What is gynecomastia?
Gynecomastia is the abnormal development of breast tissue in men resulting in breast enlargement. The condition can occur physiologically (with no pathologic basis) in newborn males (due to circulating hormones from the mother), during adolescence, and in the elderly. Gynecomastia occurs in about 60% of adolescent boys to some extent and is often a source of distress. The peak age of onset is 14 years of age, and commonly lasts one to two years. For the large majority of boys whose pubescent gynecomastia is not due to obesity, the breast development decreases or in some cases completely disappears within several years.
What causes gynecomastia?
The exact cause(s) of common (non-pathologic) gynecomastia remain unknown for certain. However, male breast enlargement has generally been attributed to a number of factors, including:
- Unopposed estrogen action on breast tissue
- Illicit drugs, such as marijuana
- Prescription medication, such as digoxin, furosemide, h1 blocker antacids and several other anti-hypertensive drugs
- Pathologic medical conditions, including:
- Liver cirrhosis
- Hormone-producing tumors
There is no relationship between gynecomastia and male breast cancer. However, every male with breast enlargement should be evaluated by a physician to assess for this rare possibility.
Who is a candidate for male breast reduction surgery?
- Adolescent males with breast enlargement that persists for 12-18 months duration
- Symptomatic patients (pain, tenderness)
- Disease of long duration that results in fibrosis (thickening) of the breast tissues
- Patients at risk for carcinoma (i.e. Klinefelter’s syndrome)
What are surgical options for gynecomastia?
There are three primary surgical options for patients suffering from gynecomastia. Each is dependent upon the type and degree of gynecomastia. These three options are:
- Liposuction alone works very well to reduce breast volume in gynecomastia patients whose breast tissue is mostly composed of fat.
- Open mastectomy: for patients with significant fibrous breast parenchyma, open excision of the dense enlarged breast tissue is often required.
- Breast lift with concurrent open mastectomy. Some patients will have great amounts of excessive breast tissue. In these cases, both the fibrous breast tissue and the associated sagging breast skin will need to be reduced.