Most people have never heard the term “Gynecomastia“. This condition is sometimes insensitively referred to as “man boobs” which just adds insult and injury to the embarrassment the man who suffers from Gynecomastia deals with on a daily basis. In about 75% of the cases of Gynecomastia, the cause is thought to be a decrease in the hormone testosterone compared to estrogen. All men and women have varying amounts of estrogen and testosterone hormones, and when that balance becomes skewed, sometimes the result is Gynecomastia in men.
Swelling of the male’s breast tissue can develop at birth when the mother’s increased estrogen causes the infant’s breasts to swell. Without treatment, this swelling usually goes away within two to three weeks. Hormonal changes in puberty can also cause enlarged breast tissue, and this too sometimes resolves itself within a few years even if left untreated. One quarter of those with Gynecomastia don’t develop symptoms until the ages of 50 – 80. The most highly affected groups are adolescent boys and middle age/older men. Medications, chromosome disorders, poor diet, lack of exercise, obesity, and thyroid issues are all suspects in the development of excessive breast tissue in men, but many times the causal factors remain unidentified.
We often see men who have not gone to a pool party or to the beach for years because they didn’t want to risk the potential cutting and damaging remarks. Sufferers often resort to wearing two or three t-shirts, or multiple layers of clothing in an attempt to mask the swelling of the breast tissue. Many will have worn binders and compression garments of all types as concealment efforts. They will also adeptly avoid locker room and communal shower situations at all costs. It’s not uncommon for these men to have given up dating and for teenagers to not ever start dating at all in an effort to avoid the inevitable awkward situations. Sufferers will develop a whole cadre of coping mechanisms to avoid embarrassment, and by the time they come in to see me, they’ve simply tired of the avoidance dance.
Gynecomastia can be treated very successfully with surgery and liposuction, which removes any glandular tissue as well as any remaining excess fat. The surgery, when done by a board certified plastic surgeon, is a relatively simple procedure lasting about two hours. A scalpel is used to excise the breast tissue much like a mastectomy procedure to treat breast cancer. Liposuction is then used to remove any remaining fatty tissue on the outer margin of the chest. If the suspected cause is obesity, it’s important that the patient initiates and maintains a calorie appropriate, low fat diet to avoid recurrence.
Surgery is not right for every Gynecomastia patient, and that’s one of the critical reasons it’s important to talk to someone who has experience in treating the disorder. It’s essential that the right patient have the surgery done at the right time. As with every decision, it’s important to consider risk versus reward. It may be very difficult for the Gynecomastia sufferer to take that first step and talk about this. If you’re a male and find yourself suffering from enlarged and swollen breasts, please call and make an appointment so we can work together to find a solution that will give you back the portions of your life you’ve perhaps put on hold for many years. Gynecomastia is treatable and this summer you could be at the pool, comfortably, by calling us now for a consultation.