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Gynecomastia - Enlarged breasts in men

Information in spanish

What is the Gynecomastia?

The gynecomastia is the pathological or physiological condition where male breasts abnormally increase in size and volume. Volume may vary from a small to a pubescent breast. Although gynecomastia may develop in one breast or both of them, unilateral gynecomastia predominates.


Types of gynecomastia

Physiological gynecomastia: It is the physiological condition in men that occurs during puberty, characterized by unilateral or bilateral enlarged glandular tissue, of gradual growth and associated tenderness. This condition may appear in adult and elderly men. Gynecomastia may occur in newborn babies caused by transplacental transfer of maternal estrogens into the fetal bloodstream.

Pathological gynecomastia: This condition is characterized by development of enlarged glandular tissue of more than 4 cm of diameter and tenderness. Physiological causes are not defined.

Pseudogynecomastia: This is a type of gynecomastia is characterized by the augmentation of adipose tissue without glandular hypertrophy.


Cancer and gynecomastia
It is possible for men to develop breast cancer. Some findings suggest that there is an increasing incidence of breast cancer in men who had suffered from gynecomastia.


Faqs - Gynecomastia



What is the Gynecomastia?

The gynecomastia is the pathological or physiological condition where male breasts abnormally increase in size and volume. Volume may vary from a small to a pubescent breast. Although gynecomastia may develop in one breast or both of them, unilateral gynecomastia predominates.


Which are the characteristics of the patient with gynecomastia?

  • In adolescent boys, a small subareolar button that tends to harden may occur. In most adolescent patients gynecomastia will recede with age.
  • When this condition persists after puberty, it may be attributed to hypertrophy of breast tissue, chest adipose tissue, or a combination of both of them.
  • This condition is often tender or painful. The symptoms may persist for weeks or months.

What kind of anesthesia is used in the gynecomastia correction surgery?


The gynecomastia correction surgery is performed under general anesthesia with intravenous induction and inhalation anesthesia. You will sleep through the entire operation, feeling no pain and remaining absolutely relaxed. The section about Anesthesia provides complete information on this medical practice along with recommendations and instructions. Patient preparation before surgery

* Patient preparation includes treating the surgical site before surgery, using appropriate antiseptic agents for skin preparation.

* In the operating room the intravenous therapy or IV will be initiated. The IV is the giving of liquid substances directly into a vein. Through a needle you will receive saline solution, anesthesia, and other medications you may need during surgery.



How long does gynecomastia correction surgery take?

Gynecomastia correction surgery may take 1-2 hours to complete, but it may take longer if other procedures are also being performed at the same time.



Treatment of gynecomastia


Once the causes of gynecomastia have been assessed, the treatment is focused on the elimination of the potential trigger factors. Surgery becomes the ultimate option for gynecomastia treatment. If surgical option has been considered, a complete preoperative assessment is performed.



Gynecomastia correction surgery preparation

It is considered you are in surgery from the moment you arrive to the surgical area until the moment you have sufficiently recovered from anesthesia. Before surgery, your surgeon, anesthesiologist and the nursing staff will meet you in the pre-operative area to discuss your medical condition and answer any question.



The anesthesia

What kind of anesthesia is used in the gynecomastia correction surgery?


The gynecomastia correction surgery is performed under general anesthesia with intravenous induction and inhalation anesthesia. You will sleep through the entire operation, feeling no pain and remaining absolutely relaxed. The section about Anesthesia provides complete information on this medical practice along with recommendations and instructions. Patient preparation before surgery


* Patient preparation includes treating the surgical site before surgery, using appropriate antiseptic agents for skin preparation.

* In the operating room the intravenous therapy or IV will be initiated. The IV is the giving of liquid substances directly into a vein. Through a needle you will receive saline solution, anesthesia, and other medications you may need during surgery.


How long does gynecomastia correction surgery take?

Gynecomastia correction surgery may take 1-2 hours to complete, but it may take longer if other procedures are also being performed at the same time.




Characteristics of the patient with gynecomastia
Which are the characteristics of the patient with gynecomastia?

  • In adolescent boys, a small subareolar button that tends to harden may occur. In most adolescent patients gynecomastia will recede with age.
  • When this condition persists after puberty, it may be attributed to hypertrophy of breast tissue, chest adipose tissue, or a combination of both of them.
  • This condition is often tender or painful. The symptoms may persist for weeks or months.
  • It is sometimes difficult to differentiate between fatty tissue and breast tissue in obese patients. Most obese patients with enlarged breasts do not suffer from gynecomastia.
  • A thorough physical evaluation is recommended to avoid misdiagnosis of gynecomastia in obese patient.
  • In most cases of pseudogynecomastia, this condition resolves spontaneously in time, and surgery is not considered. Gynecomastia is often related to a hormonal imbalance and the use of some medications.
  • Men who suffer from gynecomastia feel frustrated about their chests´ appearance. In adolescent boys this condition may cause anxiety, introspection and especially depression.


Possible causes for gynecomastia

  • Hormonal disorders.
  • Some medications may cause gynecomastia.
  • Certain testicular tumors may cause gynecomastia.
  • Renal disease.
  • Men with Klinefelter´s syndrome may present gynecomastia.
  • Gynecomastia is a potential adverse effect in men with prostate cancer, who are receiving estrogen therapy.


Most cases of enlarged male breasts are related to obesity which is not associated with gynecomastia. Since misdiagnosis may occur in some cases, the treating physician should verify the gynecomastia characteristics through a complete examination, in order to confirm the diagnosis of this condition.



Evaluation

During consultation the following conditions will be evaluated:

  • Time of appearance of gynecomastia.
  • Level of pain with or without tenderness on palpation.
  • Evolution of this condition since its appearance.
  • Unilateral or bilateral gynecomastia.
  • Clinical assessment for diagnosing androgen (male sex hormone) deficiency.
  • Assessment of the medications and drugs taken by the patient.
  • History of malnutrition.
  • Renal, cardiac, liver, or pulmonary disease existence.
  • Clinical assessment of possible testicular disease.
  • Clinical assessment of symptoms associated with estradiol, thyroxine, cortisol, prolactin, and GH (growth hormone) excess.
  • Assessment of thoracic trauma.
  • Family history of gynecomastia.


Laboratory analyses and diagnostic tests
Your physician may possibly recommend some of the following analyses to verify the gynecomastia diagnosis:

  • Mammography and/or ultrasound scan.
  • Hormonal laboratory analyses.
  • Chromosome analysis.
  • Breast puncture.
  • Esticular ultrasound scan.


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Men, Gynecomastia Surgery
The surgery is not cosmetic, it is a broader concept. Help on personal, psychological growth and increases self-esteem of all things to practice it.