Gynecomastia – Causes, Treatments and Surgery

Gynecomastia which is commonly called ‘Male Breast’ or ‘Man boobs’ is the enlargement of breast tissue in the males. Usually, there is deposition of fat along with a proliferation of breast gland tissue. It can be either one-sided or be on both sides. Gynecomastia Surgery is the only permanent solution.

The ideal male chest is flat, and the skin over chest muscle is tightly applied. There is a little breast tissue present in all men, just like all men have nipple and areola. Sometimes, due to numerous reasons, the breast tissue present between the skin and chest muscle enlarges and gives a feminine look. It can cause embarrassment and lack of confidence, especially in impressionable young boys. Peers teasing, unable to wear a shape-perfect dress or participate in bare-chest activities like swimming etc. can cause anxiety and psychosocial discomfort.

Gynecomastia usually presents after puberty or nearing old age. One in five young males develop breast tissue enlargement during adolescence but more than 75% of them resolve on their own within two years.

If you are facing a similar problem rest assured gynecomastia surgery is a simple, permanent solution.

We have written this All-in-One guide to help you understand your condition and then opt for the best treatment plan according to your needs.

In case you need consultation please feel free to book an appointment.

Is it Gynecomastia or just extra fat deposition or loose skin?

There are two other conditions similar to gynecomastia in which either the male breasts enlarge or sag downwards. When there is too much deposition of fat instead of enlargement of breast tissue, it is called ‘Pseudogynecomastia’ – False Gynecomastia. It may happen in Obesity where there is fat deposition in other body regions as well. Also in cases of massive weight loss, skin becomes loose and hangs downwards. Although there is minimal fat, the extra skin will have to be removed. Both these conditions have a slightly different treatment approach, but the result we look for is the same, i.e. An ideal male chest.

What are the Causes of Gynecomastia?

Let us keep it simple. Just keep two things in mind.

One – Our bodies develop to become male or female depending on the circulating hormones. So logically any disease which causes a disturbance in our hormonal balance can cause gynecomastia.

Second – Somehow, the hormones have to interact with the cells in our body in some way. So, if the cells are more sensitive to the hormones, it can still result in breast enlargement even when the circulating hormone levels are normal.

Keeping these two points mind the list of reasons causing gynecomastia will become very long. We have summarised just a few.

Before that remember;

Gynecomastia is not a disease in itself but a result of the underlying problem. It is more an aesthetic problem which is easily correctable by surgery irrespective of the cause.

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Age

Gynecomastia usually manifests at puberty or old age due to a physiological imbalance of estrogen and androgen. In more than 75% cases it goes away in 18 months. With the advent of puberty, boys experience newer development in their body both physical and physiological.

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Heredity

Our body shape is also dependent upon the genes that we inherit. Stubborn fat may reside at the arms chin, love handles, tummy etc.

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Underlying Disease

Gynaecomastia is mostly idiopathic in origin but may present as a symptom of an underlying disease such as liver disease, renal diseases, hormone disorders etc.

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Medication and External Hormones

Prior history of medication which affects the hormonal balance may lead to enlarged breasts. Sometimes it is an unavoidable side-effect. But can be easily corrected with the surgical technique without the need to change or stop essential drugs. Steroid abuse by bodybuilders is also associated with the development of Gynecomastia.

I might have gynecomastia what should I do next?

The next best thing to do is to book a consultation and visit your plastic surgeon. You will be examined thoroughly, asked to undergo a few investigations and asked a million questions. Don’t be scared that’s to rule out any other problems or disease. The treatment for gynecomastia will remain the same, but this will serve as a screening and help to start early treatment for any other issue. You might also have to visit an endocrinologist for hormonal status evaluation.

Pre-surgery Preparations

Once you and your surgeon have decided upon the surgery, a few pre-procedure preparations will be required.

Most of the investigations would have already been performed to make a diagnosis so only a few would remain. Even though small or straightforward all investigations are mandatory.

You will need to wear a snugly fit vest called ‘Pressure Garment’ after the surgery. It helps the skin to contract better and relieves oedema. Usually, the pressure garment is worn for the next two months. Pressure garments are custom designed to fit your body so measurements are taken beforehand and the garments are prepared in advance. Stitching and calibrations, if needed, may take a couple of days.

Your caretaker will give a detailed and well-explained set of instructions to follow. You get all that in print so that you may refer back to it whenever required.

What happens in Gynecomastia surgery?

The type of procedure selected for you will depend upon the size of the breasts. Simple liposuction clubbed with gland removal is suited for small and medium-sized gynecomastia where there is no loose skin. If there is extra loose skin, then additional techniques to remove the excess skin will be required.

Gynaecomastia Surgery may be done under local anaesthetic at the clinic if it is a small or medium grade of enlargement. Under local anaesthetic, only the area to be operated upon is anaesthetised. You will be awake the whole time, but you will have no pain. You will go back home the same day.

For large gynecomastia, general anaesthesia is required. You will be unconscious the whole time. You may have to stay back for a night after the surgery.

Tiny incisions are made through which liposuction cannulas are introduced, and the extra fat is suctioned out. Then a smile-shaped incision is made at the lower border of nipple-areola complex. The enlarged gland is dissected out and permanently removed. Since the incision lies at the junction of normal chest skin and the areola, it is not perceptible after final healing.
Sutures are placed inside the skin so do not require removal.

Post Procedure instructions

  • A small dressing is placed over the chest for five days, and the pressure garment is simultaneously applied. You will have to visit the clinic for dressing removal after five days.
  • For the first week, any movement at the shoulder joint is restricted such as pulling, pushing, lifting or raising the arms. The surgery is performed over the chest muscles. We need to allow the skin to heal and adhere to the underlying muscle.
  • From the second week, onwards routine day to day work is allowed, and a normal exercise routine is resumed after 4 weeks.
  • Pressure Garment has to be worn at all times during the first 2 – 3 months. (obviously except while bathing)

Please read and follow the post-procedure instructions carefully and thoroughly.

Dr. Vishal Purohit

Dr. Vishal Purohit

Cosmetic & Plastic Surgeon

Ranu Yadav

Ranu Yadav

Cosmetologist

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Faq’s

When will I see the results ?

A small dressing covering the chest is required for a period of 5 days. You may appreciate the result immediately after removal of the dressing. Although the pressure garment has to worn continuously over the entire day for 2 – 3 months the chest contour is remarkably improved. The final result after all healing and tissue remodeling is appreciable after 3 months.

What are the benefits of Gynecomastia surgery ?

  • Gynecomastia surgery corrects the shape of the chest. 
  • Although it is not an essential procedure this cosmetically enhances the upper body to regain confidence and overcome depression.
  • It is a permanent anatomical solution. Once the surgery has been performed there is no recurrence because the glad itself has been removed.

Who are the best candidates for Gynecomastia surgery ?

All male individuals above 16 years of age with breast tissue enlargement are candidates for gynecomastia surgery. It is preferable for the patient to be in good physical health without any preexisting problems like cardiac disease, liver or renal disease etc. If there is a pre-existing problem a prior physician review is mandatory.

What are the risks and safety considerations ?

Like all surgical procedures, there are risks related to the surgery, anesthesia, and sutures. Please read the Gynecomastia Informed Consent document thoroughly and completely to understand the risks involved.

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