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Gynecomastia

Know more about Gynecomastia

Male breasts that grow by hormonal changes or the accumulation of fat are part of a disorder known as gynecomastia. Psychological trauma can be inflicted in young boys and adolescents who suffer from gynecomastia. They often do not want to go to the beach or the pool, nor are comfortable removing their shirt in public, revealing breasts with a female aspect.

Indication

Correction of excessive development of the breast tissue in men.

Anesthesia

Normally, a general anesthesia is used.

Surgical time

An hour and a half.

Length of hospital stay

12 to 24 hours.

Recovery time

The patient can resume school activities or professional work within a week. You should avoid sun exposure for ten days. Light physical activity is released after ten days. Heavier or more intense exercise can be resumed after three weeks.

Final result

The end result can be seen in a month.

Learn more about Gynecomastia.

What is gynecomastia?

Gynecomastia is caused by excessive development of the breast tissue in males and occurs in periods of hormonal changes (childhood, adolescence and age) with no underlying pathology, in most cases. The alteration is usually caused by a variety of hormonal changes, most of them being reversible during puberty. That is, gynecomastia is, in most cases and in this age group, a benign condition that often resolves itself spontaneously. If the condition persists for a teenager, surgical correction is performed that provides a satisfactory result. As an adjuvant, liposuction can be performed in some patients, and may be used as the sole corrective procedure.

Although gynecomastia does not have any connection with virility, the format of female breast causes great shame and inhibition in men. Several sociocultural factors influence rejection, and, in modern times, can be considered a deformity. Although several studies have been conducted aiming to expand the options for drug treatment of gynecomastia,breast tissue surgery remains the method of choice for its correction. Psychological stress is the main reason for surgery, the cosmetic results are of great importance for these patients.

Clinical signs, symptoms and causes

In normal adult men, there is no palpable breast tissue. Gynecomastia is presented as a mass in the breast region, palpable ranging from 1.0 to 10 cm in diameter. It is usually unilateral and can develop over months or even years in the other breast. When both breasts are asymmetric, the history of development, sequential or simultaneous, is important.

The nipple and areola rarely show significant changes, although an increase in size due to hypertrophy of the nipples may occur. The symptoms are confined to small a palpable mass and pain, especially in adolescents, however, in most cases, the disease is asymptomatic.

Most cases of gynecomastia at puberty occurs in 65% of young people between 14 and 15 years of age. This condition disappears during the late teens, appearing in only 7% of boys at 17 years of age. The incidence increases with the progression of age, reaching 30% in older men.

The possible causes of gynecomastia determine the most appropriate therapeutic approach. The abuse of alcohol and marijuana may predispose the development of the disease. The most common cause is the increase in estrogen, the decrease in androgens or androgen receptors. That is, hormonal factors are the principal cause of this dysfunction.

If the cause is puberty, it is best to wait at least two years for spontaneous regression to occur. Interestingly, we detected that boys who shape their body in at the gym develop gynecomastia. In order to speed up the results, some ingest steroids, causing deformity, which can only be resolved surgically. Incases of older men, the use of medication in the treatment of gastric ulcers, tumors of the mammary gland and hormonal changes require further clinical investigation.

The classification of gynecomastia is based on the necessity of surgery. For surgical planning, the experts usually prefer to consider three classifications:

– Grade I: a button located in the glandular tissue concentrated around the areola. It is not chest fat and has no excess skin. This is usually easy to remove;

– Grade II: gynecomastia diffused within the chest, with more fatty tissue where the tissue margins are not well defined. This is frequently dealt with by liposuction to remove the fat tissue.

– Grade III: gynecomastia diffuses large amounts of excess skin. These patients require external incisions to the areola, the skin, or repositioning of the areola or papillary or both.

Surgery and current techniques

The surgical technique depends on the type of gynecomastia and its severity. There are three techniques which can be used separately or in combination: liposuction (the simplest), ultrasonic liposuction (considered by many to be the treatment of choice for most cases) and reduction mammoplasty (in patients with excess skin).

The main problems related to the surgical treatment of gynecomastia are irregularities on the surface of the breast and changes in the shape or position of the nipple. The postoperative edema lasted about 7 to 10 days and the lack of sensitivity is usually transient, lasting up to one year in most cases.

The surgical correction of gynecomastia consists of a small cut in the shape of a semicircle at the bottom of the areola. The scar is not apparent and is practically invisible over time. The surgeon removes the gland with hard consistency and it is later examined by a pathologist. In cases of gynecomastia fat, surgery can only be done with liposuction of the region.

The choice of local or general anesthesia depends on the type of gynecomastia, age of the patient and the anesthesiologist decision.

The correction of gynecomastia grade I (localized) is usually a simple surgical procedure. Grade II is more complex and can present problems seen as bumps on the skin after healing and may lead to depression in the center or on the sides of the lesion. The combination of liposuction surgery gives the best results.

The most common surgical complication is a hematoma. The excess skin is most common found in elderly people rather than in young people and can be corrected later if needed, as many patients have satisfactory skin retraction.

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