Gynecomastia (Male Breast Reduction)

What is gynecomastia?

Gynecomastia is a medical condition characterized by the development of breast tissue in males. Enlarged male breast tissue may be accompanied by excess fat tissue and enlarged or herniated nipples. Also called man boobs, gynecomastia can affect one or both breasts and occur in males of any age, from infancy to adulthood.

Recent years have seen a spike in obesity surgeries and massive weight loss patients, contributing to an increase in cases of sagging breast skin complaints in male patients, which can also be addressed with gynecomastia surgery.

Gynecomastia surgery is an effective solution for male patients who experience breast enlargement and sagging breasts, improving their self-esteem and psychological well-being.

 

What causes breast enlargement in men?

Gynecomastia can be caused by various factors, including hormonal imbalances, certain medications, and underlying medical conditions. In many cases, the exact cause is unknown. It is mostly caused by an imbalance of hormones in the body, specifically an increase in estrogen levels relative to testosterone levels.

Many male patients complain of sagging breasts due to excessive weight loss following bariatric surgery. Gynecomastia surgery can be used to get rid of this sagging as well.

Gynecomastia can also be seen due to conditions such as liver or kidney disease, thyroid problems, tumors in the testes, lungs, adrenal glands, pituitary gland, or obesity.

Gynecomastia can also be seen in newborns for a short period. This is due to the mother's estrogen remaining in the baby's blood for some time after birth.

Gynecomastia and breast cancer

Gynecomastia is not a condition associated with breast cancer. Although it is rare for men to get breast cancer, your doctor may perform some tests to rule out the possibility of breast cancer.

How is gynecomastia surgery performed?

After analyzing the breast tissue, a small incision is made in the lower part of the areola to remove the excess breast and fat tissue.

While each patient's needs are different, gynecomastia surgery may involve the following steps:

• Removal of the breast tissue
  An incision is made at the edge of the areola to reach and remove the excess breast tissue. This is effective in decreasing the volume of the breast. At this stage, the surgeon may decide to perform liposuction first to homogeneously remove fat tissue and then gradually remove the breast tissue. This prevents the possibility of dimpling due to removing too much breast tissue and ensures a smoother appearance.

• Correction of the herniation
  In cases where the nipple has herniated, the tissue causing herniation is horizontally and gradually removed after the removal of fat tissue and breast tissue.

• Reduction of the nipple
  When the volume of fat and breast tissue decreases, the nipple and the skin contract to a certain extent and get smaller. This shrinking is adequate for most patients. The nipple may also be reduced surgically by trimming the excess tissue with a circumferential incision. However, during the healing period of this surgery, it is not uncommon to see an expansion of the incision around the nipple and an enlargement of the nipple.

 

Gynecomastia treatment with liposuction

Liposuction may be used as a standalone method in gynecomastia patients with little breast tissue and excess fat tissue. Liposuction is an adequate treatment for young or middle-aged patients with excess fat tissue and no herniation. During liposuction, the subcutaneous fat tissue is suctioned out, and the skin on top contracts and shrinks to fit the breast's new shape.

The most important factor determining how well the result will be is the patient's skin elasticity, or how well the skin adjusts to its new environment by shrinking.

However, in cases where excess breast tissue accompanies breast enlargement, this tissue needs to be removed surgically.

 

Bariatric surgery and massive weight loss

Sagging skin is a very serious source of discomfort for patients who lose significant weight. The nipple is situated quite low in these patients. A horizontal incision is made to remove the excess breast skin entirely, and the areola is transferred to its new location. While doing this, the sensation in the nipple may or may not be preserved, depending on the patient. The technique where sensation is not preserved makes it possible to remove more breast tissue and skin, leading to a smoother appearance.