What causes gynecomastia in one breast. How is unilateral gynecomastia treated. What are the surgical options for single-sided male breast enlargement. Can gynecomastia be corrected without surgery. What is the recovery process after gynecomastia surgery.

Understanding Unilateral Gynecomastia: A Unique Challenge for Men

Gynecomastia, the enlargement of male breast tissue, can occur in both breasts or, less commonly, in just one. This condition, known as unilateral gynecomastia, presents a unique set of challenges for affected men. While not physically harmful, the emotional impact can be significant, often leading to anxiety, depression, and self-consciousness.

Unilateral gynecomastia can be particularly distressing due to the visible asymmetry it creates. This imbalance can be more difficult to conceal with clothing and may cause greater psychological distress than bilateral gynecomastia.

Causes of Gynecomastia: Hormonal Imbalances and Beyond

Gynecomastia is primarily associated with hormonal fluctuations, but several factors can contribute to its development:

• Hormonal changes during infancy, puberty, or aging
• Use of anabolic steroids or certain medications
• Genetic predisposition
• Underlying medical conditions
• Weight gain (fatty gynecomastia)

In the case of unilateral gynecomastia, the exact cause may be more difficult to pinpoint. It’s essential to consult with a medical professional to determine the underlying factors contributing to the condition.

Is unilateral gynecomastia always caused by hormonal imbalances?

While hormonal imbalances are a common cause of gynecomastia, unilateral cases may sometimes result from localized factors such as trauma, tumors, or infections affecting only one breast. A thorough medical evaluation is crucial to rule out any serious underlying conditions.

Non-Surgical Treatment Options for Gynecomastia

Before considering surgery, it’s important to explore non-invasive treatment options for gynecomastia:

1. Medication adjustments: If gynecomastia is caused by certain medications, changing or discontinuing them may help resolve the issue.
2. Weight loss: For cases of fatty gynecomastia, a comprehensive weight loss program can significantly reduce breast size.
3. Hormone therapy: In some cases, addressing hormonal imbalances through medication may help reduce breast tissue.
4. Compression garments: While not a cure, these can help minimize the appearance of enlarged breasts temporarily.

Can unilateral gynecomastia resolve on its own?

In some cases, particularly during puberty, unilateral gynecomastia may resolve without intervention. However, if the condition persists for more than two years or develops in adulthood, spontaneous resolution is less likely, and treatment may be necessary.

Surgical Solutions: The Gold Standard for Gynecomastia Treatment

When non-surgical methods prove ineffective, gynecomastia surgery, also known as male breast reduction, is often the most effective solution. This is particularly true for cases of unilateral gynecomastia, where achieving symmetry is crucial.

Gynecomastia surgery typically involves one or more of the following techniques:

• Liposuction to remove excess fat
• Excision of glandular tissue
• Skin tightening and nipple repositioning in severe cases

Even in cases of unilateral gynecomastia, surgeons often recommend treating both breasts to ensure optimal symmetry and a natural-looking result.

What determines the surgical approach for unilateral gynecomastia?

The surgical technique chosen depends on several factors, including the patient’s body type, the amount of excess tissue present, skin elasticity, and the degree of asymmetry. A skilled plastic surgeon will tailor the approach to each individual case to achieve the best possible outcome.

The Gynecomastia Surgery Process: What to Expect

Gynecomastia surgery is typically performed under general anesthesia as an outpatient procedure. The steps involved may include:

1. Making small incisions, often near the nipple or in the natural creases of the chest
2. Removing excess fat through liposuction
3. Excising glandular tissue if necessary
4. Repositioning the nipple and areola in cases of significant skin excess
5. Closing incisions with sutures

The entire procedure usually takes between one to three hours, depending on the complexity of the case.

How does the surgeon ensure symmetry when treating unilateral gynecomastia?

To achieve optimal symmetry, surgeons often treat both breasts, even in cases of unilateral gynecomastia. This may involve minor adjustments to the unaffected breast to ensure a balanced, natural-looking result. Intraoperative measurements and careful contouring techniques are used to create a harmonious chest appearance.

Recovery and Results: The Path to a New Chest Contour

Recovery time after gynecomastia surgery varies depending on the extent of the procedure:

• Liposuction-only cases: Most patients can return to normal activities within a week
• Tissue excision cases: Recovery may take two to four weeks for routine activities

Patients are typically provided with a compression garment to wear for several weeks post-surgery. This garment helps minimize swelling and supports the healing tissues.

When will the final results of gynecomastia surgery be visible?

While initial improvements are noticeable immediately after surgery, final results may take several months to fully develop. Swelling gradually subsides, and the chest contour continues to improve over time. Most patients see their final results within 3-6 months post-surgery.

Potential Risks and Complications of Gynecomastia Surgery

As with any surgical procedure, gynecomastia surgery carries some risks. Potential complications may include:

• Bleeding or hematoma formation
• Infection
• Adverse reactions to anesthesia
• Changes in nipple or breast sensation
• Contour irregularities
• Asymmetry or unsatisfactory aesthetic results

It’s crucial to choose a board-certified plastic surgeon with experience in gynecomastia surgery to minimize these risks.

How can patients minimize the risk of complications after gynecomastia surgery?

To reduce the risk of complications, patients should:

1. Follow all pre- and post-operative instructions carefully
2. Avoid smoking and alcohol consumption before and after surgery
3. Wear the compression garment as directed
4. Attend all follow-up appointments with the surgeon
5. Avoid strenuous activities during the recovery period

Scarring After Gynecomastia Surgery: What to Expect

The appearance of scars after gynecomastia surgery depends on the surgical technique used and the individual’s healing characteristics. In most cases, incisions are strategically placed to minimize visible scarring:

• Liposuction-only cases may have small, barely noticeable scars
• Tissue excision cases typically have scars around the areola or in the natural chest creases

Over time, these scars tend to fade and become less noticeable. Many patients find that the improvement in their chest contour far outweighs any concerns about scarring.

