Although there is no structural difference between the male breast and the female breast, the reason that the male breast is smaller is that the female hormone(estrogen) is not abundant in men.
However, in some cases, breasts start to grow in men and almost reach the size of a female breast. The breast, which has been a symbol of femininity and fertility throughout history, surely leads to various social and psychological problems when it reaches large sizes for men.
The solution to the problem of enlarged breasts in men, which we call gynecomastia, is available in plastic surgery. With gynecomastia surgery, men can move on with their lives by getting rid of their large and saggy breasts.
What is gynecomastia?
Gynecomastia, male breast enlargement means that the breast takes a feminine appearance. It is a problem that can be seen in about half of the male population.
A strong, tight and taut chest is one of the essentials of masculine appearance. Sagging and fatty breasts cause troubles especially in summer. Men experiencing this problem may have difficulty wearing the clothes they want and entering the sea/pool. It also leads to psychological problems in advanced cases.
Causes of enlarged breasts in men
One of the main causes of male-type breast growth is the change in testosterone (male hormone) and estrogen (female hormone) in the body and the relatively higher levels of estrogen.
The incidence of gynecomastia increases during periods of hormonal imbalances such as puberty and old age. Many factors cause breast growth in men, such as various medications, liver and kidney diseases, hormone-producing tumors, hormone and food supplements used by bodybuilders.
Obesity is also one of the most common causes of gynecomastia. As body weight increases, fats begin to accumulate in the breasts and create a feminine appearance. In addition, fat tissue in men also leads to gynecomastia by increasing the level of estrogen (female hormone).
Do enlarged breasts in men affect the health?
Although breast growth in men is not harmful for health, it may rarely be an indicator of some of the diseases mentioned previously.
As we stated above, gynecomastia has many physiological and pathological causes. Initially, the reason(s) of the current situation is tried to be understood by detailed examination and hormone tests and evaluation. If necessary, the examination is deepened with an endocrinologist's opinion and ultrasound imaging.
Should every gynecomastia be operated?
In 40% of men, growth and sensitivity can be seen in breasts during puberty. When hormones are stabilized, these symptoms often resolve. For this reason, gynecomastia should not be rushed to surgery in puberty.It can be suspended up to 2 years.
In other cases, especially in unilateral gynecomastia, detailed preoperative examination is essential.
In the past, the classic treatment of gynecomastia was the removal of all breast tissue by entering the nipple. However, this method causes the rib cage to collapse and deform. Today, except for very specific cases, we hardly use it at all.
Classic liposuction will be sufficient for the growth of breast formed by adipose tissue. If breast tissue has also increased, ultrasonic or laser liposuction methods will ease the success. There is no scar of any of these methods (unless the person has a disorder such as hypertrophic scar/keloid formation concerning wound healing).
In more advanced cases where the breast tissue is fibrotic (hardened), it is possible to remove this hard tissue with short incisions (pull-through method;this method will not leave any visible scars within a few months).
And in cases where the breast tissue is enlarged and the nipple is sagging in an advanced degree, a plan should be made to lift the nipple. In men who have had bariatric surgery and whose breasts are severely sagged after weight loss, it may be necessary to move the nipple in this way.
On the other hand, unilateral gynecomastia are the cases that need to be emphasized and examined. Since unilateral breast growth may be due to breast cancer in men, all the breast tissue can be removed if suspicious or the diagnosis can be confirmed with various biopsy techniques beforehand.
Gynecomastia surgery lasts for 1-2 hours and is performed certainly under anesthesia. A special corset is worn after the operation. At least one night hospital stay is recommended. If there is a drain, it is withdrawn the next day and the patient is sent home. The corset should be used for 3-4 weeks.
How is gynecomastia surgery performed?
You should tell your doctor if you have any illnesses or medications. One week prior to surgery, you should cut off blood thinners (aspirin, coumadin etc.), herbal tea, vitamins and food supplements.
The breast tissue is examined by your doctor during your examination before gynecomastia surgery. Sometimes, imaging methods are needed for tissue evaluation. The size of the tissue and whether it is in a nodular structure should also be determined.
In addition to these, the presence of a chronic liver disease, thyroid or kidney disease may also need to be investigated.
After all the processes and examinations, your doctor will inform you about how the most successful gynecomastia surgery will be performed and what you will experience afterwards.
Duration of surgery
If fat removal will be performed only with liposuction, gynecomastia surgery will take about 1 hour.
In cases of sagging breast, breast tissue and fat tissue should be removed together. In treatment of such patients, the nipple is reduced and replaced to where it should be. This type of gynecomastia operation requires general anesthesia and will last approximately 1.5 hours.
Recovery process after gynecomastia surgery
The corset should be worn for at least 4 weeks after discharge from the hospital. Arm movements should be restricted for the first 3 days and vehicles should not be used. After the third week, light sporting activities (such as walking) may begin. At least 6 weeks should be waited for sports involving the chest and arms.
Questions from you about gynecomastia
Is there an age limit for gynecomastia surgery?
The gynecomastia during puberty can recover by itself once hormonal balance is set up. Therefore, it is better to wait for 2 years in puberty gynecomastia.
Any post-op scars?
If liposuction alone is performed in gynecomastia surgery, there will be no scar. However, if the breast tissue is removed, there will be a very thin line under the nipple, but this will be both a vague, faint scar and will be unnoticeable as it will remain in the area where the tone difference is.
Will it be noticeable that I had gynecomastia surgery?
If liposuction only is performed, it is not possible for someone who does not know your previous condition to notice, since there will be no scars. After gynecomastia surgery where the breast gland is removed, a very small scar remains and even the presence of this vague scar doesn’t make anyone who has not seen your breasts before surgery understand the gynecomastia surgery.
When can I return to normal life after surgery?
If the procedure is carried out in the morning, you can return home in the evening. If it is in the afternoon, it is recommended to stay in the hospital for 1 night.
You can shower the next day only if the liposuction has been applied. You can return to work in 2-3 days. You should wear the corset for 3-4 weeks. It is useful to complete 6 weeks for the movements related to the chest muscles.
Can breast grow again after gynecomastia surgery?
Unless there is a medical problem such as cancer and hormone disorder, the breast will not grow again after gynecomastia surgery.
Excessive weight gain, anabolic drugs, excessive alcohol use or some diseases may rarely cause gynecomastia recurrence. As long as such situations are avoided, there is no possibility.
After surgery, when will my breast formation be finalized?
Immediately after gynecomastia surgery, you will see that the breasts have a flat shape. But there is edema due to the operation. Therefore, a complete recovery may take 6 months.
How long do I have to wear the corset?
It should be worn for at least 4 weeks postoperatively. You can then use it for another 4 weeks during the day and wear gynecomastia athletes.
Is it possible to treat gynecomastia without surgery?
Unfortunately, it is not possible to treat gynecomastia without surgery.
Could the swelling in my breast be cancer, not gynecomastia?
Breast cancer is a disease seen in men, too. Therefore, the breast swelling in men could also be cancer, not gynecomastia.
Your doctor will ask you for additional tests if s/he suspects it.