Enlargement of the male breast is known as Gynaecomastia. It is a common condition which can affect young boys or older adults as well. Although it is a benign condition in most cases, it leads to embarrassment, anxiety and poor self-esteem in affected individuals. The person feels awkward in any situation which compels them to undress publicly, or wear fitted clothes. It can happen because of change in hormone levels or as a result of certain systemic diseases or medications.
Some enlargement of the breast tissue happens in boys when they attain the age of puberty. This occurs because of the sudden increase in male hormone levels which are eventually converted into estrogen by fat cells in the body. This pubertal Gynaecomastia is physiological and most often doesn’t require treatment. It resolves after a period of few years on attaining adulthood when the hormone levels stabilise. Similar situation can occur in men over the age of 50 years with declining male hormone levels. This type of Gynaecomastia doesn’t subside on its own and may require treatment.
Other causes of Gynaecomastia are liver failure, kidney disease, excessive alcohol use, testicular atrophy or orchidectomy, certain medications and anabolic steroid use.
The treatment of Gynaecomastia will depend upon the cause and the clinical situation. In case of Gynaecomastia related to underlying disease or medication, the condition needs to be treated and the medication stopped or substituted. This will result in improvement in the enlargement of Breast tissue.
In cases of pubertal Gynaecomastia which persists into adulthood, or which is not resolving with medications, it requires surgical treatment. The surgery for Gynaecomastia can be done using a combination of liposuction using small cannula and gland removal by a small cosmetic incision. The recovery after surgery is quite rapid and patient can be discharged the same day or the next day. They can resume their routine activities after discharge and expect a complete recovery within 2 weeks. In cases of large Gynaecomastia, they might need to wear a compression garment for upto 6 weeks.