Are there ways to minimize scarring after gynecomastia surgery?

To minimize scarring, patients can:

1. Follow the surgeon’s wound care instructions meticulously
2. Avoid sun exposure to the incision sites for at least six months
3. Use silicone-based scar treatments as recommended by the surgeon
4. Maintain a healthy lifestyle to promote optimal healing

Your surgeon may also use advanced techniques during the procedure to minimize scarring, such as careful suturing methods and strategic incision placement.

Long-Term Results and Satisfaction After Gynecomastia Surgery

Gynecomastia surgery typically provides long-lasting results, especially when combined with a healthy lifestyle. The majority of patients report high levels of satisfaction with their new chest contour and experience significant improvements in self-esteem and quality of life.

It’s important to note that while surgery removes excess breast tissue, it does not prevent new tissue from forming. Maintaining a stable weight and avoiding medications or substances that can trigger gynecomastia is crucial for preserving long-term results.

Can gynecomastia recur after surgery?

While rare, gynecomastia can potentially recur after surgery, especially if the underlying cause is not addressed. Factors that may contribute to recurrence include:

• Significant weight gain
• Use of certain medications or anabolic steroids
• Hormonal imbalances
• Aging

Regular follow-ups with your surgeon and maintaining a healthy lifestyle can help minimize the risk of recurrence.

Choosing the Right Surgeon for Gynecomastia Treatment

Selecting a qualified and experienced surgeon is crucial for achieving optimal results from gynecomastia surgery. When choosing a surgeon, consider the following factors:

• Board certification in plastic surgery
• Extensive experience in male breast reduction procedures
• Before-and-after photos of previous gynecomastia patients
• Patient reviews and testimonials
• Clear communication and a thorough understanding of your goals

Don’t hesitate to ask questions about the surgeon’s experience, techniques, and expected outcomes during your consultation.

What questions should patients ask during a gynecomastia surgery consultation?

Important questions to ask your surgeon include:

1. How many gynecomastia surgeries have you performed?
2. What technique do you recommend for my specific case?
3. What kind of results can I realistically expect?
4. What are the potential risks and complications?
5. How long will the recovery process take?
6. What measures do you take to ensure symmetry, especially in cases of unilateral gynecomastia?

A reputable surgeon will be happy to address all your concerns and provide detailed information about the procedure.

The Psychological Impact of Gynecomastia and the Benefits of Treatment

The emotional toll of gynecomastia, particularly unilateral cases, can be significant. Many men experience:

• Low self-esteem and poor body image
• Social anxiety and avoidance of certain activities
• Depression and feelings of inadequacy
• Relationship difficulties

Successful treatment of gynecomastia can lead to dramatic improvements in psychological well-being. Many patients report increased confidence, improved social interactions, and a renewed sense of masculinity after surgery.

How can patients cope with the psychological effects of gynecomastia while awaiting treatment?

Coping strategies for managing the psychological impact of gynecomastia include:

1. Seeking support from trusted friends, family, or support groups
2. Engaging in regular exercise and maintaining a healthy lifestyle
3. Practicing positive self-talk and body acceptance
4. Considering professional counseling or therapy
5. Educating oneself about the condition and treatment options

Remember that gynecomastia is a common condition, and seeking treatment is a positive step towards improving your quality of life.

Financial Considerations: Gynecomastia Surgery Costs and Insurance Coverage

The cost of gynecomastia surgery can vary widely depending on factors such as:

• The complexity of the case
• The surgeon’s experience and location
• The type of anesthesia used
• Facility fees
• Post-operative care requirements

In most cases, gynecomastia surgery is considered a cosmetic procedure and is not covered by health insurance. However, if the condition causes significant pain or is the result of certain medical conditions, insurance may provide partial or full coverage.

Are there financing options available for gynecomastia surgery?

Many plastic surgery practices offer financing options to help make gynecomastia surgery more accessible. These may include:

1. In-house payment plans
2. Medical credit cards
3. Personal loans
4. Healthcare-specific financing companies

Discuss available financing options with your chosen surgeon’s office to find a solution that fits your budget.

Advancements in Gynecomastia Treatment: Looking to the Future

As medical technology continues to advance, new treatments for gynecomastia are emerging. Some promising developments include:

• Minimally invasive techniques with smaller incisions and faster recovery times
• Advanced imaging technologies for more precise tissue removal
• Hormone-targeted therapies to prevent gynecomastia recurrence
• Improved fat grafting techniques for chest contouring

While surgical intervention remains the gold standard for treating gynecomastia, these advancements may offer additional options or improved outcomes in the future.

What role might non-invasive body contouring play in future gynecomastia treatments?

Non-invasive body contouring technologies, such as cryolipolysis and high-intensity focused ultrasound, show promise for treating mild cases of gynecomastia or as adjunctive treatments. While these methods may not replace surgery for severe cases, they could offer less invasive options for some patients in the future. Ongoing research continues to explore their efficacy and long-term results in treating gynecomastia.

Ways to deal with the problem of gynecomastia in single breast in men

For men suffering from gynecomastia, the condition can be quite challenging. Gynecomastia is not physically harmful, but the emotional toll it can take on a man’s life is devastating. A lot of men who have gynecomastia experience anxiety, depression, and embarrassment about their enlarged breasts. Usually, a vast majority of patients with gynecomastia have bilaterally enlarged male breasts but a small percentage of men develop unilateral gynecomastia. The prevalence of asymmetry can often be more difficult to cope with instead of having gynecomastia on either of the sides. To treat gynecomastia in the single breast in men, a medical procedure of Gynecomastia surgery is performed.

