The Surgeon Minute

Effective Treatment Options for Gynecomastia

Effective Treatment Options for Gynecomastia

Gynecomastia, often referred to as “man boobs,” is defined as a fullness in the chest caused by an excess of breast tissue and/or fat. Though not life threatening, it can cause an enormous amount of emotional trauma. Men with gynecomastia often feel self-conscious wearing certain clothing and can be too embarrassed to participate in activities like swimming or going to the beach, taking a toll on self-confidence. Many men suffer in silence, unaware of the effective treatment options available. Dr. Sean Doherty of Boston walks through the treatment options and why men should not fear gynecomastia surgery. In fact, maybe they should seek it.

What is Gynecomastia?

Gynecomastia is an enlargement of the male breast tissue. Commonly referred to by the unfortunate moniker “man boobs,” this fullness can be caused by an excess of fat, an excess of breast tissue or both. While a fullness of the breasts is the most obvious sign that you have gynecomastia, it can also manifest as breast tenderness, pain or as nipple discharge. Gynecomastia can be one sided or it can affect both breasts.

What Causes Gynecomastia?

Gynecomastia results from an imbalance in testosterone and estrogen levels. Most men don’t realize that they all have some estrogen. If, however, your estrogen level climbs too high, it can adversely affect the look of your chest. There are really three peak onset times for gynecomastia:

  • Infancy: This typically resolves within 2-3 weeks of birth.
  • Puberty: Hormonal imbalances during this time can result in breast tissue growth, but it usually goes away on its own within 6 months to 2 years.
  • Adult Age: Gynecomastia is very common in men between the ages of 50 – 69.

In each of these peaks, there is a different proportion of men with gynecomastia. In toddlers, it’s about 70-80%. In teenagers (puberty), it’s about 40 – 50%. And in older men in their 50’s and 60’s, it’s about 50 – 60%.  In fact, as many as 1 in 4 men in this older age group are affected by the condition. “Gynecomastia is extremely common,” explains Dr. Doherty.

Pseudogynecomastia vs. Gynecomastia

If you have gone online to research “man boobs,” you may ne confused by the often interchangeable terms pseudogynecomastia and gynecomastia. Are they the same thing? In short, “no”. But both are caused by a hormone imbalance and both result in an unwanted swelling in the breasts. Pseudogynecomastia is caused by too much stubborn fat in the pectoral region of the chest while gynecomastia is caused by an excessive amount of breast tissue and/or fat. For those patients who are suffering from pseduogynecomastia and are also overweight, the first course of action is to lose the excess weight. More often than not, this will result in the pseudogynecomastia resolving on its own.

Gynecomastia Treatment Options

For gynecomastia, there are three treatment options: liposuction, a direct excision of the breast tissue, or a combination of the two. The right choice for you is really going to depend on your anatomy, goals and the degree of your gynecomastia. While many “male patients are very adverse to surgical procedures,” explains Dr. Doherty, sometimes it really is the best option for delivering the smooth, flat chest that most men desire. Liposuction may seem more tolerable since it doesn’t involve “cutting”, but it’s not always the right solution.

Gynecomastia results.

Liposuction vs. Surgical Excision

The goal of any gynecomastia treatment is to deliver a smooth, flat chest. The benefit, and the problem, with liposuction is that it only addresses excess fat. If fat is the root cause of your “man boobs” then liposuction is a great solution. It’s fast, safe and effective. But for some men, fat is only a portion of the issue.

Many men who suffer from gynecomastia, especially those in puberty, have an excess of breast tissue or breast gland. This can only be removed with a surgical excision. “That’s a cut. That’s a scar,” explains Dr. Doherty.

Dr. Doherty - gynecomastia.

Gynecomastia Scars Are Easily Concealed

No man wants a scar on his chest, but it’s worse to have a procedure that does not correct the root cause of your gynecomastia. The important thing to remember is gynecomastia scars are easily concealed. If you require a surgical excision of excess breast tissue, your surgeon will typically place the scar at the juncture between your areola and chest skin. The areola is the dark skin that surrounds your nipple. By placing the incision at that edge, the surgeon uses the transition in skin color and texture to camouflage any scar.

Men always ask ‘When should I have my gynecomastia or man boobs fixed?’ and Dr. Doherty’s answer is “Now. When you are talking to me about it because it’s obviously bothering you.” Having the surgery done sooner rather than later means that you can enjoy the smooth chest that you’ve always wanted.

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