Gynecomastia

Gynecomastia, often referred to as “man boobs,” is the enlargement of breast tissue in males, typically caused by a hormonal imbalance. While harmless in most cases, it can lead to discomfort and affect self-esteem.

What Causes Gynecomastia?

Gynecomastia arises from an imbalance between oestrogen and testosterone. Common causes include:

  • Medications: Some drugs, such as steroids, antidepressants, or heart medications.
  • Lifestyle factors: Alcohol, marijuana, and recreational drugs.
  • Health conditions: Liver or kidney disease, thyroid issues, or tumours affecting hormone production.
  • Breast tissue enlargement, either on one or both sides

Symptoms of Gynecomastia

  • Breast tissue enlargement, either one-sided or both
  • Tenderness or sensitivity
  • A firm mass beneath the nipple

Diagnosis

Doctors may use a physical exam, hormone tests, or imaging like ultrasound or mammography to confirm the diagnosis and rule out other causes.

Treatment Options

1. Observation:
Mild cases, especially during puberty, may resolve naturally over time. within 6 months to 2 years.

2. Lifestyle Changes:
Weight loss, regular exercise, and avoiding alcohol or drugs can help manage gynaecomastia.

3. Medication:
Hormonal therapies, such as tamoxifen or aromatase inhibitors, may reduce glandular tissue, particularly in early stages.

4. Surgery:
Options for removal include

  • a. Liposuction and microdebrider: this is a minimally invasive technique with a 5mm scar hidden at the areolar edge. The fatty tissue is removed with liposuction while the glandular component is removed with a microdebrider device. A compression garment is worn after surgery to help the excess skin retract.
  • b. Open excision: the glandular tissue is removed with a longer periareolar scar. This may be indicated in more severe cases.