Everything You Need To Know: Gynecomastia

Definition:

Gynecomastia is swelling of the breast tissue in males, typically explained by a hormonal imbalance

between the amount of estrogen and testosterone that is being produced by the body. Gynecomastia

can attack each breast, or both, resulting in an uneven proportion of fatty tissue. This condition can

affect males in all stages and progress at any age due to normal, natural changes in hormone levels,

although other causes do exist.

Gynecomastia may not be a life threatening predicament and is treated as predominantly a superficial

condition, but it is still an extreme ailment to cope with as it interferes with other areas of daily life. Men

and boys with gynecomastia sometimes experience intense pain in their breasts, similar to a soreness as

a woman would endure during her menstrual cycle. The physical and aesthetic attributes alongside with

the tender reactions as the two main symptoms leads to severe insecurity and embarrassment in males.

It is possible for Gynecomastia to go away on its own if hormones stabilize. Most cases require

medication or a surgical procedure.

Symptoms of Gynecomastia

Signs and symptoms of gynecomastia include:

• Swollen breast gland tissue

• Breast tenderness

When it’s time to see a physician or specialist:

• Swelling

• Pain

• Tenderness

• Nipple discharge in one or both breasts

7 Types of Gynecomastia…

• Type 1 Gynecomastia is commonly referred to as “puffy nipple”. The breast is composed of glandular tissue that is firm and dense. Many Type 1 gynecomastia patients have a lean body mass, have little fat and are of young age. Surgically removing the glandular breast tissue is the preferred choice for leading experts and are mildly invasive.

• Type 2 Gynecomastia is the most prevalent of all the types. Most males developed an excess breast volume that consumes the lower chest and is often the size of a tennis ball increasing over time to potentially the size of a large soft ball. Liposuction is the preferred and most effective treatment however; some patients have a combination of both fatty and glandular tissue. For these particular cases, a combination of liposuction and surgical removal is the preferred choice of surgery.

• Type 3 Gynecomastia has a chest angle of 45-60 degrees and starts to sag when the angle is within this range. Treatment for Type 3 gynecomastia depends on age and skin quality of the chest. Surgical removal of breast tissue is the standard technique tocertify that all of the necessary breast tissue has been removed.

• Type 4 Gynecomastia has a chest angle of 60-90 degrees. At this point, there is already a noticeable component of chest sag present and skin removal is absolutely unavoidable in order to correct the visibility of breast sag. Surgical removal of breast tissue is the ideal and optimal procedure to ensure all of the breast tissue is extracted. Liposuction is no longer an effective option for eliminating Type 4 gynecomastia.

7 Types of Gynecomastia Continued…• Type 5 Gynecomastia exhibits an obvious sagging breast tissue, which falls below the chest fold. The bottom of the areola is now visible

and located above the chest fold. Type 5 gynecomastia requires an anchor lift to properly tighten the chest. Males with Type 5 have

extra excess skin that needs to be treated accordingly. Both liposuction and surgical removal of breast tissue at the same time for this type of

gynecomastia is necessary.

• Type 6 Gynecomastia has extreme breast tissue sag and falls below the chest fold. It can be seen extending under the arm pits and

towards the back. If an individual is heavy and overweight, liposuction may be used to flatten the breast and decrease the fatty

deposits. Surgical removal of the glandular breast tissue is typically required at this level.

• Type 7 Gynecomastia has the top of the areola sagging below the level of the chest fold. There may be noticeable volume in the breast

which will often extend towards the back. Surgical removal of the breast tissue is imperative for Type 7 gynecomastia to deliver the complete

extermination of all unwanted breast tissue for male patients.

Causes of Gynecomastia Broken Down

Natural Hormonal Changes

• Testosterone and estrogen control the development and preservation of sexual traits in both men and women. Testosterone regulates male characteristics, like muscle mass and body hair production. Estrogen is the key supplier of female virtues, including the growth of breasts. Estrogen is often associated as being exclusive to the female, but men do produce it in small quantities as well. The imbalance of these two hormones for whatever reason is the main cause of gynecomastia and usually hits during one of three preeminent stages of growth.

Stages Most Likely to Occur•Infants

Most people are unaware that more than half of male infants are born with enlarged breasts due to the high exposure of their mother's estrogen. The swelling goes down on average two or three weeks after birth.

•Puberty

It seems almost customary and most probable for a young man to develop gynecomastia at this time due to the overwhelming changes occurring to his body. If swelling or other symptoms continue to progress after or longer than six months to a year, it would be wise to be evaluated by a physician.

•Senior Men

This condition may become prevalent once again between the peak ages of 50 and 80. One out of four man can be affected and the symptoms are so modest they may not even realize it.

For more information about the condition Gynecomastia or to schedule a consultation with Gynecomastia Surgeon, Dr. Steinbrech, please contact us at: (212) 750- 7100.

