Who is gynecomastia applied to?

The situation where the breasts in men are larger than they should be is called gynecomastia. In other words, it is the abnormal but benign growth of the amount of breast tissue in men due to the imbalance of estrogen and testosterone hormones. Today, the increase in consumption of hormonal food, drugs taken, excessive alcohol consumption, thyroid, kidney, liver diseases and hormonal disorders can cause the breasts to be larger than they should be, in other words, gynecomastia. Gynecomastia can sometimes be seen in one or both breasts. In addition, it may be possible that both breasts are affected irregularly by the development of gynecomastia and reach different sizes. 

If you feel that you are not free during the choice of clothes, especially if you are uncomfortable with the protrusion of your breasts during the selection of t-shirts, you may have a gynecomastia problem. In such a case, a doctor’s examination is necessary to diagnose gynecomastia, determine its degree, cause and treatment. In addition, in cases of breast pain, tenderness, swelling and nipple discharge, an endocrinologist should be examined. Usually, breast ultrasound and hormone tests are requested after the examination.

Not Every Gynecomastia Requires Surgery

Gynecomastia is a health problem that mostly affects adolescents. Breast size problem, which occurs in more than 20% of adult men, mostly occurs around the age of 13-14. The expectation is that the breasts will shrink spontaneously as a result of balancing the hormones. In this period, the approach towards boys, who are in a sensitive period, i.e. adolescence, is very important in terms of their psychological state.

The patient should be kept under control for about 2 years before determining whether the child in adolescence has gynecomastia and deciding on gynecomastia surgery as a solution. During this period, the patient’s diet should be regulated. It is important to consume healthy foods that do not contain additives that may adversely affect their hormones, and not to overeat in order to achieve weight control. In case of excessive weight gain, enlargement occurs in the breasts, as is the case with the other parts of the body. An obese person should not be diagnosed with gynecomastia before they reach their normal weight. If the breasts do not shrink at the end of a controlled waiting period of 2 years, intervention may be on the agenda. Gynecomastia is a condition that can cause psychological distress, especially in adolescent boys.

The development of gynecomastia can be seen in adolescent boys as well as in newborn boys, albeit temporarily, with the effect of hormonal changes. Gynecomastia, which is seen in newborn boys due to the effect of hormones passed from the mother, usually resolves spontaneously within 1-2 months.

How to Detect Gynecomastia Manually?

During the gynecomastia examination, it is checked whether the glands that develop due to estrogen secretion are palpable or not. For breast enlargement caused by the increase in fat production, hard and lumpy tissue is not felt, especially under the nipple. In patients who develop gynecomastia, a hard, dense, rubbery and lump-shaped tissue can be felt under the nipple.

How Is Gynecomastia Treated?

Gynecomastia treatment is determined specific to each patient. In cases of gynecomastia that does not heal spontaneously or that causes pain, sensitivity and psychological problems that affect the quality of life of the individual negatively, drug treatment or surgical intervention may be considered. 

If there are different problems such as malnutrition, hypogonadism or cirrhosis underlying the development of gynecomastia, they are first treated. If there is a drug taking that may cause gynecomastia, it is preferable to change the drug. 

In glandular-type gynecomastia, the hard breast tissue is predominant and must be surgically removed. In mixed type gynecomastia, both adipose tissue and glandular tissue are abundant. In fatty type gynecomastia, liposuction procedure is preferred since fat tissue is predominant. 

The Nydick classification is used when measuring the course of gynecomastia and the patient’s response to treatment in adolescent boys. This means that the type of gynecomastia is determined by the size of the glandular tissue disc below the areola. In cases where the disc diameter is less than 4 cm, the problem is expected to resolve itself. Medical treatment is preferred for the disc diameter between 4-6 cm, and surgical procedure is preferred if it is larger than 6 cm.

The most effective and definitive method in the treatment of gynecomastia is gynecomastia surgery performed under general anesthesia. The surgical intervention to be applied is determined individually according to the size of the breast tissue and excess skin.

Before and After Gynecomastia Surgery

Before the gynecomastia surgery, the patient undergoes a detailed examination. The scope of the surgical procedure to be applied and the methods to be performed are determined. At this stage, the patient should fully inform his doctor about his medical history and the drugs he regularly takes, if any. It is extremely important to stop taking aspirin and derivative blood thinners at least 1 week before the surgery.

After gynecomastia surgery, patients use a gynecomastia corset for the recommended period. In the first few days following the surgery, tenderness, bruising, pain and edema may occur in the application area. In the first 3 days after the operation, the patient should unconditionally follow the recommendations about lying on his back and not taking a shower. The recommendation of the doctors is not to lie face down for at least 1 week after the operation.