What causes gynecomastia?

Gynecomastia disorder can be caused by various factors. It is associated with a hormonal imbalance or fluctuation. For this reason, it is often seen as a temporary condition in infants who still might have some of the mother’s hormones remaining in their system and adolescents going through puberty. Men can develop enlarged male breasts due to various factors. Some of the most common causes of gynecomastia include hormone changes, steroids, and genetics. Also, medical conditions and weight gain (fatty gynecomastia).

Can you develop gynecomastia in one male breast?

Although it is less common, gynecomastia can certainly be present on just one side. Most people do not have perfectly symmetric or even breasts. Unilateral gynecomastia can lead to a significant level of irregularity in breast. Hence, it can be embarrassing and at the same time difficult to conceal with clothing. Gynecomastia operation can be an excellent solution for correcting the medical condition of gynecomastia.

Can gynecomastia be treated without surgery?

A crucial step in gynecomastia treatment is to decide the exact cause of your medical condition. In case of some patients, a change in their medications may be sufficient to rectify the breast enlargement. In other cases such as fatty gynecomastia weight loss may be an effective solution.

However, cosmetic surgery is often needed to correct glandular gynecomastia. And, ultimately, achieve the masculine look patient’s desire. As per the doctors, whether a patient has gynecomastia in one male breast or on both sides, bilateral treatment is the best method for achieving the possible symmetry. The technique used for the surgery will depend on the patient’s body type, for example, how much excess tissue is present, and other factors.

Typically, gynecomastia surgery is performed under general anesthesia. It involves an incision near the nipple and there is use of liposuction to remove fat from the chest. In severe cases of gynecomastia, the medical professional may also need to remove tissue surgically and tighten the skin. The doctor will also reposition the nipple for a better masculine appearing chest.

Recovery after Gynecomastia Surgery

The patients who only undergo liposuction to correct their enlarged male breasts can return to usual exercise regime and perform daily tasks in typically less than one week. But, if there is a surgical removal of the excess breast tissue, it can take anywhere between two to four weeks to heal enough to tolerate routine activities.

The recovery procedure following liposuction is quite tolerable. Patients who undergo Gynecomastia treatment are provided with a special compression garment. This needs to be worn for the first few weeks after surgery. This type of garment is useful to minimize swelling. Also, it offers support to the healing tissues.

Risk involved with gynecomastia surgery

Although the surgical procedure for gynecomastia treatment is safe and the recovery process is smooth, there is a possibility of complications. Some of the commonly noticed complications include bruising, bleeding, fluid collections and contour irregularities. Apart from these, there may be loss of nipple skin, visible scarring, numbness of the nipples, loose breast skin, etc.

What do gynecomastia scars look like?

The appearance of the scars after gynecomastia surgery recovery will depend on the surgical approach and other treatments that may be performed simultaneously. According to a lot of patients, the improvement in their physique is well worth slight scar.

There are often questions like is gynecomastia surgery safe? The answer is that yes it is quite safe as reported as of now. Before undergoing gynecomastia surgery, you must enquire about the gynecomastia surgery cost of the cosmetic surgery clinic near you.

If you are suffering from gynecomastia and wish to go for the suitable treatment options, you must reach out to a plastic surgeon that is known for the best gynecomastia surgery in Hyderabad. He/She will help you understand if going for the surgical treatment would be appropriate or not, according to the extremity of your medical condition.

Can Gynecomastia Appear On Only One Side?

Dr. Younghoon Cho | 10/13/2020

Gynecomastia can be an embarrassing medical condition for male patients. You may be unfamiliar with the term, as it is not often discussed in social circles. However, studies have shown that roughly 65% of adult men from ages 27 to 90 have dealt with breast tissue enlargement. It occurs when excess glandular tissue causes the breasts to become enlarged and swollen, taking on a more feminine-looking appearance. While some men experience this condition in both breasts (bilateral), others struggle with it in only one breast, also known as unilateral gynecomastia.

Although there are usually no health risks involved, the condition can be embarrassing and painful for patients. In most cases, gynecomastia is treatable with liposuction, male breast reduction surgery, or a combination of both. Board-certified plastic surgeon Dr. Young Cho at Chiseled in Spring, TX is highly experienced in performing these procedures for his patients hindered by this medical condition, helping them to achieve their aesthetic goals. Read on to learn more about this condition from Dr. Cho.

Why do I have enlarged breasts?

Gynecomastia is a benign breast enlargement that is a firm or rubbery mass extending from the nipple area. It is typically a bilateral condition for men, but, sometimes, can be a unilateral issue for patients. One-sided gynecomastia, like bilateral growth, is most commonly caused by an imbalance of hormones, resulting in a patient’s estrogen levels being too high or out of balance with testosterone levels. Additional scientific and medical explanations for why some men suffer from gynecomastia are:

• Lack of proper nutrition
• Overweight
• Medical conditions, such as liver disease, kidney failure, or tumors on the adrenal glands
• Adverse side effect from a prescription medication
• Anabolic steroids
• Excessive use of alcohol or certain “street drugs”

What should I know about unilateral gynecomastia?

Gynecomastia is typically a benign condition that poses no additional health risks to patients. Unilateral gynecomastia, also known as “one-sided” breast enlargement, can vary from patient to patient. The benign growth can be either small or large, making a man’s chest look less masculine and more feminine-like in appearance. It is a medical condition that can have a profound mental impact on confidence and self-esteem. In most cases, it generally is seen as a bilateral growth in both breasts, but there is a small percentage of patients who have asymmetrical gynecomastia or one-sided. It is also more common for men to develop a “man boob” on the left side of the chest for unknown reasons. The medical community is also unsure why some patients develop only unilateral gynecomastia, and both breasts are not affected simultaneously.

