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Breast Reduction in Men With Gynecomastia

What is gynecomastia?

Gynecomastia is a condition in which the male's breast tissue enlarges. Gynecomastia literally means "woman breast." This increase in tissue usually occurs at times when the male is having hormonal changes, such as during infancy, adolescence, and old age.

What causes gynecomastia?

This is usually a benign (non-cancerous) condition that may be caused by many different hormonal changes, or the cause may be unknown. The changes in hormones usually include an increase in estrogens or a decrease in androgens (testosterone). Sometimes, this condition may be associated with other diseases that must be ruled out in order to make a diagnosis. In some conditions, including breast cancer, liver diseases, lung cancer, testicular cancer, tumors of the adrenal glands or pituitary gland, drug use, certain congenital (present at birth) syndromes, or thyroid disorders or trauma, gynecomastia presents itself as a symptom. However, this is not true in all cases.

Facts about gynecomastia:

Consider the following statistics regarding gynecomastia:

  • Most cases of gynecomastia occur during puberty, and the condition often will improve after two to three years without intervention. About 65 percent of 14-year-old boys have gynecomastia.
  • Infants may have a transient form of the disease that is often related to the maternal hormones.
  • Of the males who present with this at puberty, about 90 percent will have natural regression of the breast tissue.

What are the symptoms of gynecomastia?

Gynecomastia is an increase in breast tissue. There are different classifications of the grades of gynecomastia. One such classification is as follows:

  • grade I gynecomastia - a small amount of increase in breast tissue is present with no extra skin.
  • grade II gynecomastia - a moderate amount of enlargement of the breast can be seen with or without extra skin.
  • grade III gynecomastia - an exceptional enlargement of the breast with extra skin.

The symptoms of gynecomastia may resemble other medical conditions or problems. Always consult your physician for a diagnosis.

How is gynecomastia diagnosed?

In addition to a complete medical history and physical examination, diagnostic procedures for gynecomastia may include the following:

  • blood tests (including liver function tests and hormone studies)
  • urine tests
  • consultation with an endocrinologist - a physician who specializes in the functioning of hormones and how the hormones affect multiple organs.
  • mammogram - a low-dose x-ray of the breast.

Treatment for gynecomastia:

Specific treatment for gynecomastia will be determined by your physician based on:

  • your age, overall health, and medical history
  • extent of the disease
  • your tolerance for specific medications, procedures, or therapies
  • expectations for the course of the disease
  • your opinion or preference

Surgery may be an option to help remove the excess tissue. Often, if symptoms of gynecomastia are first apparent during puberty, it may be advised to wait as long as two years to allow for natural regression of the breast tissue. Your surgeon will help decide if you are a candidate for surgery.

About the surgery:

The type of anesthesia used will depend on many factors, including your preference, the surgeon, the extent of the growth, your age, and the size of the incision. Either local or general anesthesia may be utilized. The surgeon often will make marks on the skin before surgery to indicate the areas to be removed.

There are different types of surgical procedures that may be utilized, including the following:

  • suction lipectomy
    This is a form of liposuction that allows for tapering of the edges of the tissue without unwanted side effects. Complicated gynecomastia conditions may require an open surgical procedure, in which an incision is placed into the breast tissue and the excess tissue is removed.
  • endoscopic surgery
    This newer procedure uses a small, flexible tube with a light and a camera lens at the end (endoscope) to examine the inside of the breast. Tissue is then removed without placing a large, open, surgical incision. Data regarding the accuracy or complications of this technique are not available at this time.

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