What is gynecomastia?
Gynecomastia is the enlargement of the breast tissue in boys or men due to an imbalance of estrogen and testosterone hormones. Gynecomastia can affect one or both breasts, sometimes causing embarrassment and emotional distress.
Most often, gynecomastia occurs during puberty but can also occur during adulthood. It is seen more often in obese men and older men. Certain drugs, such as anabolic steroids, heroin, and marijuana, can cause gynecomastia by affecting hormone levels.
Gynecomastia is not harmful but can signify a more serious underlying condition, such as testicular cancer. You should see your doctor for an evaluation if you have any concerns about your breasts or develop nipple discharge.
Causes of gynecomastia
Several drugs and medical conditions can cause or contribute to gynecomastia. Most often, the cause of gynecomastia is unknown. The condition commonly develops during puberty but can also occur in older men.
Drugs that can cause gynecomastia to include:
-Calcium channel blockers
-Drugs used to treat heartburn and ulcers
-Some antibiotics and heart medications
Other medical conditions that can cause gynecomastia to include:
Signs and symptoms of gynecomastia
There are several signs and symptoms associated with gynecomastia. Most boys will have some of these signs, but they don’t necessarily mean they have gynecomastia.
Signs and symptoms of gynecomastia include:
-Swelling in the chest area
-Tenderness or pain in the chest area
In rare cases, boys with gynecomastia may have enlarged breasts that look similar to those of girls. This usually happens only in pubertal gynecomastia and goes away without treatment within a few months to a couple of years.
Diagnosis of gynecomastia
To diagnose gynecomastia, your doctor will ask about your symptoms and medical history. They will also give you a physical exam.
In some cases, further testing may be needed to confirm the diagnosis or rule out other possible causes of your symptoms, such as a tumor. Tests may include:
Blood tests. These tests can measure hormone levels in your blood.
Imaging tests. Ultrasound, MRI, or CT scans can provide detailed pictures of breast tissue to rule out the possibility of a tumor.
Needle aspiration biopsy. In this procedure, your doctor inserts a needle into your breast to remove a small tissue sample for laboratory analysis.
Treatment of gynecomastia
There are several ways to treat gynecomastia, depending on the severity of the condition. In mild cases, over-the-counter medications or dietary supplements may be enough to reduce breast tissue. In more severe cases, surgery may be necessary to remove the excess tissue.
Some of the most common treatments for gynecomastia include:
-Medications: Medications such as tamoxifen and raloxifene are effective in treating gynecomastia. These medications work by blocking the effects of estrogen in the body.
-Dietary supplements: Dietary supplements such as saw palmetto and green tea extract effectively treat gynecomastia. These supplements work by blocking the effects of estrogen in the body.
-Surgery: Surgery is usually reserved for severe cases of gynecomastia. The most common type of surgery is a mastectomy, which involves removing the excess tissue from the chest area.
Surgery for gynecomastia
There are several surgical options for treating gynecomastia. The most common is liposuction, which can remove excess fat from the chest area. In some cases, excess skin may also need to be removed. Another option is surgery to remove the breast tissue, which is a mastectomy. This may be recommended for men with very large breasts or who do not respond to other treatments. Surgery for gynecomastia is usually performed on an outpatient basis, which means you can go home the same day.
Recovery from gynecomastia surgery
After your surgery, you will need to wear a compression garment for 4-6 weeks. The compression garment helps to minimize swelling and supports your chest as it heals. You will also have drains to help remove excess fluid from the area. The drains are usually removed after 1-2 weeks.
You can shower 48 hours after your surgery, but you should avoid baths, pools, hot tubs, and saunas for at least four weeks. You will need to sleep on your back or side for the first few weeks to minimize the risk of bleeding and swelling.
You should expect some bruising and swelling after your surgery, which will resolve over the next few weeks. Most patients can return to work and normal activity within 2-3 weeks. However, you should avoid strenuous activity or heavy lifting for at least six weeks.