Gynecomastia is a condition in which the size of a man’s breast tissue increases, and if it appears more prominent than normal, it is referred to as gynecomastia.
Gynecomastia does not resemble the female breast entirely, but to some extent, it follows a similar pattern.
Gynecomastia can affect any man, and it is considered a normal occurrence. It does not have any side effects; its impact is primarily aesthetic.
Gynecomastia is categorized into different grades, making it easier to understand and enabling proper treatment.
Grade I: A little breast growth with a concentrated button of tissue around the areola also know as puffy nipples
gynecomastia typically manifests as retro-areolar hypertrophy, either unilaterally or bilaterally. In these cases, the nipple-areola complex (NAC) exhibits a larger diameter, exceeding 3 cm, and appears convex. There is an absence of excess adiposity in the cross-sectional view, and the sub-mammary fold is not present. Palpation reveals a retro-areolar hard parenchymatous consistency.
Histologically, the predominant composition is glandular parenchyma with minimal adipose content. Men with grade I gynecomastia are often characterized as thin and young.
Grade II: Moderate breast growth that extends beyond the areola limits, with edges that blend into the chest.
gynecomastia is characterized by an increased volume that extends beyond the nipple-areola complex (NAC). In this stage, the NAC is positioned above the inframammary fold.
Grade III: Moderate breast growth that extends beyond the areola limits, with defined margins from the chest and skin redundancy.
gynecomastia is characterized by a notable increase in volume beyond the nipple-areola complex (NAC). Key features include enlarged areola, evident sub-mammary fold, NAC projection aligning with the sub-mammary fold, and potential skin flaccidity, ptosis, and striae. This grade is not necessarily linked to elevated BMI, although a history of childhood obesity may be present in the patient’s medical history. On examination , there is a noticeable thickness in glandular tissue, often associated with increased adipose tissue.
Histologically, findings reveal increased fat deposits in multiple region of chest, especially in patients with higher BMI. The clinical pictures in the Cordova classification illustrate Stage III as the
NAC being on the inframammary fold or 1 cm below.
Grade IV Gynecomastia: Breast Resembling Female One
presents breasts that closely resemble female breasts. Characteristics include a significant increase in volume, enlarged areola, well-defined sub-mammary fold, presence of cutaneous striae, nipple-areola complex (NAC) projected below the inframammary fold, and a distance between the fold and areolar margin exceeding 4 cm. Patients with Grade IV gynecomastia typically exhibit a high BMI, with significant fat deposits in zones four and three. Mammary adiposity often dominates over glandular hypertrophy in these cases. Patients with childhood obesity, especially ex-obese individuals experiencing ptosis due to weight loss, fall into this category.
Pseudogynecomastia, or “false gynecomastia,” is characterized by excess fat in the male breast area without significant glandular tissue enlargement. Unlike true gynecomastia, which involves actual breast gland development, pseudogynecomastia results from increased adipose tissue. Factors like weight gain, obesity, and hormone imbalances can contribute. While pseudogynecomastia doesn’t involve glandular growth, it presents similar aesthetic concerns with enlarged breasts. Management includes lifestyle changes—diet and exercise—to reduce overall body fat. Surgical options like liposuction may be considered for a more contoured chest. Consulting a healthcare professional is essential for an accurate diagnosis and personalized treatment plan.
While this classification guides surgical choices, it is essential to individualize treatment based on factors such as age, skin quality, BMI, and the pathogenesis of dysmorphia. Elasticity in young subjects may yield better results compared to elderly individuals with flaccid skin or ex-obese patients.
If gynecomastia is caused by hormonal imbalances, we can understand it from a physiological perspective. In any male, there are two essential hormones, testosterone and estrogen, both of which play crucial roles in the body.
When there is a specific balance between these hormones, it is considered normal. However, when there is an imbalance, it is termed as hormonal imbalance. For example, consider a hypothetical male with a testosterone level of 700 and an estrogen level of 40 as the normal balance.
If, due to certain reasons, an imbalance occurs, such as testosterone level to 600 and estrogen increasing to 60, it may lead to gynecomastia. If the hormonal imbalance is corrected after a few days, and the gynecomastia was mild, it may resolve on its own.
