What is Gynaecomastia?
Every time a young male patient walks into my clinic and looks healthy but is wearing a very loose shirt or a T-shirt, I know the diagnosis in 9 out of 10 is going to be gynecomastia. In simple terms, “Gynaecomastia” means abnormal enlargement of breasts in males. In colloquial terms, it is also referred as ‘male-boobs’. The typical patient is a young adult male between 20-28 years of age and is embarrassed with his looks and avoids changing in public or doing activities like swimming. Anything which will make youngsters look different from their peers and invite ridicule can have a dampening effect on their self-esteem and confidence.
What are the causes of Gynaecomastia?
1. Pubertal Gynaecomastia or Male Breast Enlargement is due to an imbalance between estrogens (female hormones) and androgens (male hormones). Most cases are just developmental during adolescence and no real cause can be found. In pubertal gynaecomastia which persists in adults, the hormone levels are found to be normal and it may be due to the difference in sensitivity of circulating hormones.
2. Obesity plays in different ways. It has been found that in obese people there is an increased activity of a body enzyme called 'aromatase' which causes conversion of androgens into estrogens by a process called 'aromatization'. Estrogens being female hormones thus cause breast enlargement in males.
3. Steroids—Those wanting to be super fit and trying to ape their superstars six packs take the shortcut with nutritional supplements laced with steroids which cause inhibition of our body's natural male hormones (androgens) causing an imbalance between estrogens and androgens. Under the influence of relatively increased activity of estrogens, there is male breast enlargement.
4. Prolonged use of certain drugs like antacids and antiepileptic drugs can also sometimes cause gynecomastia. Uncommon causes of Hypothyroidism, hypogonadism, testicular tumours can also cause gynecomastia. Rarely, it can be malignant especially if only one breast is involved and the lump is hard.
What is the treatment of Gynecomastia?
In established cases of gynecomastia where no other pathology has been found, surgical correction yields excellent results. Recent advances allow us to perform gynecomastia surgery with virtually no or very minimal scars. A combination of advanced ultrasonic liposuction (VASER) and minimal scar gland excision leads to a fast recovery and normal contour in most cases. Very rarely in patients with gigantic breasts skin may need to be excised.
Satisfaction rates of the surgery are very high and almost all patients feel confident and normal about themselves. It may appear to be just an aesthetic procedure for others but the patients often call it a real ‘life-changing’ surgery. Increased awareness that this condition is correctable in a safe way through minimal scar surgery has made this one of the most popular plastic surgery procedures in males.