Medications/Drugs/Health ConditionsMedications

• Anti-androgens prescribed to treat prostate enlargement, prostate cancer and other diseases/disorders

• Anabolic steroids • AIDS medications• Anti-anxiety medications,(Valium)• Tricyclic antidepressants• Over the counter antibiotics• Ulcer medications• Cancer treatment (chemotherapy)• Heart medications

Recreational Drug Usage & Alcohol Consumption

• Large quantity of alcohol• Amphetamines• Marijuana• Heroin• Methadone

Herbal ProductsIn rare instances, natural plant oils, like lavender or tea tree, commonly added to shampoos, soaps and lotions have been linked to gynecomastia. The correlation between those products directly reflects weak estrogenic activity.

Health Conditions• Hypogonadism• Aging• Obesity• Tumors• Hyperthyroidism• Kidney Function• Liver Failure and Cirrhosis• Malnutrition and Starvation

Testing & Treatments for Gynecomastia …Testing may include:

• a brief evaluation from your physician

• an assessment of your family history as well as medical history

• blood tests and mammograms may also be administered to confirm or negate initial suspicions of gynecomastia

**Gynecomastia may go away if left untreated once hormones begin to stabilize and balance out. Although exercising and dietary plans

always beneficial for an overall healthy lifestyle, they are not the solutions to correct gynecomastia. **

Gynecomastia Shirts• Quick fix but not a long-term solution, Does not alleviate any real symptoms of the condition • Created and designed to sustain self-confidence among the individuals experiencing this condition• Acts as a compression vest to hide the physical alternations to your breast tissue and muscle • Instantaneous support and reinforcement to the appearance in males concerned with the overall

aesthetics that this condition exposes• Comfortable and non-restricting to daily activity

MedicationsMany of the same medications or similar techniques that are used to treat other conditions such as breast cancer often produce optimal results in easing and healing the pain and physical attributes amongst gynecomastia patients. Medications may currently be approved by the Food and Drug Administration, but they have not yet been approved specifically for this use. Individuals, under no circumstance should begin taking any medications unless under the surveillance and sanction from your medical professional.

Surgical Procedures Surgical Procedures Available to Gynecomastia Patients

• Only guaranteed way to resolve gynecomastia.

• Most personalized and custom treatment technique

• Little to zero guesswork involved as to what the outcome will be

• Provide the fastest results, quick recovery times, and specialty care from trained medical professionals

The Two Major Procedures Include:

• Liposuction- remove excess breast fat

• Mastectomy- dispose of the breast gland tissue

• More often than not a combo of the two is suggested to achieve optimal results.

The Quick Facts

• Surgery is often completed endoscopically, meaning only small incisions are used

• Less invasive type of surgery demands much less recovery time

• Actual surgical time is on average about two hours

• Requires local or general anesthesia

RecoveryRoutinely

• Swelling and Bruising

• Temporary diminished feeling in the chest and the nipples

• Discomfort, described as a “minimally intense chest muscle burn” like after a rigorous workout

• Scarring is minimal

(Recommended to review your surgeons “Before & After” photos so there are clear, realistic, and appropriate expectation)

• Expect to wear a special compression garment for a period of time during recovery to help support the newly augmented contours of your chest.

• Strenuous exercise, activity, and sports should be avoided for approximately four weeks after the surgery. Completion of healing time for full recovery may take anywhere from three to six months as if varies for each individual.

• Pain killers are prescribed as well as an antibiotic to prevent infection

Other lasting benefits from the surgery may include:

• A change in posture

• A change in attitude

• Newly restored or found self–confidence

• Enhanced cosmetic appearance

Prevention and InformationA few factors that may reduce the risk of gynecomastia

• “Say No!” Do not participate in the recreational use of illegal drugs. Examples include steroids and androgens, amphetamines, heroin, and marijuana.

• Avoid alcohol. Do not drink frequently or extreme large quantities of alcohol.

• Review your medications. Always consult your physician prior to taking medication. Even if the medication is prescribed or over the counter, having knowledge of the potential side effects are crucial to preventing gynecomastia. If there is any foreseen symptoms or effects of your medication, a medical physician can provide you with other choices or treatments.

We encourage you check out the Before & After Photo Gallery from maleplasticsurgerynewyork.com

About Dr. Steinbrech

Dr. Douglas Steinbrech is a fully-trained Plastic Surgeon, Board Certified by the American Board of Plastic Surgeons under the American Board of Medical Specialties. Dr. Steinbrech specializes in Minimally Invasive Aesthetics. He incorporates this philosophy into all of his surgical and non-surgical techniques. He has been selected as one of America’s Top Plastic Surgeons by the Consumers’ Research Council of America.

Surgical Training:Dr. Steinbrech underwent eight years of surgical training at New York University in General Surgery and Plastic and Reconstructive surgery. He was trained in Plastic and Reconstructive Surgery at the prestigious NYU Institute of Plastic and Reconstructive Surgery.

Learn more about Dr. Douglas Steinbrech.