Gynaecomastia

What is Gynaecomastia?

Gynaecomastia is the enlargement of breast tissue in males. It occurs due to an imbalance between the hormones testosterone and oestrogen, where there is either an increase in oestrogen or a decrease in testosterone.

Causes of Gynaecomastia

  • Hormonal Changes – Common during puberty, aging, or conditions affecting hormone levels.

  • Medications – Certain drugs, such as anti-androgens, anabolic steroids, antidepressants, and some heart or ulcer medications.

  • Health Conditions – Liver disease, kidney failure, thyroid disorders, or tumours affecting hormone production.

  • Substance Use – Alcohol, marijuana, heroin, or anabolic steroids.

  • Obesity – Increased fat tissue can lead to higher oestrogen production.

Symptoms

  • Swelling or enlargement of one or both breasts

  • Tenderness or sensitivity in the breast tissue

  • Sometimes, a rubbery or firm mass under the nipple area

Diagnosis

  • Physical Examination – To assess the size and consistency of the breast tissue.

  • Medical History Review – Including medications, substance use, and health conditions.

  • Blood Tests – To check hormone levels.

  • Imaging Tests – Such as ultrasound or mammogram to rule out other conditions.

Treatment Options

  • Observation – If gynaecomastia is due to puberty, it often resolves on its own within a few months to years.

  • Medication – Hormone therapy or medications like tamoxifen may be used in some cases.

  • Surgery – If the condition is severe, persists, or causes discomfort, surgical options like liposuction or mastectomy may be considered.

Surgical Treatment for Gynaecomastia

If gynaecomastia persists despite lifestyle changes or medical treatments, surgery may be considered.

Types of Surgery

  1. Liposuction – Removes excess fat but does not remove glandular tissue.

  2. Mastectomy (Glandular Tissue Removal) – Removes breast gland tissue through a small incision around the nipple.

Who is a Good Candidate for Surgery?

  • Individuals with persistent gynaecomastia for over a year

  • Those who experience discomfort or emotional distress

  • People without significant underlying medical conditions

During Surgery

  • The procedure is usually done under general anaesthesia.

  • It typically lasts 1–2 hours.

  • A small incision is made, and excess tissue or fat is removed.

Recovery & Aftercare

  • Pain & Swelling: Mild discomfort, swelling, and bruising are expected.

  • Compression Garment: Wearing a compression vest for a few weeks helps reduce swelling and supports healing.

  • Activity: Light activities can resume in a few days, but strenuous exercise should be avoided for 4–6 weeks.

  • Results: Initial results are visible immediately, but final results take a few months.