Many men worldwide are affected by a condition known as Gynecomastia. We sometimes may hear a loose term like “man boobs” used referring to the condition that can present a physical and sometimes emotional challenge for a man.
This is a condition that will lead many men to search for male breast reduction techniques if they are unable to control the situation through diet and exercise alone.
If surgery is a consideration, speaking with a highly experienced board certified plastic surgeon like Dr. Charles J. Galanis at Galanis Plastic Surgery Beverly Hills, may be the answer.
If you are personally navigating gynecomastia or are seeking information for a loved one, here is some useful information for beginning to understand the condition in more detail.
What is gynecomastia?
Gynecomastia refers to an increased level or overdevelopment of breast glandular tissue in males. This breast enlargement occurs due to an imbalance of hormones with an estrogen excess and a lower level of free testosterone. This condition may impact either one or both breasts, occasionally leading to uneven enlargement.
The majority of cases begin with a preteen(prepubertal gynecomastia) or teenage male(pubertal gynecomastia) as they are experiencing hormonal fluctuations.
To date, gynecomastia has not been linked to or considered an increased risk factor for male breast cancer. Men have a very low risk of breast cancer, yet your plastic surgeon may request some lab work to rule out all possibilities of breast cancer.
Gynecomastia Symptoms
If you believe that you are affected by chronic gynecomastia you could do a pinch test using your forefinger and thumb to feel the area around and beneath your nipple. During your physical examination you are searching for the presence of a hard lump that is located beneath the nipple.
Excess adipose tissue in the chest due to genetics or lack of physical conditioning is a different situation than having fibrous palpable breast tissue. Performing the above mentioned pinch test can help to determine this.
A couple of other factors that could be associated with the symptoms of gynecomastia may include:
- Breast pain, particularly with teenagers
- Sensitive nipples
- Breast swelling
- Tender breasts
Gynecomastia Causes
Gynecomastia is typically a noncancerous condition that is associated with various factors affected by hormonal changes. The underlying cause in many cases is often unknown and referred to as idiopathic gynecomastia.
Fluctuations of increased estrogen production(female hormone) and free testosterone levels (male hormone) are common culprits that assist to develop gynecomastia, but other factors can also contribute to its development.
Sex hormone binding globulin(SHBG) controls how much testosterone that your body is able to utilize. Lower levels of SHBG allow for more testosterone availability, while higher levels will cause a decreased amount of free testosterone that can be utilized. Factors such as liver disease, hyperthyroidism, and obesity can contribute to the lack of efficiency of this process.
Drug Induced Gynecomastia
Drug induced gynecomastia can be caused by certain medications. Antidepressants, anti-anxiety medications, ulcer medications, antibiotics, chemotherapy drugs, prostate cancer medicines, and cardiovascular drugs may cause breast tissue proliferation as a side effect.
Illicit substances such as heroin, cannabis, and anabolic steroids are also known to cause breast swelling as potential causes of gynecomastia.
Prostate Cancer Patients
Advanced prostate cancer patients who have undergone hormonal treatment, such as androgen deprivation therapy or antiandrogen monotherapy, often encounter gynecomastia as a common complication. Fortunately, there are medical treatment alternatives to prevent the onset of gynecomastia, including the use of tamoxifen and prophylactic breast radiotherapy.
Cell Tumors
Gynecomastia can also be associated with tumors that disrupt the hormonal balance in the body. A testicular tumor or adrenal tumors have the potential to interfere with the normal production and regulation of hormones, leading to an elevated level of estrogen compared to testosterone.
We have briefly discussed a couple of the several medical conditions and diseases that can cause gynecomastia. Here is a quick list of these conditions included:
- Chronic kidney disease and chronic liver disease
- Klinefelter syndrome
- Lung cancer
- Testicular tumors or cancer
- Tumors of the pituitary gland leading to primary or secondary hypogonadism or adrenal glands
- Thyroid disorders
- Trauma or injury
- Obesity
Male Chest Reduction Candidate
When deciding if you are a good candidate for surgical treatment of your gynecomastia, your cosmetic surgeon will consider many factors. The ideal candidates are non-smokers and non-drug users who don’t have any preexisting medical conditions that could reduce their ability to heal.
Your plastic surgeon will also like to see that your breast development has stopped and that you are around a normal weight and in good overall physical health.
Consideration will also be given to treat gynecomastia in patients who are experiencing mental distress due to the feeling that their male breast tissue is excessive.
The Gynecomastia Surgery Procedure
Prior to your surgical procedure, medications will be provided to ensure your comfort. Intravenous sedation and general anesthesia are the options for anesthesia that your doctor will choose between for the most suitable option based on your individual circumstances.