Is there any treatment for unilateral gynecomastia?

At least one in every four male patients can develop excessive glandular breast tissue, leading to an ongoing condition unless treated. For adult men plagued by this condition, approximately 35% – 45% of cases are unilateral gynecomastia. While it’s uncommon for individuals to have a perfectly symmetrical chest area, pronounced breast enlargement on one side upsets the balance and symmetry, making it difficult to hide under clothing or with body posture. In terms of diagnosis and treatment, both types of gynecomastia are the same. Some patients in Spring, TX try testosterone replacement therapy or other prescribed medications to reduce enlarged breast tissue. In more severe cases, liposuction or male breast reduction surgery, or a combination of both can reduce symptoms of unilateral gynecomastia, providing body contouring help so patients can feel confident again when shirtless.

Although unilateral gynecomastia typically does not pose any severe health concerns, this condition’s hallmark symptoms of swollen breast tissue should be examined to rule out a more serious medical issue, such as breast cancer. When medications can’t reduce the breast’s size, liposuction or a breast reduction surgery can be highly effective at restoring a more masculine-looking appearance and self-confidence. To learn more or schedule a consultation at Chiseled with Dr. Young Cho, contact our office in Spring, TX today.

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Gynecomastia ▷ How to get rid of breast enlargement in men

What is gynecomastia?

Gynecomastia means an enlargement of the mammary gland in a man. It should be distinguished from lipomastia, in which only fats are deposited in a man’s chest. With gynecomastia, the glandular tissue of the breast grows, while the increase can occur on one or both sides.

In most cases, breast enlargement is benign, but cases are not excluded.

breast cancer in men

, especially if the breast grows on one side. Therefore, if there is any doubt, an ultrasound examination should be performed together with

mammography

.

Frequency and grading of gynecomastia

In half of the patients, the pathogenesis of gynecomastia is unclear. Although more than 90% of all newborns have physiological gynecomastia, it decreases to about 50-70% during puberty, and at this age it is also not necessarily associated with the disease. About half of all men experience breast enlargement at some point in their lives.

To be able to determine the stage of the disease, three degrees are distinguished according to Deutinger:

• Grade I: Small, inconspicuous breasts appear.
• Grade II: The male chest resembles that of a young girl.
• Grade III: severe gynecomastia with folds under the breasts.

Reasons: why can gynecomastia develop?

Gynecomastia can occur for physiological and non-physiological reasons. Physiological breast enlargement in men determines non-pathological changes.

Physiological:

Gynecomastia is considered normal if it occurs during infancy, puberty, or old age. Thus, gynecomastia is associated exclusively with hormonal levels, for example, with excess weight. However, here we are only talking about adipose tissue, so this is not gynecomastia as such, but pseudogynecomastia or lipomastia.

Non-physiological

: Here, male breast enlargement occurs due to pathological changes caused by medication or hormonal imbalance in a man.

Drug gynecomastia

There are certain drugs that are an important factor in the development of gynecomastia:

• Finasteride: a prostate drug that is also used as a hair restorative
• Anabolic steroids: Muscle-building drugs in bodybuilding (called “gyno” by bodybuilders for short)
• Spironolactone: a diuretic for the kidneys
• Anti-acidity drugs: cimetidine, omeprazole, pantoprazole, ranitidine
• Hormonal drugs: estrogens and antiandrogens, increasingly used in sex reassignment
• Cardiac drugs: quite rarely digitalis, beta-blockers, calcium antagonists
• Alcohol and drug abuse can also cause pathological gynecomastia.

Hormonal disorders as the cause of breast enlargement in men

Gynecomastia can develop when there is an excess of the female sex hormone estrogen or a lack of the male sex hormone testosterone. An increase in estrogen occurs with tumors of the adrenal cortex or testicles.

In addition, the symptom of gynecomastia can also be caused by cirrhosis of the liver. Androgenic hormone deficiency is associated with underdeveloped testicles, castration, hyperthyroidism, or special conditions such as prolactinoma or Klinefelter’s syndrome, in which patients have one or more extra X chromosomes.

How is gynecomastia diagnosed?

In any case, the diagnosis includes laboratory analysis of hormones, as well as liver and thyroid values ​​​​using the usual blood sampling procedure. Especially in elderly patients with unilateral breast augmentation, malignant breast cancer should be excluded by appropriate mammography and ultrasound.

The more accurate the diagnosis, the more the attending physician knows about the patient’s medical history and the more thorough the physical examination, as this is the only way to develop an optimal treatment concept for each patient.

Symptoms of Gynecomastia

With breast augmentation in men, pain plays a secondary role. Here, rather, a psychological moment that worries the patient: visually, as well as in terms of awareness of his body as a man.

As a rule, with gynecomastia, the nipples and areola also increase. Glandular tissue is easy to distinguish from adipose tissue: as the tissue grows, it pushes the nipple outward, making it larger.

If an extreme form of gynecomastia is manifested, the so-called fold under the breast, like in a woman, may develop. Particular attention should be paid to breast cancer in men: the changes are the same as in a woman, but usually appear only on one side with the following symptoms:

• Bleeding around the nipple with very rough, palpable knots
• Skin may tighten or shrink
• inflamed skin
• With advanced breast cancer, the skin sticks out like an orange peel
• Also at a later stage, tissue defects and swelling of the armpits can occur.

Treatment of gynecomastia

Treatment options may be conservative without surgery or include surgical methods.

Treatment of gynecomastia without surgery

The conservative method aims to relieve the symptoms mentioned above and eliminate possible hormonal imbalances. Here, the interaction of different specialists is necessary: ​​endocrinologists, cardiologists, therapists, general practitioners and urologists work together. Conservative therapy cannot reduce enlarged male breasts, but it can prevent or slow down progressive growth. Conservative and operative methods are often combined together.

