Quite a few affected men find breast enlargement (gynecomastia) extremely embarrassing and unpleasant. In everyday life, these breast enlargements are also disparagingly referred to as Man Boobs. For this reason, men usually consider surgery. During this procedure, glandular and/or fatty tissue is removed, so that as a result a flatter, firmer and therefore masculine breast is created.
What is gynecomastia?
It is not only women who have a particular problem with the image of their breasts. Some men also suffer from the fact that their breast areas grow steadily and thus become more and more similar to the female breast. This outgrowth is considered a medical condition and is called gynecomastia. This is an enlargement of the male breast, which is caused by an increase in tissue. Under this clinical picture there are two different types. On the one hand the real and on the other hand the false gynecomastia. The cause of the so-called false gynecomastia is overweight. Here, fat deposits within the male breast give the appearance of this significant swelling. The so-called true gynecomastia is also based on a hormonal disorder.
Causes
According to statistical records, at least forty percent of men are affected by gynecomastia. The reason for this, that there is an atypical enlargement, is usually not clear. It may be due to glandular diseases or altered liver functions, but also to the use of anabolic steroids (estrogen-containing drugs), drug or alcohol consumption or, in rare cases, a tumor, that a masculine breast becomes feminine, i.e. gynecomastia. Some men have an increased amount of female hormones (estrogens), which are responsible for the unpleasant growth of the male breast. The trigger for this can be, for example, a hypothalamus disorder. The excess estrogen in gynecomastia may also be partly due to the fact that the body of the respective man produces too little male hormones. However, some men also influence the body’s own hormone balance. Thus, while taking some anabolic steroids, the supplied testosterone can be largely converted into estrogen by the man’s own body.
Symptoms, complaints and signs
The main symptom in gynecomastia is breast enlargement in men. This breast enlargement can be physiological or pathological. Physiological gynecomastia such as pubertal, neonatal, geriatric and pseudogynecomastia has no pathological value. However, psychological abnormalities can develop in those affected due to a feeling of shame. This sometimes leads to withdrawal from society, social isolation or even depression. Other symptoms do not appear. The affected person often needs psychotherapeutic care, up to and including cosmetic surgery, in order to regain self-confidence. Sometimes, however, gynecomastia is pathological. In this case, further physical symptoms can occur, which on the one hand affect the gynecomastia itself and on the other hand are triggered by the respective underlying disease. In the case of pronounced gynecomastia, for example, there is sometimes a feeling of pressure or even pain in the breast. The nipples may be hypersensitive. Skin irritation is possible in the breast crease, leading to severe pain. Movement of the breast tissue often produces a particularly unpleasant sensation. During sports activities, these tissue movements can even cause severe pain, which can be avoided by wearing a compression shirt or sports bra. In some cases of pathological gynecomastia, unilateral breast growth can also occur. In addition to hereditary hormone imbalances, serious causes such as cancer or drug abuse sometimes lead to gynecomastia.
Diagnosis and course
If gynecomastia is to be eliminated, an initial consultation is held in advance for the purpose of intensive consultation with a specialist (urologist). During this examination, for example, the hormone balance is checked as well as other causes are investigated in order to be able to make a clear diagnosis. The various triggers that may be considered are also included in this process. Which further measures are to be applied for the treatment of the gynecomastia is decided by the physician per diagnosis.In very rare cases, surgical intervention is performed. Only in the case of extremely severe tissue proliferation, which also continues to progress, breast surgery can restore the normal condition as a last resort. In this case, the superfluous breast tissue is removed by liposuction. However, this does not treat the cause of gynecomastia, but only changes the current condition. Thus, even after the surgical intervention, further effective treatment must take place. This can, for example, reduce gynecomastia through a change in diet or hormone balancing.
Complications
Male breast augmentation does not usually lead to any health complications or discomfort. However, these can occur if the enlargement occurs due to obesity or some other medical condition. In most cases, however, there is psychological discomfort. Most men feel uncomfortable and not beautiful with the enlarged breasts. Inferiority complexes are formed and self-esteem is greatly reduced. It is not uncommon for patients to withdraw from social life and depression and other psychological upsets occur. The psychological complaints are usually treated by a psychologist, with no particular complications. Treatment of male mammary gland enlargement always takes place causally. In case of obesity, the affected person must change to a healthy lifestyle to avoid further growth. In the further course, the enlarged breasts can be reduced surgically. In many cases, medications can lead to breast enlargement in men and therefore must be discontinued or replaced with other medications after consultation with a physician. Male mammary gland augmentation itself does not lead to a decreased life expectancy. However, the underlying condition may be serious and must be investigated in any case.
When should you go to the doctor?
