Gynecomastia (enlarged breasts in men)

Quite a few affected men feel one Enlargement of the breast (gynecomastia) as extremely embarrassing and uncomfortable. In everyday life, these breast augmentations are also called derogatory Man boobs (English for men's breasts). For this reason, most men consider surgery. As part of this procedure, glandular and / or fatty tissue is removed so that the result is a flatter, firmer and therefore masculine breast.

What is gynecomastia?

Not only women have a particular problem with the image of their breasts. Some men also suffer from the fact that their chest areas grow steadily and thus become more and more similar to the female breast. This outgrowth is considered a clinical picture and is known as gynecomastia.

This is understood to mean an enlargement of the male breast, which results from the increase in tissue. There are two different types of disease. On the one hand the real and on the other hand the false gynecomastia.

The cause of what is known as false gynecomastia is overweight. Fat deposits within the male breast give the appearance of this substantial swelling. The so-called real gynecomastia is also based on a hormonal disease.

causes

According to statistics, at least forty percent of men are affected by gynecomastia. The reason for the fact that there is an atypical enlargement cannot usually be clearly explained.

It can be due to glandular diseases or changes in liver functions, but also to the use of anabolic steroids (estrogen-containing drugs), drug or alcohol consumption or, in rarer cases, a tumor, that a masculine breast becomes feminine, i.e. gynecomastia.

Some men have an increased proportion of female hormones (estrogens), which are responsible for the uncomfortable growth of the male breast. The trigger for this can be, for example, a hypothalamic disease. The excess estrogen in gynecomastia can also be due in part to the fact that the body of the respective man is producing too few male hormones.

However, some men also influence the body's own hormonal balance themselves. For example, while taking some anabolic steroids, the testosterone supplied can be largely converted into estrogen by their own body.

Symptoms, ailments & signs

The main symptom of gynecomastia is breast enlargement in men. This breast augmentation can be both physiological and pathological. Physiological gynecomastia such as puberty, neonatal, old age and pseudogynecomastia has no disease value. Here, however, a feeling of shame can lead to psychological abnormalities in those affected.

This sometimes leads to withdrawal from society, social isolation or even depression. There are no other symptoms. The person affected often needs psychotherapeutic care up to and including cosmetic surgery in order to be able to rebuild self-confidence. Sometimes gynecomastia is also pathological.

Then further physical symptoms can occur, which on the one hand concern the gynecomastia itself and on the other hand are triggered by the underlying disease. With pronounced gynecomastia, for example, there is sometimes a feeling of pressure or even pain in the chest. The nipples can be overly sensitive. Skin irritation is possible in the breast fold, which leads to severe pain.

The movement of the breast tissue often creates a particularly uncomfortable feeling. During exercise, these tissue movements can even cause severe pain, which can be avoided with a compression shirt or sports bra. In the case of pathological gynecomastia, one-sided breast growth can also occur in some cases. In addition to hereditary hormonal disorders, serious causes such as cancer or drug abuse can also lead to gynecomastia.

Diagnosis & course

If a gynecomastia is to be eliminated, an initial consultation is held in advance for the purpose of intensive consultation with a specialist (urologist). During this examination, for example, the hormonal balance is checked and other causes are researched in order to be able to make a clear diagnosis.

The various triggers that may come into consideration are also included here. Which further measures are to be used to treat gynecomastia is decided by the doctor based on diagnosis. In very rare cases, surgery is performed. Only in the case of extremely strong tissue proliferation, which also continues to progress, can breast surgery as a last resort restore the normal state.

Here, the excess breast tissue is removed by liposuction. However, this does not treat the cause of gynecomastia, but only changes the current condition. Further effective treatment must also take place after the surgical procedure. This can, for example, reduce gynecomastia through a change in diet or hormone balancing.

Complications

The enlargement of the mammary gland in men usually does not lead to any health complications or complaints. However, these can occur if the enlargement is caused by obesity or another disease. In most cases, however, there are psychological complaints. Most men feel uncomfortable and not beautiful with the enlarged breasts.

Inferiority complexes develop and self-esteem is greatly reduced. It is not uncommon for patients to withdraw from social life, leading to depression and other psychological upsets. The psychological complaints are usually treated by a psychologist, with no particular complications occurring.

The treatment of the enlargement of the mammary gland in men is always causal. In the case of obesity, the person concerned must switch to a healthy lifestyle in order to avoid further growth. Later on, the enlarged breasts can be surgically reduced. In many cases, drugs can lead to breast enlargement in men and must therefore be discontinued or replaced by other drugs after consulting a doctor.

The enlargement of the mammary gland in men does not lead to a reduced life expectancy. However, the underlying disease can be serious and must always be investigated.

When should you go to the doctor?

