1. What causes gynecomastia?
There are many known and unknown causes of gynecomastia. Most commonly in Indians it's idiopathic- meaning literally as `no known cause`. Gynecomastia is usually linked to changes or abnormalities in hormones. Sometimes, the male body experiences an imbalance in the production of the hormones testosterone and estrogen. Males normally produce estrogen in very small amounts. However, when males produce abnormally high levels of estrogen that are out of balance with levels of testosterone being produced by the body, breasts may form. Additionally, taking certain antibiotics, medications, or having serious health conditions can contribute to the formation of enlarged male breasts. Aging also plays a part in the growth of male breasts.
2. How is the gynecomastia graded?
The extent and severity of gynecomastia are graded by many methods. The commonly used method is Clark’s classification. It grades the gynecomastia based on the amount of breast tissue and the extent of loose skin over the breast. Clinically gynaecomastia is graded as follows:
Grade 1: Small enlargement, but without excess skin over the chest
Grade 2a: Moderate enlargement, without excess skin over the chest
Grade 2b: Moderate enlargement with extra skin over the chest
Grade 3: Marked enlargement with extra skin over the chest.
3. Can it be treated with diet and exercise?
The simple answer is NO!
They are strongly recommended – they are great for your general health. But neither will do too much for your gynecomastia. Because gynecomastia is excess breast and not excess fat and hence cannot be burnt by dieting or exercise. The amount of muscle or fat do however change the nature of chest and may make the chest look different depending on the proportion of muscle and fat and the amount of constant breast tissue that does not change in volume after puberty.
4. How is gynecomastia treated?
Medications may help some men manage the pain or symptoms of gynecomastia. For younger male patients who have the condition due to puberty, medication and periodic evaluations of the individual’s condition will be necessary. For men who find the condition bothersome, Lipo-excision surgery is the best option. It will remove fat and tissue from the breasts, as well as excess skin sometimes, giving patients a firmer, more pleasing appearance.
5. Are there any other methods of treatment of gynecomastia?
Male breast reduction surgery for established gynecomastia is the only known and recognized treatment. Creams, lotions, massage, injections, exercise and “magic pills” all will do nothing for established gynecomastia.
6. How do I know if the surgery is for me?
If you feel stressed out or embarrassed by the appearance of enlarged breasts and have social issues with it, the surgery may be right for you. Your doctor will work closely with you to determine what treatment is right for you!
7. Do I have an increased risk of cancer if I have gynecomastia?
The presence of gynecomastia does not make you more prone or less prone to breast cancer. Several studies have concluded that there is no increased risk of male breast cancer in those men with gynecomastia. It is important to note, however, that one percent of all breast cancers do occur in men. While it is very rarely seen in young men, older men must be made aware of this possibility. Therefore, any new lump, one-sided growth (asymmetry of the breast), skin changes of the breast or nipple, or bloody nipple discharge should be immediately investigated by a physician. A biopsy, a mammogram or a sonogram (ultrasound) examination may be advised.
8. What is the relationship between gynecomastia and drugs or medications?
Many drugs and medications produce gynecomastia as a side effect. If you are taking any medications, you would be wise to read about any potential gynecomastia-like side effects online. Some illicit drugs such as marijuana, heroin and bodybuilding steroids can also produce gynecomastia. It may also occur while taking seemingly harmless “supplements”, some of which may have hormone-like qualities. In some cases, stopping the medication may result in a diminishment of gynecomastia but most often, once the gynecomastia is present and established, it usually will remain unless corrective male breast reduction surgery is performed.
9. Are hormonal tests needed before surgery?
No. Hormonal tests are needed in only a minority of patients who have clinical signs of hormonal abnormalities. Its unnecessary to conduct the tests in everyone.
10. How should I prepare for surgery?
If you are a smoker, you will be asked to stop smoking well in advance of surgery. Aspirin and certain anti-inflammatory drugs can cause increased bleeding, so you should avoid taking these medications for a period of time before surgery. Your surgeon will provide you with additional preoperative instructions. Gynecomastia surgery is usually performed on an outpatient basis. If this is the case, be sure to arrange for someone to drive you home after surgery and to stay with you for at least the next day or two.
11. What results can I expect?
The result of gynecomastia surgery is usually straightforward. However, before you proceed you will need some tests to check your fitness for the procedure.
12. How will the recovery period progress?
The initial recovery period is the 3 to 7 days after your procedure. Total recovery time can vary from patient to patient. Most patients can expect to be fully healed by 3-6 weeks. The final results will, however, be obvious after three months. At this point, most or all of the bruising and swelling should have dissipated and the scars should have begun to shrink and fade. Sometimes, it may take as long as a year to completely heal to the point where the scars are no longer visible. For the first 3 to 6 weeks after surgery, it is necessary to avoid all strenuous activities, especially those involving the upper body such as lifting weights or intense workouts at the gym. In addition, patients are advised to wear a compression garment for 6 weeks post-operatively. After the surgery, you will need to do massage of the operated area twice daily for three weeks. This helps the swelling to reduce faster and the skin to even out better. Also, the pressure garment is mandatory for the proper reshaping of the chest.