Gynecomastia is a combination of the words “female” GYNE “and breast” MASTOS “in ancient Greek. It describes benign, excessive breast enlargement in men. Gynecomastia has been reported as high as 32-36% in men. Gynecomastia can have many causes. Interestingly, the most common cause is “IDIOPATHIC”, it is observed without any reason. In some cases, gynecomastia is depend on growth and aging periods. The mother’s estrogen hormone is the cause of neonatal gynecomastia, but this process is self-limiting within weeks to months and treatment is rarely required. Gynecomastia occurs in varying degrees in adolescence, and regresses within a few months-years. Pathological gynecomastia occurs due to various metabolic disorders (alcoholic cirrhosis, adrenal tumours), endocrine disorders (hyperthyroidism, hypothyroidism, adrenal cortical hyperplasia), and high estrogen levels (bronchogenic carcinoma, true hermaphroditism, testicular tumours). Pharmacological gynecomastia occurs when the estrogen level increases or the androgen level or sensitivity decreases due to the drugs taken.
The relationship between gynecomastia and breast cancer: Many studies have shown that men with gynecomastia do not have an increased risk of cancer compared to normal men.
The nipple-areola complex has a smooth structure in the normal male breast. The diameter of the nipple-areola complex measures 2-4 cm (mean 2.8 cm) and is at the level of the 4th intercostal space. The distance between the nipple and the sternal notch is measured as an average of 20 cm.
More attractive masculine contour is created for the breast after the treatment of gynecomastia. After gynecomastia surgery, high patient satisfaction is often observed and the patient’s self-esteem and self-confidence increase.
How is Gynecomastia Surgery Performed?
There are two structural causes of gynecomastia, in men. These are excessive fat accumulation in the breasts and enlargement of the mammary gland. In the past, classical liposuction was used to remove excess fat and surgical excisions to remove the mammary gland. Surgical excisions were made through incisions made between the areola and normal skin on the lower side. Sometimes there would be a scar after surgery, and collapses were often observed in the anterior chest wall called ”plate” deformity. Classical liposuction removes fat from the breast, but its effect on the mammary gland is limited. In addition, the classical liposuction provides limited improvement on the sagging skin of the breast .
Technological advances emerging today have also introduced innovations in gynecomastia surgery. It uses ultrasonic liposuctin sound waves called VASER. With this device, the mammary gland consisting of both adipose tissue and connective tissue is melted with sound waves in appropriate settings. In addition, this device also tightens the sagging skin after surgery. All these procedures are performed through small incisions. For this reason, no obvious scarring is observed after surgery.
How is Recovery After Gynecomastia Surgery?
After surgery, it is normal for the breasts to swell. After the operation, a compression garment is worn to reduce swelling. It is recommended to wear this special garment for 1 month continuously and then at night for the next two months. It is very important for the patient to rest in the first week after operation. Most patients are able to return to his work one week after surgery. For heavy work involving physical force, this period is extended to two weeks. Light walking exercises can be started two weeks after the operation. Chest and back exercises, including weight lifting, are more suitable to start again after four to six weeks.