Publicado por Dr. Miguel Fernández Calderón: 30/11/2023
Gynecomastia in men is a condition that affects a large number of men, more common than you might think. It is characterized by enlarged breast tissue in males. Keep reading! We explain what it is, the causes and treatments.
What is Gynecomastia in Men?
Gynecomastia is a condition that appears exclusively in boys and men, involving the formation and accumulation of breast tissue in the chest area.
Gynecomastia can affect one breast or both, sometimes unevenly.
Although it can cause discomfort, in most cases gynecomastia is not a serious problem, but for those who experience it, it can be difficult to cope with this condition. They may even feel embarrassed, which is why the best option is to choose surgery to correct it.
Differences Between Gynecomastia and Pseudogynecomastia
Often, we tend to refer to fat accumulation alone as gynecomastia, but the truth is that breast tissue must be present to diagnose this condition.
In cases where only fat accumulates in the male chest, we would be talking about pseudogynecomastia. However, it is very common to see cases where both gynecomastia and pseudogynecomastia occur in the male chest.
Even if we lose weight, we may still have excess glandular tissue, which causes even very thin men to notice enlarged and unattractive breasts.
Common Causes of Gynecomastia
The causes of gynecomastia are, in the vast majority of cases, clinically unknown. This is because it can develop for various reasons, including hormonal changes and the intake of certain medications.
Regarding hormonal changes, gynecomastia can appear when testosterone levels fall compared to estrogen levels.
On the other hand, medications that can cause gynecomastia include: antiandrogens, anabolic steroids, antiretroviral medicines, ADHD medications containing amphetamines, anxiety medications, antidepressants, some antibiotics, chemotherapy agents, among others.
Additionally, recreational drugs, illegal substances and alcohol are believed to contribute to the development of gynecomastia.
Certain health conditions can also affect hormonal balance and cause or be associated with gynecomastia, including aging, tumors, thyroid problems, kidney or liver insufficiency, malnutrition, among others.
At Different Life Stages
Gynecomastia can occur at any stage of a man’s life, although it is more common during adolescence due to the various hormonal changes that can occur during this period.
- Gynecomastia in infants: More than half of male babies are born with enlarged breasts because their mothers’ estrogen levels are elevated. Breast tissue swelling typically disappears two to three weeks after birth.
- Gynecomastia during puberty: Hormonal changes during puberty can cause gynecomastia. Most of the time, the swollen breast tissue disappears on its own within six months to two or three years.
- Gynecomastia in adulthood: This type of gynecomastia usually appears due to intake of certain medications or hormonal changes caused by a disease. However, at this age, fat accumulation (pseudogynecomastia) is more common.
In the case of pseudogynecomastia, the most common cause is sudden weight change, where even after losing weight, localized fat deposits remain that are difficult to eliminate through diet and exercise.
Main Risk Factors
Puberty, aging, obesity, use of anabolic steroids and certain health conditions we mentioned earlier can be risk factors for developing gynecomastia.
Symptoms of Gynecomastia in Men
Symptoms of gynecomastia can include:
- Pain, especially in adolescents.
- Swollen breast tissue.
- Tender breasts.
- Sensitive nipples, especially when rubbing against clothing.
We recommend that you see a doctor if you feel the area is swollen, experience pain or tenderness, if fluid comes from one or both nipples, if you feel a lump, or if you notice dimpling of the chest skin.
Diagnosis of Gynecomastia
The diagnosis of gynecomastia aims to detect the presence of sub-areolar breast tissue in men, along with other signs such as nipple retraction, small skin dimpling, or discharge of any kind.
Clinical evaluation
The primary method used by physicians to detect gynecomastia is a physical examination, through which they can palpate the presence of glandular tissue measuring two centimeters or more in diameter. In addition, the specialist may resort to other methods and tests to complete the evaluation.
Recommended diagnostic tests
- Blood tests: performed to determine hormone levels such as estrogen, testosterone, hCG, LH, and FSH. Hormonal alterations may indicate an underlying condition of which gynecomastia is a secondary effect.
- Liver function tests: some pathologies associated with the kidneys can cause an increase in breast tissue in men. Therefore, assessing the patient’s liver and/or kidney function can help the physician with diagnosis.
- A mammogram or ultrasound: can be used to rule out that the enlarged breast size is due to the presence of other types of tissue, as well as abscesses or boils.
- Biopsies or tissue samples: these tests are used to extract tissue from the breast area and analyze it to detect cancer or tumors.
After all these tests, the physician can determine whether the patient indeed has true gynecomastia, and can recommend treatment or whether surgery may be necessary.
How can we treat gynecomastia?
The approach to treating gynecomastia will vary depending on whether the patient presents true gynecomastia, pseudogynecomastia alone (fat accumulation), or both. In the first case, we would opt for mastectomy; in the second, for liposuction; and in the third case, we could combine both procedures to achieve the best result.
Male breast reduction through mastectomy is currently the only effective treatment for gynecomastia, as it offers a lasting, if not permanent, solution. After this surgery, patients typically feel comfortable, as they can remove their shirt without self-consciousness and report having gained greater confidence in themselves.
