is no problem, he is discharged. Patients should come for control every other day for 1 week. If there is no problem in the 2nd week, it gets out of control. There may be excessive swelling, bruising and pain in the first 2-3 days after the operation. These complaints decrease after 3 days and usually disappear completely at the end of the 1st week. However, stinging, burning pain in the breast area that does not cause extreme discomfort may continue for several months. This is due to the hard fibrous tissues formed during the healing of the breast tissue. The final shape after the gynecomastia operation is formed at the end of the 6th month.
What Should Be Considered After the Operation?
After the gynecomastia operation, patients should avoid heavy physical activities for 1 month. These physical activities include strenuous actions such as walking, jogging, and lifting weights. In addition, sauna, solarium and steam bath, which have a swelling-increasing effect in the operation area, should be avoided for at least 1 month. Patients should wear a printed shaping corset for 24 hours for the first 3 weeks to be used immediately after the operation. In the second 3 weeks, he should use a printed corset for a total of 6 weeks, at night.