Gynecomastia refers to benign enlargement of male breast tissue. Most commonly the cause of gynecomastia is unknown, but it can be associated with other more concerning conditions, such as: endocrine disorders, liver disease, and testicular tumors. It can also be associated with certain prescription medications, the use of marijuana, steroids, and some work-out supplements. Gynecomastia to some degree is common during adolescence but usually resolves within one year. Because of the association with other more concerning conditions, men with abnormal breast enlargement that is painful, asymmetric, develops after adolescence, or persists for more than one year following pubertal development should seek evaluation by a board certified physician.
Gynecomastia is graded based on the degree of excess skin and breast tissue:
- I: Minor enlargement, no skin excess
- II: Moderate enlargement, no skin excess
- III: Moderate enlargement, skin excess
- IV: Marked enlargement, skin excess What are treatment options for gynecomastia?
Many men with gynecomastia seek surgical treatment from a board certified plastic surgeon because they are self conscious about their disproportionate breast size, embarrassed to remove their shirt in public or wear tighter fighting clothing, and want to increase their social confidence.
The treatment approach to gynecomastia varies depending on the degree of excess fatty tissue, breast glandular tissue, and skin. In some cases, such as the 24 year old patient below, the excess tissue is primarily fatty, there is little to know skin excess, and complete correction can be obtained with liposuction alone.
The most common operation involves a combination of liposuction and direct excision of excess glandular breast tissue. Frequently there is a firm area of excessive breast tissue below the nipple that will not be amenable to liposuction alone and requires direct excision via an incision placed at the border of the areola (pigmented tissue around the nipple). The 23 year old male below was treated with a combination of liposuction through a small incision in the arm pit and direct excision of the more dense breast tissue below the nipple via an areolar incision.
In more extreme cases where skin excess is also a problem, various additional incisions that will be more visible may be necessary to achieve a satisfactory reduction in breast tissue and skin. A surgeon will review the options that are most appropriate during your consultation.
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