Surgery for Gynecomastia: Male Breast Reduction

The surgery option for gynecomastia depends on the type of breast augmentation.

Surgery for pseudogynecomastia

With breast augmentation due to the growth of adipose tissue, liposuction is indicated in most cases. Often you can do without a skin incision in the areola. Instead, a small incision is made in the border area of ​​the pectoral muscle, a small amount of fluid is infiltrated, which increases the adipose tissue, and then it is pumped out.

In some cases, the breasts are so pronounced that liposuction alone will not give good results, so an additional classic breast reduction has to be performed.

Surgery for gynecomastia

Breast enlargement is corrected not only by liposuction, since the glandular tissue is too rough and dense for this. Accordingly, liposuction and removal of the male mammary gland, the so-called mastectomy in men, is performed. Here, an incision is made in the nipple area, through which excess glandular tissue is removed.

Since gynecomastia often results in an enlarged nipple, it can also be reduced during surgery. At the end of each such intervention, a drain is installed to drain the tissue fluid.

In severe forms of gynecomastia (Deutinger grade III), breast reduction can be indicated, which is also performed in women: a T-shaped, I-shaped or special incision in the areola provides access through which the glandular tissue is removed. The chest is then pulled up and stitched back together.

What should be considered after gynecomastia surgery?

If breast reduction was performed with liposuction alone, outpatient treatment is possible. However, if a mastectomy has been performed, a hospital stay is mandatory. When diagnosing a severe and moderate course of the disease, the patient is operated on under general anesthesia.

As with any surgery, there may also be general risks and complications such as infections, bruising, bleeding, or impaired wound healing, although these are rare. Sports activities are prohibited for six weeks after the operation. In addition, a compression vest is mandatory, especially during the initial phase after surgery, to prevent or minimize swelling, effusion, and bruising.

Which doctors and clinics are specialists in the treatment of gynecomastia?

Men with breast augmentation first need to find out the cause. The first point of contact here is usually the family doctor. If malignant breast cancer or hormonal disorders are suspected, the patient may be referred to a specialist in gynecology, urology, or endocrinology. After that, if the person concerned wants to have an operation to remove gynecomastia, he should contact a specialist in plastic and aesthetic surgery. They specialize in male breast reduction.

We will help you find a specialist to treat your disease. All the listed doctors and clinics have been checked by us for their high qualification in the field of gynecomastia surgery. They are waiting for your request or request for treatment.

reasons how to cure and get rid of big nipples

Medicine and health

08.09.22

And spent 362,900 rubles on it

Ismail-Mel Redwolf

got rid of gynecomastia

Author profile

It all started with a slight tingling in my chest, but later I had to undergo two surgeries to get rid of a bunch of problems.

I used to run a lot, participated in long-distance races, prepared for them. While jogging, I noticed a problem with nipples. It so happens that at a distance of more than 10 kilometers they can be rubbed against a T-shirt. Then I thought that the pain was connected with it.

I went to the doctor, and after the examination, the therapist said that nothing terrible was happening. For a couple of years, I was increasingly bothered by pressing pains, and then I noticed that the area around the nipple became larger. Then I again turned to the therapist, but asked him a targeted question. They sent me with him to a surgeon, after the surgeon to a urologist, and he to a mammogram. It turned out that I developed gynecomastia.

Go see a doctor

Our articles are written with love for evidence-based medicine. We refer to authoritative sources and go to doctors with a good reputation for comments. But remember: the responsibility for your health lies with you and your doctor. We don’t write prescriptions, we give recommendations. Relying on our point of view or not is up to you.

What is gynecomastia

Gynecomastia is an unpleasant situation for any man, namely female-type breast enlargement. By the nature of origin, the disease is divided into two options: true and false. The latter is also called pseudogynecomastia.

True gynecomastia is an enlargement of the mammary gland, an analogue of the female mammary gland, which men also have, but are not normally developed. With false gynecomastia, the breast increases due to the redistribution of adipose tissue.

They try to fight conservatively with breast enlargement: they look for the cause, they treat it. If the mammary gland does not decrease, then conservative treatment will no longer help. It has to be removed surgically.

11 important questions for mammologist Mikhail Mazo

With false gynecomastia, everything is simpler: an increase in the fat layer in the chest area is due to obesity. To get rid of breast enlarged for this reason, a man needs to lose weight. Locally, fat does not go away, so you need to adjust your diet, exercise, change your lifestyle. Then you will become healthier and at the same time get rid of gynecomastia.

Why true gynecomastia occurs

There are several reasons for the occurrence of true gynecomastia. They can be combined or lead to the disease one by one – in this case, if your gynecomastia is amenable to conservative treatment, it will be cured in a year and a half, and if not, further treatment will be surgical.

Epidemiology, pathophysiology and causes of gynecomastia – Uptodate

Hormonal changes. Gynecomastia may develop briefly in infants, adolescents, adult men and the elderly. In newborns, this is due to the fact that some of the mother’s hormones enter their bloodstream during pregnancy. In adolescents – with a predominance of the production of the hormone estrogen in the phase of active growth. In adult and elderly men, the cause may be an imbalance between the synthesis of estrogen and testosterone.

Medicines. A number of drugs based on phytoestrogens or with synthetic analogues of estrogen, prolactin, as well as affecting the balance of hormones in the body, generally cause the development of gynecomastia. This also includes drugs for the treatment of HIV infection and prostate tumors.

What restrictions do people with HIV face

If you experience chest pain while taking these drugs, you should contact your doctor and stop taking the drug in time. Even the beginning of gynecomastia can manifest itself visually: the nipple begins to protrude forward, the area near it becomes dense and “separate” from the pectoral muscle.

