Gynaecomastia is a common endocrine disorder in which there is a benign enlargement of breast tissue in males. It is a common disorder present in at least in 1/3rd men. The development of gynaecomastia is usually associated with benign pubertal changes, but in rare cases may be seen in association with certain disease states. In adolescent boys, the condition is often a source of psychological distress; however, 75% of pubertal gynaecomastia cases resolve within two years of onset without treatment. Disturbances in the endocrine system that lead to an increase in the ratio of estrogens/androgens are believed to be responsible for gynaecomastia development. This may occur even if the levels of estrogens and androgens are both appropriate but the ratio is altered. The disorder is usually diagnosed by a physician after a detailed history and physical examination. Conservative management of gynaecomastia is often appropriate as the condition commonly resolves on its own. Medical treatment of gynaecomastia that has persisted beyond two years is often ineffective. Medications such as aromatase inhibitors have been found to be effective in some chronic cases but surgical removal of the excess tissue is usually required.
In majority of the cases, the treatment modalities is non-surgical and resolving the issue of hormonal imbalance to medication. When the medication does not bring the desired results, the option of surgery is considered. The first and foremost, clinical examination of the patient and all the necessary urine, blood test are conducted to ensure stable health to undergo the procedure. Patients medical history is very important. Any other endocrine disorders, metabolic disorder if present must be well-treated to be in normal limits.
The surgical procedure involves, administration of general anaesthesia. The surgeon marks the area to remove the excess tissues that need to remove under the brast skin as a part of the reduction. Small incisions are made and the excess tissue is slowly retracted without causing damage to the nerves, blood vessels and glands. Drainage tubes are used to collect the underneath fluids. They may be kept for 1-2 days till the output is reduced. The external sutures are after 1-2 weeks once the healing process is almost complete and visible. The incisions are finely sutured to achieve the reduction. The procedure does cause pain, Temporary bruising, swelling, soreness, burning sensation at the sign of incisions. All swelling and bruising should be gone in 3-6 months. Temporary loss of breast sensation or numbness could be experienced by few patients. Patient can return back to the normal activities in 4- weeks.Post procedure the chest look Flatter, firmer, more masculine chest contour. Full final appearance can be seen only 3 months.
For good recovery plenty of rest is recommended with good nutritional support. Patient should refrain from smoking and drinking alcohol. Patient should begin walking as soon as possible to reduce swelling and it lowers the chances of blood clot. There should be no attempt until okayed by the surgeon for any physical exercises, gymnasium training, lifting heavy load etc. Post surgery sexual activity must be avoid for at least two weeks. The incisions must be taken care of. Direct exposure to the sun affects healing and must be avoided for at least 1 year. Incisions must be cleaned daily and inspected for any signs of infection. Loose garments should be worn Recommended pressure garments must be worn for at least 6 weeks following the surgery.
Early clinical examination during puberty can help resolve the signs of gynaecomastia. Early medication is an effective treatment option.
Is gynaecomastia a common disorder?
Yes, it is a very common disorder affecting almost 70% of boys at puberty. In majority of the cases the condition resolves automatically without treatment.
Whom should I consult for the treatment?
Patient should get clinically examined by an endocrinologist and an andrologist.
Are the surgeries effective?
Yes; surgeries are effective and give permanent solution. Advice from the endocrinologist and andrologist is must.
Can I go for trekking after recovery from the surgery?
It is not recommended to go for such physical activities without doctor’s advice Direct exposure to the sun is harmful for the incisions and must be protected for at least 1 year from the sun rays.
Can I do my work out in the gymnasium?
Yes; not immediately after the surgery but only after your doctor allows you to d so. For initial few months you must not engage yourself in strenuous exercise and activities.
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