What is Gynecomastia? Symptoms, Causes, and Surgical Solutions

Gynecomastia is the enlargement and/or hardening of breast tissue in men. It is usually harmless, but in some cases, it may be a sign of an underlying health issue. Caused by an imbalance between male and female hormones, gynecomastia does not resolve on its own unless treated. Gynecomastia surgery is generally considered a low-risk procedure.

What is Gynecomastia?

Gynecomastia is the enlargement of breast tissue in men. Breast tissue is present in both men and women, but is usually limited in men. In gynecomastia, the breast tissue grows beyond normal size, leading to enlarged breasts. This condition often appears on both sides. While gynecomastia usually does not cause serious health problems, it may sometimes be a symptom of an underlying disease.

What causes breast enlargement in men?

In adults, gynecomastia is caused by hormonal imbalances between male and female hormones and does not regress on its own unless treated. It can also appear during infancy and old age, and may be triggered by certain medications. Substance use, such as drugs or alcohol, is also among the causes. Some health problems (such as testicular cancer) may also disrupt hormonal balance and lead to gynecomastia. Another cause of gynecomastia is weight gain due to fat accumulation (pseudo-gynecomastia). In most adult patients, the most common cause is excess weight.

In adolescence, hormonal changes can lead to gynecomastia, which often resolves on its own. If there is an underlying hormonal disorder, treatment is provided by pediatric endocrinologists. If no hormonal disorder or other underlying cause is found, surgery may be considered after waiting 6–12 months.

What are the symptoms of Gynecomastia?

Symptoms of gynecomastia appear as enlargement or swelling of breast tissue in men. In addition, the following symptoms may occur:

• Hardness in the breast tissue
• Pain or tenderness around the nipple and areola
• Unilateral or bilateral breast enlargement or sagging
• Nipple discharge or fluid secretion
• Darkened skin around the nipple
• Underlying health issues such as liver or kidney disease causing gynecomastia

How is male breast enlargement diagnosed?

Diagnosis of breast enlargement in men is usually based on physical examination, medical history, and additional tests if necessary.

During the physical exam, your doctor will check your breast tissue and chest area. If the breast tissue is enlarged, swollen, or firm, gynecomastia may be diagnosed. Excess weight may also cause fat accumulation in both breasts, leading to an appearance known as pseudo-gynecomastia.

In medical history, your doctor evaluates factors such as gender, age, health status, medications, alcohol, or substance use. Since certain medications or diseases can cause gynecomastia, identifying these factors is important. If necessary, your doctor may order additional tests such as blood tests or imaging studies. These help identify the underlying cause of gynecomastia.

Once gynecomastia is diagnosed, your doctor will work to determine the underlying cause and recommend appropriate treatment.

How is Gynecomastia treated?

Treatment of gynecomastia depends on the underlying cause and the severity of symptoms. Treatment options may include medication, surgery, and lifestyle changes.

• Medication: If gynecomastia is caused by hormonal imbalance, medication may help regulate hormone levels.
• Surgery: Surgery is usually recommended when there is no underlying cause. The procedure removes or corrects excess breast tissue. It is generally performed under general anesthesia and takes a few hours. Recovery time usually ranges from a few days to a few weeks.
• Lifestyle changes: Weight management, quitting alcohol or substance use, exercising regularly, and following a healthy diet can help reduce symptoms.

The choice of treatment depends on the patient’s symptoms, underlying causes, and overall health. In every case, your doctor will recommend the most appropriate option for you.

Are there risks associated with Gynecomastia surgery?

Gynecomastia surgery is generally a low-risk procedure. However, like any surgery, it carries certain risks. These risks vary depending on the type of surgery, the patient’s health condition, and other factors. Possible risks include bleeding, infection, anesthesia-related complications, loss of sensation, asymmetry, scarring, and recurrence. Choosing an experienced plastic surgeon is crucial to minimize these risks.

For more detailed information about possible risks after gynecomastia surgery, consult your doctor.

Gynecomastia during Adolescence

Gynecomastia is common during adolescence and often resolves on its own. Hormonal changes at this stage can increase estrogen levels.

Symptoms may last up to a year and usually do not require treatment. However, if symptoms persist longer or are severe, a doctor should be consulted.

Your doctor may order tests such as blood tests, breast ultrasound, mammography, or evaluations for underlying medical issues. Special treatment is usually not necessary, but if symptoms cause psychological distress or embarrassment, your doctor may suggest treatment options, including surgery.

How common is Gynecomastia?

Gynecomastia, characterized by enlarged breast tissue in men, occurs in about 30–40% of all men. However, its prevalence varies across age groups.

About 50% of adolescent boys may experience symptoms, which usually resolve on their own. The prevalence also increases in older men, with about 25% of men over age 50 showing symptoms.

What is Pseudo-Gynecomastia?

Pseudo-gynecomastia occurs when there is no actual breast tissue enlargement but rather an increase in fat tissue in the chest area. This condition is characterized by swelling caused by fat accumulation instead of breast tissue growth.

Pseudo-gynecomastia has similar symptoms to real gynecomastia and is often misdiagnosed as such. However, it is more common than true gynecomastia and is typically seen in overweight men.

For diagnosis, your doctor may examine the breast area and order imaging tests such as ultrasound or mammography. Once diagnosed, treatment may include diet, exercise, and fat reduction methods. Depending on severity, liposuction or combined techniques may be sufficient.

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