Gynecomastia or Male Breast Treatment- Dubai General Surgery Clinic

It is an enlargement or swelling of breast tissue in males. It is defined as presence of breast tissue greater than 0.5 cm in diameter. Estrogen is the primary female sex hormone and testosterone is the primary male sex hormone. Nevertheless, both sexes produce hormones, for example, a small amount of estrogen in males and small amount of testosterone in females.

Testosterone controls the male traits including muscle and body mass and growth of body hair. In females, estrogen is also responsible for secondary sex characteristics such as breast growth. Any disturbance or imbalance in the hormonal levels which increases estrogen levels in males leads to gynecomastia.

Gynecomastia can occur naturally at different stages of male’s life. 

• Newborn: because of persisting effect of estrogen from the mother, but in about 3 weeks’ time, it will disappear.
• Puberty: hormonal changes between the age of 12-14 years can cause gynecomastia which may last up to two years.
• Between age of 50-80 years, gynecomastia can exist in almost 25% of men.

Other conditions that may cause gynecomastia:

• Obesity.
• Liver disease.
• Malnutrition.
• Kidney failure.
• Hypogonadism.
• Hypothyroidism.
• Hypoandrogenism.

Drugs related to gynecomastia:

• Estrogen.
• Anabolic steroids.
• Antihistamines and proton pump inhibitors.
• Amphetamines.
• Diazepam (anti-anxiety).
• Ketoconazole for fungal infection.
• Metronidazole for bacterial infection.

Symptoms of Gynecomastia

Patient usually complains of tenderness, enlargement of breast, a firm swelling is felt beneath the nipple area and is movable.

Diagnosis or Treatment of Gynecomastia

• Clinical examination, medical history and history of medication is mandatory (metabolic disorders).
• It must be distinguished from pseudogynecomastia or lipomastia (presence of fat deposit).
• Some imaging tests are done to rule out breast cancer although rare in men such as ultrasound, mammogram, and MRI.

Differential Diagnosis: Breast cancer, fatty breast tissue.

Management

• Treatment should be targeted depending on the cause of gynecomastia. In general, most cases are self-limiting.
• Any gynecomastia longer than 12 months will cause fibrosis which is difficult to treat with medication.
• Data for medication used in treatment of gynecomastia is very limited and drugs are still not approved by FDA.

For example:

• Testosterone: In older men, a replacement of low levels of testosterone. In younger patients with normal testosterone levels, it is not effective.
• Tamoxifen: Selective estrogen receptor modulator showed reduction in breast volume without elimination of all tissue.
• Clomiphene: It also helps in reduction without complete elimination.
• Danazol: It is a synthetic derivative of testosterone that decreases estrogen synthesis. Nevertheless, it has high masculinity side effects such as voice deepening, acne and excessive hair growth.
• Surgery: It is only recommended if it is causing pain with tenderness or embarrassment.

3 Types of Surgery:

• Liposuction technique: In case of excessive fatty tissue. This excessive tissue is removed from the body by vacuum suction. A thin hollow tube is inserted through small incision.
• Excision technique: It is recommended because of firm glandular tissue with excess skin.
• Combination of both techniques may be required.

Feel free to consult your surgeon for further information.

DRHC offers male breast surgery in Dubai Clinic. To book an appointment, call +97142798200.