Gynecomastia (The Large Male Breast)
According to the Greek language, Gynecomastia means "woman (Gyne) breast (Mastos)" and in simple terms, it means abnormally large breasts on men. The condition is relatively common and affects approximately 40% of men. Gynecomastia can cause feelings of shame, self-hate, inadequacy and sufficient embarrassment to interfere with the patient's social life.
Some of the causes of Gynecomastia are:
- Cancer (rare) of the breast and testicles
- Chronic liver disease
- Genetic causes
- Kidney disease
- Klinefelter syndrome
- Idiopathic (unknown)
- Medical drugs: estrogens, cimetidine, antidepressants, digoxin, spironolactone, anti-psychotics etc.
- Puberty: 50% of adolescent boys have the condition.
- Steroids used by body builders
- Social drugs: Marijuana, Alcohol, Heroin, Amphetamines
- Testicular insufficiency
- Thyroid problems
The Treatment of Gynecomastia:
The patient should be seen by a specialist in order to identify the potential cause and exclude conditions such as breast cancer.
Gynecomastia in teenage boys tends to resolve spontaneously in 90% of cases with observation for 1-2 years.
If the condition is causing sufficient embarrassment to interfere with the patient's social life, then the cause if identified should be removed or the underlying medical condition should be treated. Painful gynecomasia may also respond to tamoxifen (10 mg per day).
Surgery is usually the most effective treatment of symptomatic gynecomastia. The best surgical technique involves a combination of surgical excision and liposuction using short scars below the nipple. The excess skin tends to reduce in size over time. We recommend the avoidance (if possible) of techniques which involve removal of excess skin and free transfer of nipples in view of the inferior cosmetic results associated with these techniques.
Psychological counselling may be required for some patients.