What Is Gynaecomastia?
Growth of the breast tissue in men is common and is called gynecomastia. This condition often occurs during puberty and in many occasions resolves spontaneously. It can also occur in old age in which case it is unlikely to resolve but rarely requires treatment.
In people under the age of 20 treatment is rarely performed as the condition is likely to improve. In most cases the cause for the condition remains uncertain (idiopathic gynecomastia) and is has generally been attributed to an inbalance in sex hormones or the tissue unresponsiveness to them.
There are a number of factors that can produce the condition which need to be excluded. These include generalised weight gain. This is known as pseudogynecomastia and is best treated by judicious weight loss. Other causes include:
- Medication- the following drugs are believed to cause gynecomastia: Cimetidine, Omeprazole, Spirinolacte and Cannabis
- Increase in the production of the female hormone estrogen. This occurs in certain testicular tumours and in patients with hyperthyroidism.
- Decrease in the production of the male hormone testosterone. This can be caused by genetic conditions such as Klinefelter syndrome. Diseases of the hypothalamus or pituitary can also lead to low testosterone levels. Abuse of anabolic steroids has a similar effect.
It is important to remember that in the vast majority of cases no cause is found for the condition. In many cases other male members of the family have the condition and it can be considered hereditary.
Treatment
If you are overweight it is sensible to try and lose weight as this will reduce the fatty content of the breast tissue. In some cases this will not reduce the fullness in the area as it is composed of breast tissue rather than fatty tissue.
Exercising and building up the pectoralis muscled under the breast may make the condition worse. This is because it makes the muscle bigger and thicker but has little effect on the overlying breast tissue.
There a number of medications that are reported to reduce gynecomastia. There is little evidence that they are effective but they may be worth trying in the first instance as they are unlikely to cause any harm.
Surgical reduction of gynecomastia is possible and is either performed by fat reducing or excisional techniques. Liposuction is the main fat reducing technique and is works best on people with generalised prominence in the area without excessive skin laxity. Advantages of liposuction include minimal downtime and very little scarring. The scarring is limited to 2-3 short incisions approximately 5mm in length located at the edges of the breast tissue.
In some cases, it’s actual chest fat and not breast enlargement (due to growth of breast tissue) that gives the impression of man boobs. This condition is called pseudogynecomastia.
