Gynecomastia

Wirth Plastic Surgery

In this post, we will cover some important things you should know about gynecomastia, identify a number of the symptoms, and highlight a few options you have when it comes to treating this disorder.

Talking about one’s anatomy can be an uncomfortable topic for anyone, but this can be especially true for men when it comes to talking about of the size of their chest – or more specifically – their breasts.

Gynecomastia is the enlargement of glandular tissue in the breast of males. Based on how uncommon it is within the male population, it is still seldom discussed outside of medical offices and text books. Although it is almost always benign, it is a good idea to talk to your doctor if you show any signs of abnormal growth anywhere on your body.

Dr. Wirth sees many patients with gynecomastia. He often recommends getting the first workup done with your primary care physician and an endocrinologist to help evaluate the hormones. Once cleared for surgery, Dr. Wirth will discuss your surgical options and can work with you on an agreed-upon plan to correct the chest/breast appearance.

What You Need to Know About Gynecomastia

Symptoms of gynecomastia can be temporary or permanent and may show up on one or both sides of an individual’s chest. It is not age-specific and can occur for any number of reasons; many of which we will cover later on in this post.

Gynecomastia can be identified as a generally round mass of tissue, centered under the nipple and areola (the colored tissue around the true nipple), which develops beneath the skin. It is important to note that in true gynecomastia, it will be the glandular tissue that has enlarged and not fatty tissue. While the enlargement of breast tissue in males is completely normal (especially during puberty), more often than not it completely disappears after puberty, and sometimes only leaves a small, firm mass that doesn’t bother most men.

It is important to be mindful of certain abnormal qualities that could be a sign of diseases such as cancer (Breast cancer occurs about 1% of the time in men). If an individual suffers pain or discomfort from the enlargement of the glandular tissue, they might be experiencing what is known as “symptomatic gynecomastia.” This usually happens during initial stages of growth and should be monitored closely. Again, if you notice anything out of the ordinary, please consult your doctor who will work with you to diagnose the situation and help come up with a treatment plan specific to you and your needs.

Causes of Gynecomastia

Possible Causes of Gynecomastia include:

Idiopathic Gynecomastia: This is the diagnosis when gynecomastia presents itself with no known cause. While it may be frustrating to hear, this is actually a good thing, as it means that your doctor has ruled out many of the dangerous causes of the disorder.

Physiologic Gynecomastia: Diagnosed by your doctor as the result of your body’s response to a fluctuation of the hormone estrogen (the dominant hormone in females) and androgen (which is greater in males). This is typical for most newborns, pubescent boys, and men aged 60 and over. As men get older, the production of androgens and testosterone decreases, which allows estrogen to become more prevalent in the body and therefore can result in the enlargement of breast tissue.

Medications: Many medications can cause hormone imbalances which, again, can lead to abnormal breast growth. Common examples of medications that may result in gynecomastia include cimetidine for heartburn, spironolactone for high blood pressure, digoxin for heart disease, anti-androgens for prostate cancer, and other chemotherapy drugs. Other things linked to gynecomastia are anabolic steroids, herbal supplements, and the abuse of marijuana and opioids.

Medical Conditions/Genetic Abnormalities: Things such as kidney or liver failure, certain thyroid disorders, primary testicular failure, and tumors that secrete hormones are the most common in this category. Klinefelter syndrome is a genetic disorder with an extra female “X” chromosome and patients who experience this disorder often experience gynecomastia.

Treatment Options for Gynecomastia

  • Stay the Course: Once your physician had determined that the growth is benign, it is perfectly acceptable to not take any action at all. Physiologic gynecomastia will typically diminish on its own in boys at the end of puberty.
  • Surgery: If the patient choses to take this path, medical procedures such as liposuction, a mastectomy, or even direct excision can be done to remove the tissue altogether. The most common surgeries done to help treat gynecomastia are direct excision (the preferred method for Dr. Wirth), Suction-Assistant Lipectomy (SAL) and Ultrasound-Assisted Lipectomy (UAL). For patients with Klinefelter syndrome, a mastectomy is required to reduce the risk of breast cancer. Consult your doctor to learn more about the best option for you.
  • Adjustment of Medicine: If your gynecomastia is linked to medication(s), adjustments can be made by your doctor to help reverse the symptoms you are experiencing.

NOTE: Never make any adjustments to your medication schedule and/or dosage without first consulting your doctor. Consulting your doctor is always best before jumping to any conclusions. While gynecomastia is almost always benign when no other symptoms exist, it is important to distinguish it from breast cancer to ensure there are no underlying medical conditions.

Early detection is key when it comes to treating both gynecomastia and breast cancer, so be sure to check yourself regularly, and consider picking up a copy of Personalized Breast Care to learn more about breast care today!

Also, schedule your consultation with Dr. Wirth here, or call our Newport Beach office at: (949) 238-6713.

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