Some diseases. A number of endocrine diseases can negatively affect the appearance of a man. These are hyperthyroidism, lack of testosterone, hypogonadism, the appearance of Leydig cells in the testicles, and chronic kidney disease. With these diseases, the principle of development of gynecomastia is similar. When the balance of hormones is disturbed, the body tries to compensate for the lack of some by producing others, but an excess of female hormones provokes the growth of the mammary glands.

Modern ideas about the epidemiology, etiology and pathogenesis of gynecomastia — journal Andrology and Genital Surgery

Tumors. Pituitary tumors can synthesize excess prolactin, progesterone, which can also lead to gynecomastia. Adrenal tumors can also synthesize estrogen and cause female breast development.

Herbal products. Tea tree and lavender oils, vegetable oils that are used for skin care in lotions, soaps and shampoos, can also provoke gynecomastia.

Clinical case reports of gynecomastia associated with the use of lavender products – Journal of Clinical Endocrinology and Metabolism

Hunger and liver pathology. Too rigid a diet can cause gynecomastia, as well as obesity, lack of mobility. During hunger, the body produces stress hormones, testosterone levels drop without exercise, and the level of female hormones designed to retain water, energy reserves in the body and weight increases, which contributes to the development of gynecomastia.

How to Diagnose Gynecomastia

To understand whether you have gynecomastia or not, it would be right to make an appointment with an endocrinologist or andrologist. But for many men, a visit to the doctor with a similar problem seems somewhat awkward. Therefore, you can start with an ultrasound of the mammary glands or mammography. With an increase in the mammary glands, gynecomastia is confirmed.

2500 Р

average cost of breast ultrasound in Moscow

This can be a complete blood count, an analysis of sex hormones and thyroid hormones. Analyzes and functional studies of the adrenal glands, the work of the pituitary gland may be required. More often these are MRI of the brain, ultrasound of the abdominal organs, less often – tests for hormones of the adrenal cortex.

In my case, they limited themselves to mammography and analysis for sex hormones. The andrologist confirmed the development of gynecomastia, pronounced enlargement of the mammary glands and fibrosis on the left. Probably, I developed gynecomastia against the background of testosterone deficiency and elevated prolactin levels.

I was not offered any conservative treatment. Later, I found out that according to compulsory medical insurance they can remove the mammary gland in men if there is a tumor. This option did not suit me. Therefore, I started saving up for an operation, looking for information on who and how could solve my problem.

Hormone testing

How to distinguish gynecomastia from breast cancer

Gynecomastia is important to distinguish between other causes of breast enlargement, especially cancer. This will be done by the doctor during the examination. Breast cancer usually develops on one side, while the tumor is painless and often fixed, that is, immobile relative to the surrounding tissues. In addition, the malignant tumor is hard to the touch and may be accompanied by the appearance of dimples on the skin, discharge from the nipples and an increase in the nearest, for example, axillary, lymph nodes. Gynecomastia can also be distinguished from cancer by ultrasound or mammography.

How is the conservative treatment of gynecomastia

To cure gynecomastia, the doctor must understand its causes. The simplest thing is to cancel or replace drugs with analogues that could provoke the development of gynecomastia. If gynecomastia appeared due to another disease, the underlying disease should be treated.

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If there is no change in a man’s appearance after three months of observation and the problem still bothers him, the doctor may prescribe drugs that suppress the production of female hormones, such as tamoxifen, clomiphene, mesterolone. Keep in mind that many of these drugs are toxic. During their administration, it is necessary to monitor the state of the liver, pancreas and thyroid gland. If the doctor does not prescribe them, you should not insist on their use.

Even during the period of conservative treatment, you need to put your diet in order: balance the intake of fats, carbohydrates and add proteins to the diet. If you are overweight, reduce your calorie intake. If the weight is normal, the doctor will remind you to eat right: eat cereals, raw vegetables, enough fiber, proteins, omega 3 and 6 fats, include fish in the diet.

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Nutrition for gynecomastia is not only for weight loss. This is nutrition that restores the body, because gynecomastia can also occur against the background of exhaustion. During the treatment, I took sports vitamins and separately vitamin E, omega 3 and 6, since they were not enough in my diet.

An example of a diet for breakfast

How to eliminate gynecomastia with the help of surgery

As part of conservative treatment, the doctor tries to return the patient’s hormonal background to normal. In the early stages of the development of gynecomastia, this method helps to get rid of the problem without resorting to surgery. But if the treatment does not work, and the aesthetic appearance of the breast bothers the man, surgery is likely to be needed.

Surgical treatment should be considered if conservative treatment fails for a year or more. If you do not have surgery, you will need to undergo a mammogram every year, the risk of breast cancer and discomfort from the appearance of the body remain.

It is important to choose a surgeon with good aesthetic results for gynecomastia, and not with good reviews, for example, for liposuction. It would be useful to see photos before and after the operations. This is important for understanding how your body will look after the intervention.

In the first stage of the development of gynecomastia , the method of skin removal along the contour of the areola or with complete excision of the nipple and return to the skin is used. In the latter case, the nipple is completely detached from the skin and returned to a new location. The nutrition of the separated flap is disturbed, the consequences of such a technique are greater.

For second and third degree gynecomastia, the beam method is used, when excess skin is pulled up from the side or under the breast. But even at the first stage of gynecomastia, it can be offered. If you don’t want big scars, it’s best to look for a doctor who is proficient in both methods.

Even in the third stage of gynecomastia, the “smile” method is used. In this case, the surgeon has to remove a lot of tissues: they are pulled down as much as possible, connected under the breast.

The method of surgical treatment of gynecomastia depends on the stage of the disease and the preferences of the surgeon. Sometimes it happens that the doctor will still offer you the method of operation that he is used to, even if you can get a more aesthetic option with a different method.