Treatment of gynecomastia always makes sense. This prevents further complications and complaints and also strengthens the man's attitude to life. However, the treatment is not medically necessary in every case, so that a clarification discussion with a doctor should take place first. A doctor should usually be seen if the man's mammary glands or breasts in general are significantly enlarged. A feeling of tension in the breasts can also indicate gynecomastia and should be examined by a doctor.

The breasts themselves are sensitive to touch, so that the nipples can also hurt when touched. If these symptoms occur for no particular reason, treatment by a doctor is advisable. Since gynecomastia can also lead to depression or other psychological upsets, a psychologist should be consulted. The first examination and diagnosis can be carried out by a general practitioner. The surgical procedure is usually carried out in a hospital and leads to a positive course of the disease.

Treatment & Therapy

If gynecomastia is mainly based on enlarged or excess mammary gland tissue, this can be removed by means of an operation so that the man's breast can be modeled flatter.During this treatment, one or more incisions are made in the areola (larger incisions, extensive incisions) so that excess glandular tissue can be removed directly.

In most cases, the common method "Ultrasound-Assisted Aspiration Lipectomy" (UAL) is used. In this procedure, an innovative cannula emits special ultrasonic energy to the fatty tissue, which, so to speak, "bursts" the superfluous tissue and then liquefies it. After the operation you will notice swelling and numbness, as well as some bruises in the chest area.

Such symptoms will usually go away within a maximum of three weeks. As a rule, an elastic bandage is applied for compression after the procedure, which actively supports the regression of the swelling and wound healing. The majority of those affected are enthusiastic about the result of the procedure, as this eliminates the cause for which the unmanly breast is responsible. Unfortunately, there is no medical intention for gynecomastia surgery, so it is considered a pure cosmetic operation.

Outlook & forecast

Gynecomastia usually begins in early puberty and does not resolve on its own in the course of life. Once the mammary glands are enlarged, they will remain in this size unless they are treated with drugs or surgery.

Real gynecomastia has to be differentiated from false gynecomastia, which is caused by obesity and fat deposits in the chest area. Incorrect gynecomastia can regress by reducing body weight - with correct weight loss even without hanging skin flaps. Real gynecomastia, on the other hand, only improves with medical treatment. In addition, the breasts with real gynecomastia are usually much larger than with the wrong shape.

If gynecomastia does not occur during puberty, it can also begin in old age when the proportion of male hormones decreases. While this process is completely natural, it also increases the proportion of female hormones and can cause the mammary glands of an aging man to enlarge. Often, however, the gynecomastia is not as pronounced as in the case where it begins in young men during puberty.

Hormone therapy and surgical breast reduction in the case of very high enlargement can help. While the surgical method is quickly successful, hormone treatment alone takes longer, but ensures the long-term success of the treatment.

prevention

Hormone-related gynecomastia can only be prevented to a limited extent. Men should definitely refrain from using anabolic steroids and other growth hormones for their sport or bodybuilding. Obesity-related gynecomastia can be prevented with plenty of exercise, endurance exercise, and a healthy diet.

Aftercare

The options for aftercare are severely limited in the case of a male breast enlargement. The first priority is the correct treatment of this disease and usually also the diagnosis of the underlying disease in order to prevent further complications and complaints. Of course, the trigger for the enlargement of the mammary gland in men should be found and avoided so that the disease can be completely resolved.

The treatment of the enlargement of the mammary gland in men usually takes place with the help of a surgical procedure. This usually takes place without any particular complications and also leads to success. This usually completely alleviates and limits the symptoms. After the procedure, the person concerned must remain in bed and rest in any case.

The chest region should then be supported and not experience any unnecessary strain. In general, exertion or stressful activities should be avoided. Since the enlargement of the mammary gland in men can also lead to psychological upset or even to depression, psychological treatment is necessary in some cases. Conversations with family or friends can also have a positive effect on the course of the disease. The patient's life expectancy is not restricted by the enlargement of the mammary gland in men.

You can do that yourself

Gynecomastia restricts those affected very much in everyday life; Swimming, sauna and tight clothing are avoided out of shame. In addition to drug or surgical therapy, there is often little self-help.

However, it is possible to reduce visibility through clothing, such as by wearing wide tops. Polo shirts or shirts that are worn openly over a T-shirt are distracting, especially if they have different colors or patterns. Avoid conspicuously printed shirts. But also shaping or so-called compression shirts make the body look firmer and more upright. The orthopedic chest strap or a good sports bra prevents the tissue from moving, making the chest appear flatter and firmer.

Diet changes, endurance sports and targeted training of the chest muscles create relief and minimize fat tissue, but they take time. Rowing and swimming are most effective. But push-ups or archery also transform the fatty tissue into muscles.

The consumption of beer must be avoided entirely; not only because of the alcohol and the increased calorie intake, but rather because of the phyto-oestrogens in hops. An open approach to gynecomastia and discussions about it ensure understanding and support the mental state.