Gynecomastia Surgery (Male Breast Reduction)

Gynecomastia is defined as benign, excessive breast development in men. Some studies say that one out of every 3 men has gynecomastia. Gynecomastia, which can also be observed in infancy and old age, most commonly occurs in adolescence. Although gynecomastia is not a condition that is harmful to health, it causes distress and embarrassment in the person himself. Long-standing gynecomastia cannot regress spontaneously. It requires medical treatment and, if necessary, surgical intervention.

What are the causes of gynecomastia?

Gynecomastia is caused by an irregularity or imbalance of estrogen and testosterone hormones. In other words, if the amount of testosterone in the body decreases or the number of estrogen increases, gynecomastia may occur. This hormonal change can have many causes. Some of these changes are natural and there is no other underlying medical condition. Other gynecomastia may occur due to another ailment.

Gynecomastia treatment options

  • Before starting gynecomastia treatment, it should be evaluated whether the patient has an underlying hormonal disorder. Therefore, if an individual suspect that they have gynecomastia, they should first consult an endocrinologist.
  • Gynecomastia treatment options are determined according to the type of gynecomastia. There are many classifications of gynecomastia. The course and response to treatment of gynecomastia in adolescents is measured using the Nydick classification. In this classification, the type of gynecomastia is determined by the size of the glandular tissue disc located under the brown ring (areola) on the nipple. In adolescents with a disc diameter of less than 4 cm, it would be more appropriate to inform the patient and wait for it to pass spontaneously. However, if the patient’s complaint lasts longer than 4 years or if the clinical findings that disturb the patient increase, there is an indication to start treatment. If the disc in the patient is in the range of 4-6 cm, medical treatment can be applied. In cases with a disc diameter larger than 6 cm, surgical intervention is recommended.
  • Medical treatments are also arranged according to the patient’s age, hormonal level, and underlying medical reasons. Tamoxifen is the most commonly used drug in medical treatments. It shows its effect in about two weeks. During drug use, the patient should be followed closely every month. This drug does not show any benefit in adults with gynecomastia for more than one year.

Symptoms such as swelling, pain, tenderness in the breasts, and fluid coming from one or both nipples are among the symptoms of gynecomastia.

A manual examination of both breasts is important for gynecomastia. A hard, walnut-sized mass behind the nipple is palpable. These examination findings should be confirmed by performing breast USG on the patient. Examination and USG findings are guiding for diagnosis and planning of treatment.

Adolescents, the elderly, those who use anabolic steroids and androgens to improve their athletic performance; Those with liver, kidney, or thyroid disease, and those with Klinefelter syndrome are at risk for gynecomastia.

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