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Each surgeon requires his own list of examinations before the operation. At the same time, most prefer to remove gynecomastia under anesthesia rather than under local anesthesia. So the operation goes without discomfort for the patient and the doctor.

Before the operation, you will most likely be asked to have an ultrasound of the breasts, consult with an anesthetist and have tests:

• blood test for syphilis, HIV, hepatitis B and C;
• clinical blood test;
• biochemical blood test;
• blood type and Rh factor test.

The operation takes from 30 minutes to two hours. You will need to stay in the clinic for a day. During the first operation, I was discharged the next morning, and during the second, under my responsibility, as soon as I came to myself after anesthesia.

Antibiotics must be taken for five days after the operation. You can return to work immediately, they don’t give you sick leave after an aesthetic operation, but if your employment is related to physical labor, it must be interrupted for two months. In many ways, returning to work will depend on your capabilities, conditions, and the severity of the postoperative period. With the third degree of gynecomastia, there is more damage, recovery will take time.

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How I did my first operation for gynecomastia

In my case, I had to look for doctors in Moscow and St. Petersburg. For three months, I talked to more than 30 doctors and selected two specialists who were suitable for the proposed method of intervention, cost and professional qualities.

I had stage 1 gynecomastia, with a bit of excess skin, but even then, many doctors suggested a beam lift, either with a suture under the breast, or with a complete excision of the nipple and return to a new place where the skin would be tightened.

To avoid post-operative problems, I spent more time looking for a doctor, but found a suitable specialist who agreed to perform the operation. To do this, I went from Samara, where I live, to St. Petersburg. Before the trip, I contacted the clinic and remotely agreed on the operation. Within a week, I passed tests at my clinic, received the go-ahead for the operation, and set off on my journey.

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I didn’t eat or drink anything in the morning before the operation. I checked in at the clinic, at nine in the morning I went for a consultation with a surgeon, and at ten the operation began. Until the end of the day, I was given antibiotics, glucocorticosteroids, and painkillers. Discharged the next day.

Surgery for gynecomastia is painful. When I left the clinic on the second day after the operation, I had drains installed that needed to be drained and flushed every hour. Any movement was associated with a new portion of pain. You can’t raise your hands to shoulder level, you can’t wear something heavier than a kilogram either.

I spent another week in St. Petersburg: I ​​went for dressings, bought medicines that the doctor prescribed for the treatment of necrosis and seroma. On the tenth day after the operation, I went back to Samara by train.

I paid 233,500 R for the first gynecomastia surgery

Surgery

135,000 R

Rehabilitation

70,000 R

Medicines after surgery

25 000 Р

Bandage

3500 Р

You can do without the last point, but you shouldn’t: saving on health is a big check in the future. To quickly get back in shape, I took a vacation. During rehabilitation, a bandage is used, and therapeutic massage is used to restore the functioning of the lymphatic system. You can try to replace it with compression underwear for the whole body, but I was uncomfortable in this.

Compression underwear after gynecomastia surgery should be worn for three months, almost without removing

What complications can occur after surgery for gynecomastia correction

Depending on the method of the operation, there are a number of postoperative complications:

• seroma;
• postoperative infection;
• infiltrate;
• adhesions;
• areola necrosis;
• partial preservation of breast tissue;
• keloid scar;
• seam separation;
• hematoma;
• decreased or no sensation in the surgical area.

Let me tell you more about the complications that I had to face.

Seroma is a lymphatic fluid that accumulates under the skin. The fact is that by removing the mammary gland, the surgeon cannot but damage the patient’s lymphatic system. This is because the operation area is riddled with lymphatic vessels and nodes. Because of this, a seroma develops. It impregnates nearby tissues, and an infection comfortably develops in a liquid medium. That is why gray is important to treat.

In 90% of cases of breast surgery, seroma is the norm of the postoperative period. To reduce its volume and prevent infection, a postoperative bandage is used and a course of antibiotics is prescribed.

I also had a seroma after the operation. Severe swelling of the tissues near the wound in the first days is normal. In order for the lymph to go away, a bandage and antibiotics, NSAIDs are used, but if the swelling remains under the skin, a transfusion is felt for more than five days, then the gray needs to be treated. The doctor prescribed me punctures to reduce the volume of seroma to 5 ml. I pumped out 20-60 ml with a syringe on my own for a month.

In my case, due to seroma, adhesions of the skin and muscles formed, with which the body tried to glue the spaces where the lymphatic fluid accumulated.

Partial marginal necrosis of the areola is quite common after breast surgery. To reduce the chance of necrosis, it is better to prefer an areola-sparing operation without loss of skin contact. It is important not to overtighten the postoperative area and avoid excessive tissue tension. On the other hand, weak seams can come apart.

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Areola necrosis in my case became noticeable on the first day after the operation. The surgeon immediately told me to apply the Branolind ointment bandage to improve microcirculation in the tissues, but necrosis went further. Thanks to the treatment, we were able to avoid the spread of necrosis to the entire areola, which could lead to its loss.

Partial breast preservation can lead to repeated gynecomastia if the hormonal background has not yet recovered. This can cause chronic chest pain, which in my case was the reason for re-correction.

Marginal necrosis of the left areola, seroma, second week after surgery A month and a half later

Why correction may be necessary after surgery for gynecomastia

If you do not have the first stage of gynecomastia, it is likely that correction will be needed, and here is why:

• difficult to achieve aesthetically good result at a time;
• possible removal of the breast not completely;
• marginal or total necrosis of the areola makes its own adjustments to the aesthetic result;
• Adhesions and rough scars may form after surgery.

Often, surgical correction of gynecomastia is followed by skin resurfacing to reduce the visibility of postoperative scars.

