Gynecomastia Treatment in Delhi, India

Gynecomastia is the enlargement of breast tissue in men or boys. The condition can affect one or both the breasts. Various factors, including obesity and fluctuating hormone levels, can contribute to the development of gynecomastia. One common symptom associated with this condition is breast tenderness or pain.

In many cases, Gynecomastia resolves on its own and is not a serious condition. If it does not, treatment options include medicine or surgery, depending on the underlying cause.

One of the primary causes of Gynecomastia is hormonal fluctuation. An increase in oestrogen levels and a decrease in testosterone levels in males lead to the development of this condition. Hormonal fluctuations may occur at birth, often due to maternal oestrogen exposure. They can also happen during puberty or later in adulthood.

Hormonal fluctuations, certain health conditions such as hyperthyroidism, kidney disease, male hypogonadism, and testicular tumours can also contribute to the development of enlarged breasts.

Gynecomastia may also be a side effect of certain medications. Speak to a doctor about dosage adjustments or possible alternatives if Gynecomastia is a side effect of current treatment.

Certain risk factors are associated with Gynecomastia, including:

• Age: Males over the age of 50 are more prone to developing enlarged breasts.
• Puberty: Hormonal changes during puberty increase the risk of developing Gynecomastia.
• Obesity: Obesity is directly related to oestrogen levels. In males, fat cells can be converted into oestrogen. An increase in oestrogen levels relative to testosterone can lead to breast enlargement.

Gynecomastia symptoms vary from person to person and may include:

• Swollen breast tissue
• Pain and tenderness in the breasts when touched.
• Sensitive nipples

Diagnosis of Gynaecomastia begins with the doctor asking questions about symptoms and any family history of  breast cancer or Gynecomastia. A physical examination follows, focusing on identifying lumps, tenderness, or unilateral growth in the breast tissue.

After the medical review and physical examination, the following tests may be ordered for confirmation of Gynecomastia:

• Biopsy: A biopsy may be performed to rule out breast cancer.
• Blood Test: Blood tests are conducted to measure hormone levels such as testosterone and oestrogen. An increase in oestrogen and a decrease in testosterone levels may suggest hormonal fluctuations as the cause of Gynecomastia.
• Mammogram: A mammogram provides detailed images of the breast tissue helping to differentiate Gynecomastia from breast cancer.

If the breast enlargement is due to puberty, treatment is often unnecessary as the condition typically resolves on its own within a year or two.. However, if the condition does not improve or is caused by an underlying issue, treatment specific to that cause may be required.

Medications

When Gynaecomastia is caused by hormonal imbalance, doctors may prescribe medication to help reduce the breast tissue. These medications aim to restore hormonal balance by either decreasing excess oestrogen or increasing low testosterone levels. Medications are most effective when prescribed during the early stages of Gynecomastia.

Testosterone Replacement Therapy

Testosterone replacement therapy is recommended for males with low testosterone levels, where hormonal imbalance is the underlying cause of Gynecomastia. This therapy helps increase testosterone levels, which may reduce breast swelling. It is generally recommended for patients with confirmed hormonal imbalance.

Surgery

Surgery is often recommended for men with chronic or severe Gynecomastia that does not respond to medication. It provides a more long-term solution by removing excess tissue and fat from the chest area. Surgical options for reducing breast enlargement include liposuction and mastectomy:

• Liposuction: Liposuction is a minimally invasive procedure to remove excess fat from the chest area.
• Mastectomy: A procedure to remove glandular breast tissue, suitable for males with significant breast enlargement. The surgery preserves the skin, nipple, and areola.

The appropriate treatment for each individual case depends on many factors including the size of the breast, the age at which Gynecomastia is diagnosed, and any existing health conditions.

There aren’t many complications associated with Gynecomastia. The most common problem experienced by men is emotional distress and social anxiety resulting from changes in chest appearance. Men with Gynecomastia often experience reduced self-confidence and body image concerns.

Some men experience tenderness or soreness in the breast tissue, especially if the condition worsens or persists for a long time.

Surgical treatment for Gynecomastia carries general surgical risks such as infection, bleeding, and scarring.

Gynaecomastia caused due to hormone imbalance cannot usually be prevented. However, for other causes, the following prevention tips may help:

• Considering medication alternatives: Medications with Gynecomastia as a side effect can sometimes be replaced with alternatives, following consultation with a doctor.
• Maintaining healthy weight: Maintaining a healthy weight helps reduce chest fat deposition, lowering the risk of obesity-related Gynecomastia.
• Avoiding substance abuse: Avoiding consumption of alcohol, drugs, or steroids can help in preventing Gynecomastia, as these substances are known to disrupt hormonal balance.

1. Is Gynecomastia a common condition?

Yes, Gynecomastia is quite common, especially during puberty due to hormone fluctuations and in older men. Most cases resolve on their own, without requiring any specific treatment.

2. Are both the breasts affected equally in gynecomastia?

No, Gynecomastia does not necessarily affect both breasts equally. It is common for one breast to be more enlarged than the other. This asymmetry often occurs due to variations in hormonal activity. In some cases, only one breast is affected, a condition known as unilateral Gynecomastia.

3. What are the differences between Gynecomastia and pseudoGynecomastia?

Gynecomastia refers to enlargement of breast tissue caused by hormonal imbalances, whereas pseudoGynecomastia is characterised by fat accumulation in the chest area. Gynecomastia involves firm glandular tissue, while pseudoGynecomastia is characterised by soft fat deposits in the chest.

4. Are there any non-surgical methods, such as exercise, that can help reduce the appearance of Gynecomastia?

Exercise cannot directly reduce Gynecomastia, as it is typically caused by hormonal imbalances or health conditions. However, pseudoGynecomastia, caused by fat accumulation, can be managed through exercise and weight loss to reduce chest fat.

5. Is Gynecomastia in adolescents different from that in adults?

Yes, Gynecomastia in adolescents is usually a temporary condition and resolves on its own within a year or two, as it is related with hormonal changes during puberty. In adults, Gynecomastia is often caused by chronic health conditions, medications. or persistent hormonal imbalances, which may require treatment like surgery or hormone therapy.

6. Can Gynecomastia return after treatment or surgery?

Yes, recurrence is possible, especially if underlying hormonal imbalances or contributing factors like substance abuse are not addressed. To prevent recurrence of Gynecomastia, maintaining a healthy lifestyle and managing underlying health conditions can help.

7. What kind of doctor treats Gynecomastia?

The treatment of Gynecomastia depends on its cause. A primary care physician usually provides an initial diagnosis and may refer patients to an endocrinologist if a hormonal issue is identified. Surgical cases are often managed by a plastic or reconstructive surgeon with expertise in breast reduction procedures. When associated with other health conditions, specialists such as urologists or oncologists may also be involved.

Reviewed By Dr. Sunil Choudhary, Principal Director & Chief of Plastic Surgery (Max Institute of Reconstructive, Aesthetic, Cleft & Craniofacial Surgery (Miracles), on 24 Dec 2024.

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