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Gynecomastia

Enlargement of breast in males is known as Gynecomastia. The word is derived from Greek (gynaik- woman, mastos- breast), in other words, breast like a womanís. It must be differentiated from generalized fat accumulation, which occurs in obese men, and is known as pseudogynecomastia, or sometimes, as lipomastia. It is also different from the bulge, that occurs in body builders, which is largely, due to hypertrophy of pectoral muscle.

  1. What is the cause of gynecomastia?
    All individuals, whether male or female, possess both type of hormones, namely estrogens (female hormones) and androgens (male hormones). Any factor, which causes an imbalance leading to excess of estrogens in a male, persistent over a period of time, is likely to lead to gynecomastia.
  2. What leads to this imbalance?
    Liver diseases, malnutrition and recovery from it, intake of steroids, unsupervised intake of body building medications, disorders of male sex organs (testes) such as injury, tumours, infections, genetic disorders such as Klinefelterís syndrome, chronic renal failure, hyperthyroidism and sometimes, non testicular tumours may also cause this.
  3. I have been taking a medicine for a long time, due to a medical condition. Can this cause gynecomastia?
    Medicines used to treat high blood pressure (nifedipine, captopril, enalapril ), diuretic (spironolactone), antibiotics (ketoconazole, metronidazole), anti ulcer medicines (ranitidine, cimetidine, omeprazole), drug to treat parkinsonism (methyldopa), anti androgen or estrogen therapy for prostate cancer, digitoxin, diazepam, anti HIV drugs, alcohol etc may cause gynecomastia.
  4. Can this breast enlargement subside on it's own?
    Gynecomastia which occurs in normally growing infants and pubertal boys, can subside on itís own and is known as physiologic gynecomastia. In these instances also, you should consult your physician. Pseudo-gynecomastia which is due to generalized obesity, can respond to a diet and exercise regimen. Gynecomastia, which is due to medication, can reverse if this medicine is stopped early.
  5. How should I proceed?
    You can start by contacting our team. After detailed history, examination, lab investigations and the necessary hormonal assessment, a plan of treatment will be charted out. If necessary, then surgery will be advised.
  6. How is the surgery done?
    Surgery is carried out through a small incision, from 3 to 9 ĎO Clock position in the junction of dark (areolar) and normal skin. Initial liposuction is carried out to get rid of the fatty element. After this, the breast gland tissue is excised through the same incision. Small suction drains are left, exiting through armpits, to drain off any collected fluids and are removed at 48 hours. Incision is then closed with fine sutures. The scar is normally fine and not obvious. A pressure garment vest is advised to be worn for upto 3 months, to hold the now loose skin in correct position, while it shrinks under the influence of skinís own elastic fibres. The sutures are removed at 2-3 weeks.
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