Some men can develop enlargement of their breasts due to many reasons, this is called Gynecomastia. It can make you very self-conscious or even avoid situations where you otherwise be shirtless. Male breasts are actually a mixture of fat and breast tissue, similar to a female patient.
Causes
All men have a small amount of breast tissue that may respond to changes in hormone levels, especially at times like puberty. Consequently, the breasts in teenage boys may enlarge leading to a troublesome appearance. This can be seen either on one side or both. It can last for several years before the hormone levels settle down and the breasts return to a more masculine appearance. If the gynecomastia persists following puberty, then it may require surgery to correct the appearance. Most of the time observation is appropriate and a “watch and wait” attitude will lead to resolution without the need for male breast surgery.
Endocrine (hormonal or glandular) problems may also result in male breast enlargement, however, this is relatively rare. If this is suspected blood tests may be needed to measure various hormone levels. Adult men who have a new onset of breast enlargement, especially if it happens on both sides, with stable body weight should be tested to ensure endocrine problems are not the cause. Some of these endocrine abnormalities may be due to testicular or pituitary tumors. Consequently, a good general exam by an internal medicine doctor or endocrinologist should be performed. In addition, testicular ultrasound and brain MRI exams may be necessary.
Certain drugs can also cause Gynecomastia. One of the most common drug types to cause this problem are those used to treat prostate enlargement. Other prescription medications can also have this side effect and should be discussed with your doctor before surgery is considered. Marijuana and alcohol, if used frequently, may lower testosterone levels.
As with any enlargement or lump that can arise in the body, tumors must be considered a possibility when evaluating a male breast enlargement patient. If a discrete mass or lump is identified on an exam, or if the growth is new, then a complete workup with mammography, ultrasound, and/or MRI may be indicated. Needle biopsies or other treatments may also be recommended. Breast cancer in men is rare but it should be considered if the history or physical exam is suspicious.
Treatment
Dr. Matt Goldschmidt in Cleveland, Ohio uses several different approaches to effectively correct male breast enlargement. One of the most important factors is the amount of fat in relation to breast/glandular tissue. If there is a significant amount of loose skin as well, this may also play a role in determining which treatment is recommended. All of the recommended procedures are performed at an outpatient surgery center.
If enlargement is small or mild, then liposuction may be used to treat the deformity. Drains may not be needed but most patients will have to wear a compression garment for a brief period of time.
If enlargement is graded moderate, then liposuction may be combined with open removal of excess breast tissue. Most times, ultrasonic liposuction (Vaser Liposelection) is used to break up the tissue and help to create skin tightening. Nonetheless, some patients may still need a small incision to remove some of the remaining breast tissue.
In severe cases of Gynecomastia or cases of massive weight loss with lots of loose skin, a traditional breast reduction surgery may be recommended. The breast tissue will be removed, the nipple will be adjusted and moved upwards, and the loose skin will be tightened.
Risks
All surgeries carry some risk of problems afterward. Fortunately, these risks are rare, especially the more significant ones. The most common problems after Gynecomastia surgery are skin irregularities, asymmetry, nipple numbness, scarring, residual glandular tissue, healing problems, and pain.
For more information about Male Breast Surgery (Gynecomastia) or to schedule your Male Breast Surgery (Gynecomastia) consultation with Dr. Matt Goldschmidt, please call (216) 264-8100.