I needed a correction because my breast was not completely removed. When I was choosing a medicine for hormone replacement therapy, the endocrinologist noticed that I had a lump in the postoperative chest area. Having done an ultrasound of the mammary glands, I made sure that the gland was not completely removed. And since at that time we had not yet selected the optimal dosage of testosterone for the treatment of my main disease – secondary hypogonadism – I still had a hormonal imbalance. Because of him, the gland grew slowly, but.

But the problem was not only in the growth of the mammary gland. After the first operation, I still had adhesive bands under the skin. When I began to build muscle in the chest area, the adhesions began to stretch, pulling the nipple inward, towards the armpit. There was chronic pain. Then I again went in search of a surgeon.

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After checking the list of previous specialists and the nearest clinics, I turned to a surgeon in Tolyatti. This doctor was trustworthy, since he deals with only a few areas of aesthetic and reconstructive surgery, works in his own clinic. I called him, signed up for a consultation and an operation in one day.

All I needed was an ECG for the operation. The operation took 20 minutes. An hour later, I was able to leave the clinic.

During the correction, the postoperative period was the same:

• prolonged wearing of the bandage;
• soreness and weakness;
• restrictions on physical activity.

Complications – seroma again. This time it was less, but persisted for ten days.

For the rest, it was necessary to be careful: do not carry heavy things, do not overexert yourself, do not overheat. The second time I did not need to resort to therapeutic massage: there were no restrictions in the shoulders, the seroma passed quickly without lymphatic drainage effects.

Now I am satisfied with the result of the operations. It could have been better, but I could not have foreseen many complications. So, now there is still no sensitivity of the skin under the mammary glands, although the perception of tissues above the nipples has returned.

I paid R120,000 for the second gynecomastia surgery

Operation

95,000 R

Medications after surgery

25,000 R

Result now

How to avoid complications after surgery

The postoperative period is the key to a good aesthetic result and minimal consequences of anesthesia and surgery for health.

But it is worth starting to prepare for surgical correction in advance:

• reduce in three months, and it is better to exclude smoking, alcohol;
• remove the load on the muscles of the torso in 14 days;
• remove blood-thinning drugs, NSAIDs in seven days.

In the postoperative period:

• wear a bandage for at least two months;
• not return to physical activity for at least a month;
• antibiotics for seven days;
• Follow all other doctor’s recommendations.

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Postoperative bandage cost me 3500 R

At the same time, unlike some classical surgeries, immediately after you regain consciousness, you need to minimize bed rest. Moderate walking, proper nutrition, and keeping your medication schedule on track are the ideal way to quickly recover from gyno removal.

I had gynecomastia surgery twice – in summer and in winter. From my experience, I can say that in winter the operation was worse for immunity, but better for sutures: it is hot in summer and a moist, warm environment is created under the bandage, which promotes inflammation.

How to choose a surgeon

I had first stage gynecomastia, so a second operation could have been avoided. So that you do not have to do the operation two or three times, I share tips and observations.

Pay attention to experience, quality of work and then the price. When I was looking for a doctor, the spread was from 60,000 to 210,000 R per operation. In my comparison experience, the best performance in the middle range is up to 170,000 R.

Find out before the operation if the cost includes hospital stay, medicines, nursing care. Depending on the level of the clinic, about 10,000 R can be added to the costs.

It is important to find out from the surgeon:

• the experience of operations and length of service. One surgeon can work for 15 years, but perform breast surgery once a year, another – 50 per month. It is better to choose someone who works with aesthetics and breast surgery more often;
• method of correction – how to make an incision, collect the skin and, if necessary, remove excess fat;
• suture material, drugs. If you are prone to allergies, it is worth clarifying that threads with low allergenicity are chosen, drugs are not from the prohibited list;
• complications from experience, recommendations, management. It is better to find out in advance what problems there are in the practice of this surgeon. For example, I did not learn this from my first doctor and later could not avoid adjustments.

In the initial conversation with the doctor, the following should alert you:

• the surgeon categorically suggests one method of treatment. Most often this is due to the fact that this method of correction is convenient for the surgeon. But this does not mean that the proposed option is the best for you;
• not ready to show portfolio. Most likely, this is due to a poor aesthetic result, the scarcity of the portfolio;
• have negative reviews. An effective way to learn from clients how a surgeon works;
• manner of communication and conditions are not suitable. If the surgeon communicates openly with you, meets you halfway, tries to help during the first dialogue, he will probably help after the operation. And, on the contrary, if from the very beginning it seems to be doing you a favor and offering 1001 analyzes to “cover the rear”, here, in case of complications, there will most likely be no feedback and support.

How I survived 7 operations due to postoperative adhesive disease

In the early postoperative period, two things can be understood:

• whether there will be necrosis;
• how well the skin was removed.

At this time, without a bandage, it is easy to understand that the surgeon made an asymmetrical arrangement of the nipples, removed insufficient skin, overtightened the suture, and therefore the nipple turns blue – there will be necrosis. But whether the entire gland was removed, how strong the seroma will be, whether there will be fibrosis, adhesions and infection – you can’t guess.

I can advise what the second operating surgeon told me:

• ask for a video or photo from the operation;
• 10 days after the operation, do an ultrasound of the mammary glands.

In this case, you will make sure that the glands have been removed, and if there are complaints, you can contact the surgeon or the court with the materials.

Here are the photographs that were presented to me in the second clinic after the corrective surgery. There is nothing wrong with asking the surgeon in advance to take such pictures or even make a video of the operation

I spent 362,900 R for the treatment of gynecomastia

First operation

135,000 R

Second operation

95,000 R

Rehabilitation

70,000 R

Medicines after two operations 90 005

50,000 Р

Tests before anesthesia

9400 Р

Bandage

3500 Р

Remember

1. Gynecomastia can be true and false.