This term, which is unfortunately established around the world, is deprecated and men who deal with the condition may even consider it to be derogatory. Gynaecomastia usually involves a hypertrophy of the adipose tissue and mammary gland in men and appears during puberty. In 98% of the cases this condition does not conceal any hormonal disorder and is the result of a hormonal failure during puberty when gender differentiation begins and when the secondary character of the two genders develops.
It is of course advisable to seek the opinion of an endocrinologist when the problem first appears so that any hormonal disorder may be ruled out. Quite often, boys who deal with this condition try to camouflage it by allowing themselves to gain weight so that breast growth may seem as a result of fat. When they later loose the extra weight they deal with skin laxity. Correction is achieved through surgery. Depending on the amount of adipose tissue or mammary gland in the breasts we propose either liposuction or mammary gland removal. Most of the times we make a semi-circular incision on the lower half of the nipple and after raising the nipple as a flap with the appropriate width, we remove all remaining mammary gland. In cases of significant skin laxity, we make a circular incision around the nipple and proceed with simultaneous periareolar tightening of the breast. Anaesthesia is usually local or combined with sedation and the patient remains at the hospital for a few hours or overnight. A special compression dressing that is not visible underneath clothes is used and should remain in place around the chest for 10 days, until stitches are removed. The chest will take its final form in 4-6 months when swelling subsides. In most cases, scars heal completely and given that most men have chest hair, they can show up without a shirt on within six months after surgery without being afraid that someone might be able to tell they’ve undergone this procedure.
Approximately 30 per cent of men develop a certain degree of gynaecomastia during puberty. Of them, thirty percent will continue to deal with gynaecomastia as adults. Among the elder, gynaecomastia may develop due to a hormonal disorder of the body, the use of specific pharmaceutical substances, cannabis, etc.
The rate of men who shall develop breast cancer is not relevant to the existence or absence of gynaecomastia.
Apart from the physiological reasons that may lead to aesthetic reconstruction, the removal of the male mammary gland is imperative in cases of rapid increase of breast volume in a limited period of time without other pathological cause.
This procedure can be safely performed after the age of fourteen. When the procedure is performed at a young age, the results are better, since the patient’s skin has greater elasticity. Moreover, the psychological benefits for a teenager are very important since his self-confidence is boosted significantly.