Excess Fatty Tissue
If excess fatty tissue is the primary reason that is associated with your gynecomastia, liposuction techniques alone may be employed. Liposuction involves the insertion of a cannula, which is a slender hollow tube, through several small incisions.
The cannula is maneuvered in a controlled motion to dislodge the extra body fat, which is subsequently extracted from the body through vacuum suction.
Several liposuction techniques exist. The most suitable one for your case will be determined prior to your procedure.
Fibrous Glandular Breast Tissue
If fibrous glandular male breast tissue is the dominate reason for your breast enlargement, your surgeon will need to make an incision at the lower edge of the areola to remove the excess breast tissue growth.
Depending on your anatomy and the complexity associated with gynecomastia, your cosmetic surgeon could need to make additional larger incisions to achieve the natural contours of your chest.
Excision techniques are advised when correction of gynecomastia involves the removal of glandular breast tissue or excess skin. This approach is also necessary when adjustments to the areola size or repositioning of the nipple to achieve a more natural male contour are required.
Gyno Surgery Recovery
Recovery time following your plastic surgery will depend on what techniques your surgeon needed to employ to achieve your results.
When liposuction alone is sufficient for addressing gynecomastia, the standard recovery period post surgery is generally shorter when compared to procedures that will include the treatment of glandular tissue and/or loose skin associated with gynecomastia.
Following your surgeon’s instructions and staying with your scheduled post op appointments will keep you on the road to a smooth recovery. Here are a few important steps to follow to help with your recovery time:
- Get plenty of rest and avoid strenuous activity
- Stay hydrated and eat a nutritious balanced diet
- Avoid exposure from the sun to your treated area
- Wear your compression garment to help reduce breast swelling
- Take your recommended pain medications
- Discuss massage therapy with your surgeon to help with swelling and scar tissue
Gynecomastia Surgery Cost Beverly Hills
As with any plastic surgery, a gynecomastia surgery price will vary based on each individual’s set of circumstances. Opting for a more experienced and board certified surgeon will obviously incur higher fees, as you will be taken care of with the highest regards for safety.
The components contributing to the overall cost will include the surgeon’s fee, geographical location, facility fee, general anesthesia fee, medical tests, and post-surgery fees. All of these components will be discussed in detail during your personal consultation.
Questions and Answers
Why do I have man boobs?
The accumulation of excess weight in the chest area can give the appearance of enlarged breasts, commonly referred to as “man boobs.” This condition is attributed to the storage of excess fat in the chest, but it can also result from a hormonal imbalance known as gynecomastia.
Man boobs are a prevalent occurrence, affecting 40 to 60 percent of men. While the condition may cause discomfort for some, there are methods for men to address and reduce unwanted chest fat.
Is Treatment Of Gynecomastia Covered By Insurance?
Generally the cost to treat gynecomastia does not qualify for insurance coverage. Of course, you should reach out to your provider to see what would be the reasons to qualify for a claim. The American Society of Plastic Surgeons has published their criteria for reconstructive cases in gynecomastia. Inquire with your physician to receive this document to present to your insurance provider.
Will I Have Gynecomastia Scars?
Gynecomastia surgery involves making incisions, which lead to the formation of scars. The extent of scarring will be more prominent when excess skin and/or glandular breast tissue necessitates larger incisions.
In contrast, liposuction entails very small incisions that are expected to become barely visible with time. Regardless of the initial size of your scars, diligent care during the gynecomastia recovery period should contribute to their flattening and gradual fading over the months and years.
How Does Human Chorionic Gonadotropin Lead to Gynecomastia?
Human chorionic gonadotropin (hCG) stimulates testosterone production but can also increase estrogen levels indirectly. Elevated testosterone levels can convert to estrogen causing an imbalance that then can lead to a condition known as aromatase excess syndrome.
What Is The Androgen Ratio Referring To?
The activity level of androgen receptors and a favorable androgen-to-estrogen ratio are crucial for preventing gynecomastia. Disruptions to these mechanisms, whether due to genetic factors, hormonal imbalances, or environmental influences, can contribute to the development of gynecomastia.
What Is Persistent Pubertal Gynecomastia?
Persistent pubertal gynecomastia is the continued enlargement of breast tissue in males beyond puberty. It may result from hormonal imbalances, genetic factors, certain medications, or underlying medical conditions. Unlike typical pubertal gynecomastia, which resolves within a few months to years, persistent cases require medical attention. It can cause psychological distress and self-esteem issues. Treatment options include hormonal therapy, surgery, or addressing underlying conditions.
