GYNECOMASTIA SURGERY

•Definition of Gynecomastia• Signs and symptoms• Causes•Diagnosis• Treatment by surgery• Prognosis• Epidemiology• Gynecomastia Surgery in Bangalore India

TABLE OF CONTENTS

DEFINITION OF GYNECOMASTIA• It is a common endocrine disorder in which there is a benign enlargement of breast tissue in males. • The development of Gynecomastia is usually associated with benign pubertal changes, but in rare cases may be seen in association with certain disease states.

SIGNS AND SYMPTOMSo Male breast enlargement with rubbery or firm glandular subcutaneous chest tissue palpated under the areola of the nipple in contrast to softer fatty tissue.o Milky discharge from the nipple is not a typical finding but may be seen in a gynecomastic individual with a prolactin secreting tumor.

SIGNS AND SYMPTOMSo The enlargement may occur on one side or both.o Males with gynecomastia may appear anxious or stressed due to concerns about the possibility of having breast cancer.o An increase in the diameter of the areola and asymmetry of the chest tissue.

CAUSES An altered ratio of estrogens to androgens mediated by an increase in estrogen production.

An altered ratio of estrogens to androgens mediated by a decrease in androgen production.

An altered ratio of estrogens to androgens mediated by a combination of these two factors.

CAUSES Estrogen acts as a growth hormone to increase the size of male breast tissue.

The cause of gynecomastia is unknown in around 25% of cases.

DIAGNOSIS A thorough history and physical examination are obtained by a physician.

Examination includes evaluation of male breast tissue, evaluation of penile size and development, evaluation of testicular development and proper development of secondary sexual characteristics such as the amount and distribution of public and underarm hair.

DIAGNOSISMammography is the method of choice for radiologic examination of male breast tissue in the diagnosis of gynecomastia when breast cancer is suspected.

TREATMENT BY SURGERY If chronical gynecomastia is treated then surgical removal of glandular breast tissue is usually required.

Surgical approaches to the treatment of gynecomastia include subcutaneous mastectomy, assisted liposuction mastectomy, laser assisted liposuction and laser-lipolysis without liposuction.

TREATMENT BY SURGERY Complications of mastectomy may include hematoma, surgical wound infection, breast asymmetry, changes in sensation of the breast, necrosis of the areola or nipple, seroma, noticeable or painful scars and contour deformities.

PROGNOSIS Gynecomastia is not physically harmful, but in some cases it may be an indicator of other more serious underlying conditions, such as testicular cancer.

The glandular tissue typically grows under the influence of hormonal stimulation and is often tender or painful.

Losing weight will not reduce the glandular component .

EPIDEMIOLOGYNew cases of gynecomastia are common in 3 different age populations: newborns, adolescents and men older than 50 years of age.Newborn gynecomastia occurs in about 60-90% of male babies and most cases resolve on their own.

EPIDEMIOLOGYDuring adolescence, up to 70% of males are estimated to exhibit signs of gynecomastia during their adolescence.Senile gynecomastia is estimated to be present in 24-65% of men between the ages of fifty and eighty.

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