Gynecomastia (The Large Male Breast)
According to the Greek language, Gynecomastia means "woman (Gyne) breast (Mastos)" and in simple terms, it means abnormally large breasts on men. The condition is relatively common and affects approximately 40% of men. Gynecomastia can cause feelings of shame, self-hate, inadequacy and sufficient embarrassment to interfere with the patient's social life.
- Idiopathic (unknown)
- Puberty: 50% of adolescent boys have the condition.
- Steroids used by body builders
- Medical drugs: estrogens, cimetidine, antidepressants, digoxin, spironolactone, anti-psychotics,…etc.
- Genetic causes
- Social drugs: Marijuana, Alcohol, Heroin, Amphetamines
- Cancer (rare) of the breast and testicles
- Chronic liver disease
- Kidney disease
- Klinefelter syndrome
- Testicular insufficiency
- Thyroid problems
The patient should be seen by a specialist in order to identify the potential cause and exclude sinister conditions such as breast cancer.
Gynecomastia in teenage boys tends to resolve spontaneously in 90% of cases with observation for 1-2 years.
If the condition is causing sufficient embarrassment to interfere with the patient's social life, then the cause if identified should be removed or the underlying medical condition should be treated.
Painful gynecomasia may respond to tamoxifen (10 mg per day).
Surgical correction remains the most effective treatment of symptomatic gynecomastia. The best surgical technique involves a combination of surgical excision and liposuction using short scars below the nipple. The excessive skin tends to shrink over time. We recommend the avoidance (if possible) of techniques which involve removal of excessive skin and free transfer of nipples in view of the inferior cosmetic results associated with these techniques.
Psychological counselling may be required in some patients.