Treatment of gynecomastia is always advisable. This prevents further complications and discomfort, and also restores the man’s sense of life. However, the treatment is not medically necessary in every case, so that first of all a clarifying conversation with a doctor should take place. As a rule, a doctor should be consulted if the mammary glands or the man’s breasts in general are significantly enlarged. A feeling of tightness in the breasts can also indicate gynecomastia and should be examined by a doctor. The breasts themselves are sensitive to touch, so the nipples may also hurt when touched. If this discomfort occurs without any particular reason, treatment by a doctor is advisable. Since gynecomastia can also lead to depression or other psychological upsets, a psychologist should be consulted. The initial examination and diagnosis can be performed by a general practitioner. The surgical procedure is usually performed in a hospital and leads to a positive course of the disease.
Treatment and therapy
If gynecomastia is mainly based on enlarged or increased mammary gland tissue, it can be removed by surgery so that the man’s chest can be modeled more flatly. In this treatment, one or more incisions are made in the areola (or extended incisions if there is an increased amount) so that excess glandular tissue can be removed directly. The most commonly used method is “Ultrasound Assisted Aspiration Lpectomy” (UAL). In this procedure, an innovative cannula delivers a special ultrasound energy to the fatty tissue, which “blasts” the excess tissue, so to speak, and then liquefies it. After the operation, swelling and numbness are noticeable, as well as possibly some bruising in the chest area. Such symptoms usually disappear within a maximum of three weeks. As a rule, an elastic bandage is applied for compression after the operation, which actively supports the reduction of the swelling and the healing of the wound. The majority of patients are delighted with the results of the procedure, as the cause of the unmanly breast has been eliminated. Unfortunately, gynecomastia surgery lacks medical intention, so it is considered a pure cosmetic surgery.
Outlook and prognosis
Gynecomastia usually begins in early puberty and does not regress on its own throughout life. Once the mammary glands are enlarged, they remain at that size unless treated with medication or surgery. True gynecomastia must be distinguished from false gynecomastia, which is caused by obesity and fat deposits in the breast area. False gynecomastia can be reversed by reducing body weight – with correct weight loss even without hanging skin flaps. True gynecomastia, on the other hand, improves only with medical treatment. In addition, the breasts of true gynecomastia are usually much larger than those of the false form. If gynecomastia does not occur during puberty, it can still start in old age, when the amount of male hormones decreases. This process is perfectly natural, but it also causes the proportion of female hormones to increase, and the mammary glands of an aging man may enlarge as a result. Often, however, the gynecomastia is then not as noticeable as in the case where it begins in a young man as early as puberty. Hormone therapy as well as surgical reduction of the breast in the case of very severe enlargement can provide a remedy. While the surgical method brings quick success, hormone treatment alone takes longer, but ensures the long-term success of the treatment.
Prevention
Hormonal gynecomastia can only be prevented to a limited extent. Men should absolutely refrain from using anabolic steroids and other growth hormones for their sports or bodybuilding. Gynecomastia due to obesity can be prevented with plenty of exercise, endurance sports and a healthy diet.
Aftercare
Aftercare options are severely limited for male breast augmentation. The first priority is the proper treatment of this condition and usually the diagnosis of the underlying disease to prevent further complications and discomfort. In doing so, the trigger of male mammary gland enlargement should of course be found and avoided so that the condition can be completely resolved. The treatment of mammary gland enlargement in men is usually carried out with the help of a surgical procedure. This usually takes place without any particular complications and also leads to success. As a result, the symptoms can usually be completely alleviated and limited. After the operation, the patient must remain in bed and rest. The breast region should be supported afterwards and should not be subjected to unnecessary stress. In general, exertion or stressful activities should be avoided during this process. Since male breast augmentation can also lead to psychological upsets or even depression, psychological treatment is also necessary in some cases. Talking to family or friends can also have a positive effect on the course of the disease. The patient’s life expectancy is not limited by male breast augmentation.
What you can do yourself
Gynecomastia greatly restricts those affected in everyday life; swimming, sauna, tight clothing are avoided out of shame. In addition to drug or surgical therapy, there is often little self-help. However, it is possible to reduce visibility through clothing, such as by wearing loose tops. Polo shirts or shirts worn open over a T-shirt are distracting, especially if they have different colors or patterns. Strikingly printed shirts should be avoided at all costs. But also shaping or so-called compression shirts, let the body image appear firmer and more upright. The orthopedic chest belt or a good sports bra prevents the movement of the grown tissue, the chest appears flatter and firmer. Dietary changes, endurance sports and targeted training of the chest muscles provide relief and minimize the fatty tissue, but takes time. Rowing and swimming are the most effective. However, push-ups or archery also convert the fatty tissue into muscles. Beer should not be consumed at all, not only because of the alcohol and the resulting increase in calories, but also because of the phytoestrogens contained in hops. Dealing openly with gynecomastia and talking about it provides understanding and supports the psychological condition.