If we feel uncomfortable with the appearance of our chest, or if we have been avoiding certain activities for fear of showing it, treatment to eliminate gynecomastia and pseudogynecomastia is an excellent option to consider to help our insecurities disappear once and for all.
With the help of an experienced aesthetic surgeon, the procedure can offer spectacular and almost immediate improvements. At Sculpture Clinic we specialize in all types of breast and body surgeries, always striving to find the perfect solution for you.
Gynecomastia with tissue removal (mastectomy)
Severe cases of gynecomastia may require surgical tissue removal to achieve optimal results. Patients who have loose, wrinkled, and sagging skin around the breasts may also benefit from this treatment. This allows the surgeon to remove more glandular tissue than would be possible with liposuction alone.
The location and length of incisions depend on the extent of the surgery. However, they are typically made around the edge of the nipple (periareolar), or within the natural breast fold. An expert and qualified plastic surgeon should perform the incisions in a way that makes them as inconspicuous and well-hidden as possible.
Gynecomastia with liposuction
Today, aesthetic surgeons can treat an increasingly large number of patients with pseudogynecomastia through liposuction. This is due to advances in this technology, which have resulted in increasingly less invasive and safer procedures.
However, the surgeon’s skill and experience also play an important role, and choosing a breast surgeon with training in liposuction and experience in gynecomastia and pseudogynecomastia removal is essential.
Treatment is typically performed under local anesthesia with sedation or general anesthesia, and consists of small surgical incisions on both sides of the chest. Depending on the patient’s needs, the surgeon may prefer one type of incision over another.
Through these incisions, the surgeon removes excess fat, while sculpting a natural-looking breast contour that suits the body.
Postoperative Recovery Process
The recovery process varies depending on the type of surgery performed, whether liposuction or mastectomy.
In general, the greatest discomfort lasts a few days, discomfort and sensitivity disappear within a week or two, and you will likely be able to return to work in 15 days.
Avoid lifting heavy objects during recovery, raising your arms over your head for the first few weeks, and always follow your surgeon’s recommendations.
In both cases, it is essential to understand that each person heals at their own pace. Therefore, we will strive to provide our patients with a personalized recovery period, as well as specific recommendations for their recovery.
Mastectomy postoperative
The recovery process is similar to that of liposuction; however, it is not uncommon for patients to experience pain, some swelling, and bruising. In any case, these discomforts are usually managed perfectly with pain relief medication.
You will have bandages and a compression garment around your body while you heal. This will help reduce swelling. You will be prescribed pain relief medication.
After the procedure, patients must rest before returning to work, which can occur within one to two weeks. Typically, a gradual return to exercise is allowed after three weeks or a month.
Liposuction postoperative
After liposuction, the recovery process is usually quite comfortable. Following surgery, patients typically wear a compression garment to help minimize swelling and provide support to healing tissues during the first few weeks.
Exercise is usually restricted for about three weeks, but many patients return to work within a few days of having the procedure.
You may have drainage tubes placed to remove fluids and blood after surgery, and you will be informed when they will be removed.
Keep in mind that you will not see results in the first few days; you will need to wait between three to six months after surgery. This is because chest tissue takes time to heal and you must wait for all swelling to disappear.
Benefits of Gynecomastia Surgery
Those who undergo this surgery feel much more confident in themselves and more comfortable with their appearance. They will be able to remove their shirt when going to the pool or beach without fear.
Additionally, this excess tissue can cause discomfort and even pain that, once the surgery is performed, will no longer be a problem. They will be able to jump, run, and do activities they used to avoid.
Psychological Impact and Support for Gynecomastia Patients
Those diagnosed with gynecomastia, in addition to suffering from the physical condition, often experience self-esteem issues, anxiety, and can feel considerable shame. In more complex cases, the patient may suffer from depression and reluctance to appear in public, even to the point of isolating themselves from their environment.
Men whose breasts are very large may be subject to bullying, which makes them feel rejected in family situations, educational settings, or even at work.
Additionally, they seek ways to hide their situation, concealing it with clothing; although often they find it difficult to find garments that fit well and make them feel comfortable. For others, gynecomastia can also affect their sex life, as they do not feel good about their body or the way they look.
Addressing Emotional Impact and Support Options
Because gynecomastia can affect the patient psychologically, consulting with a mental health specialist can be an effective solution so they can deal with the feelings this condition provokes. A therapist can also teach coping mechanisms to handle negative thoughts and manage the stress and anxiety they may feel when looking in the mirror or being in front of others.
Seeking support groups is another way to help these patients, as they can share experiences and stories with people in similar situations. In these groups, it is possible to exchange ideas, advice, and learn from what others have achieved.
Gynecomastia Surgery for Men in Madrid
In conclusion, at Sculpture Clinic you will find all the information you need for gynecomastia surgery for men in Madrid. We will conduct a detailed analysis of your case and address all your concerns. Finally, we will provide you with a tailored quote based on your needs.
