GYNECOMASTIA (MALE BREAST REDUCTION)
Gynecomastia or Gynaecomastia is the abnormal development of large mammary glands in males resulting in breast enlargement. The condition can occur physiologically in neonates (due to female hormones from the mother), in adolescence, and in the elderly (Both in adolescence and elderly it is an abnormal condition associated with disease or metabolic disorders). In adolescent boys the condition is often a source of distress, but for the large majority of boys whose pubescent gynecomastia is not due to obesity, the breast development shrinks or disappears within a couple of years. The causes of common gynecomastia remain uncertain, although it has generally been attributed to an imbalance of sex hormones or the tissue responsiveness to them; a root cause is rarely determined for individual cases. The condition may also be caused by an imbalance of estrogenic and androgenic effects on the breast, resulting in an increased or unopposed estrogen action on breast tissue. Approximately 4 to 10% cases of gynecomastia are due to drugs. Spironolactone (Aldactone) is a common cause, inducing gynecomastia in 10% of those receiving it as a treatment for heart failure. Both Digoxin and Furosemide are also reported to cause the same condition. Although, chances of gynecomastia could be more if these two drugs are coadministered. Breast prominence can result from hypertrophy of breast tissue, chest adipose tissue (fat) and skin, and is typically a combination. Breast prominence due solely to excessive adipose is often termed pseudogynecomastia or sometimes lipomastia. Gynecomastia should be distinguished from muscle hypertrophy of the pectoralis muscles caused by exercise (e.g., swimming, bench press, etc.). These are often seen together. Gynecomastia is commonly treated with liposuction with 3-4 mm incisions lateral to the chest. This procedure performed with moderate sedation is completed in less than two hours. Swelling begins to subside in three days; visual decrease in chest size is noticeable in one week. Results improve over the next several months. Patients return to work in two days with moderate soreness. Work outs can be resumed within a few days. A compression band should be worn for one month. Occasional patients may require an incision surrounding the areola to remove firm breast tissue below the areola. This can be performed either concomitantly or after the liposuction.