Gynecomastia is a common condition in older men and boys. This causes the breasts to swell and become abnormally large. Both males and females have mammary glands, but they are usually not visible in males.
Breast enlargement can affect men of all ages, including newborns, during puberty, and the elderly. Gynecomastia is the result of extra breast tissue, not fat. Exercising or losing weight does not reduce breast tissue in gynecomastia.
Pseudogynecomastia is another condition in which a man’s chest area has excess fatty tissue around, behind and under the nipples, possibly due to being overweight or obese.
The breast consists of hard, dense glandular tissue and softer adipose tissue.
The ratio of gland to fatty tissue in the breast varies from person to person. A man with gynecomastia may have too much tissue.
Liposuction can remove excess fat. A small tube is inserted through the an opening. During excision, the tissue is cut with a scalpel to remove excess glandular tissue. This usually leaves a scar at the rim of the nipple.
When significant tissue and skin reduction is required, the incisions and scars will be larger.
After male breast reduction surgery, the breasts are bruised and swollen, and the person may need to wear elastic compression garments to reduce swelling.
It usually takes about 6 weeks for patients to return to their normal routine. Complications from surgery are rare. These include inadequate lifting of breast tissue, uneven breast contours, and decreased sensation in one or both nipples.
Excision carries the risk of forming a blood clot, which may require drainage.
Treatment options for gynecomastia
Gynecomastia usually goes away without treatment between 6 months and 2-3 years. However, if there is an underlying condition, treatment may be necessary.
If the condition results from one drug, the person may need to switch to another drug. If the person uses the drug for a short time, the condition is temporary.
Treatment is rare but may include breast reduction surgery or hormone therapy to block estrogen.
Drugs used to treat gynecomastia
Tamoxifen is a drug that blocks the effects of the female hormone estrogen in the body. This is usually a treatment for breast cancer, but can also relieve breast pain and symptoms of enlarged breasts in men.
Aromatase inhibitors are the typical treatment for breast and ovarian cancer in postmenopausal women, but they can also prevent or treat gynecomastia.
Testosterone replacement may help in gynecomastia treatment in older men with low testosterone levels.