However, if the hormonal imbalance persists, gynecomastia tends to progress gradually and becomes permanent. In such cases, the most viable option is to undergo surgery to address gynecomastia.
Obesity
The first and foremost cause is obesity. Gynecomastia can develop in some individuals due to obesity. Both men and women have breast tissue, and one of the primary reasons is the excess fat present in our bodies.
The fats in our bodies undergo enzymatic conversion in adipose cells, converting steroids into estrogen. As a result, fat cells within the body tend to increase in size. Gynecomastia is relatively common in overweight individuals.
Family History
If someone in your family, such as your father, mother, grandparents, or any previous generations, had gynecomastia, it’s possible that you or your child may experience this condition as well. Family history can be a contributing factor to this issue.
Alcohol consumption
Yes, excessive alcohol consumption can potentially be a cause of gynecomastia. Some individuals who consume alcohol in large quantities may experience symptoms of gynecomastia because it can lead to changes in hormonal balance.
Excessive alcohol intake can increase the production of estrogen while reducing testosterone levels, potentially causing an imbalance between these hormones. This hormonal imbalance can lead to the development of gynecomastia, characterized by breast tissue growth in men.
Health conditions
There are certain health conditions in which symptoms of gynecomastia are observed, and gynecomastia has been associated with these causes as well.
Gynecomastia, the development of enlarged breast tissue in males, can occur at various ages. Here’s a general breakdown by age:
The medical treatment of gynecomastia depends on the underlying cause and the severity of the condition. In many cases, gynecomastia may resolve on its own, especially if it is related to hormonal fluctuations during puberty or other temporary factors. However, if the gynecomastia persists and is causing discomfort or psychological distress, medical intervention may be considered. Here are some approaches:
Medical treatments is not very effective in gynecomastia treatments so Surgery is a best treatments
Dr. Gaurav Shalya’s patients often say that after a month, it’s hard to tell where the surgery was done; there are no visible marks. Dr. Gaurav Shalya performs a liposuction through a small incision and removes the entire gland.
What is Seroma Formation? After gynecomastia surgery, some patients may experience a condition called seroma formation. This when a kind of liquid collects at the site where extra fat has been removed from the breast. It’s like the body forms a watery pocket in that area.
Dr. Gaurav Shalya’s Approach: In Dr. Gaurav Shalya’s practice, he shares that none of his patients have faced seroma formation issues after gynecomastia surgery. His techniques seem to be effective in preventing this complication.
Understanding Seroma: When extra fat taken out from the breast, the body might respond by creating a liquid-filled space. This is what we call a seroma. It’s not uncommon, and it happens to some patients.
No Need to Worry: Even if seroma formation occurs, there’s no need to panic. Dr. Gaurav Shalya reassures that it can treated. It’s like a small hiccup in the healing process, but it can fixed.
Dr. Gaurav Shalya’s Assurance: If you choose Dr. Gaurav Shalya for your gynecomastia surgery, you can be confident. Even if seroma formation happens, his techniques and care can take care of it. There’s no need to be afraid.
In the context of gynecomastia surgery for grade 3 and 4 cases, the potential issue of loose skin postoperatively is a common concern. Notably, patients treated by Dr. Gaurav Shalya have reportedly shown no instances of loose skin, demonstrating a remarkable success rate of zero patient issues with loose skin after surgery.
While the possibility of skin or muscle damage exists after gynecomastia surgery, there have been no reported cases of such complications with Dr. Gaurav Shalya’s technique to date.
Using Dr. Gaurav Shalya’s technique in gynecomastia surgery, many patients experience minimal or no bruising. Swelling usually lasts for 1 to 2 weeks and is very minimal.
It depends on the grade and excess fat around the chest. Dr. Gaurav always contour compact chest on do liposuction of around chest Prices range from 60,000 to 100,000, applied based on grades.
According to books and literature, complete gland excision is not always necessary; often, removal of only the central part of the gland is sufficient in male breasts, but this may lead to recurrence. Dr. Gaurav, however, opts for complete gland removal, reducing the likelihood of gynecomastia recurrence. Having performed over 3000 gynecomastia surgeries, he has encountered only 500 cases of recurrence, outcomes from other doctors.
