GYNECOMASTIA

The term comes from the Greek words gyne meaning "woman" and mastos meaning "breast" In practical terms, this means abnormally large breasts on men. Gynecomastia is a abnormal enlargement of the glands within the mammary of males, with secretions of milk occurring at times. The elderly to the adolescent can be affected by this condition. At times, boys of an adolescent age can become extremely distressed because of gynecomastia. Obesity is not the majority cause of this condition as some people think. The true actual cause is still unknown. Responsiveness of the tissue and the males sex hormonal imbalance has been associated with it but not a determining factor as a cause of this condition. Steroid abuse, obesity, marijuana use, tumors, genetic disorders, chronic liver disease, side effects of many medications, castration, Klinefelter Syndrome, Gilbert's Syndrome and aging may cause gynecomastia. The condition is relatively common in adolescent boys, and 90% of the time symptoms disappear in a matter of months, or, as adolescence wanes, a few years later. But the remaining 10% are burdened with a social handicap that causes a deep and complex shame, and puts one's relationship with one's body at risk.

Men who have developed gynecomastia later in life from steroid abuse or some other cause may have little to no psychological distress. However, for some in this situation, it can leave them feeling out of control of their body or emasculated in some matter. Hopefully, corrective surgery will resolve these feelings, for some it will not and therapy will needed to relieve the distress. For many men, the best solution is surgery. That accomplishes step one of the healing. Step two is psychological redress. From childhood taunting to a lifetime of hating his chest, the hurt feelings will not go away with the fact of breast reduction alone.

During surgery excess tissue of the mammary glands will be taken out and removed with a surgical scalpel. An incision is usually placed in a location that will not be too noticeable, at the lower border of areolas. The excess tissue is cut away and removed through these incision areas, along with excess skin and fat around the breast bottom, sides and areola. You may have a drain which will not be very large inserted in by another tiny incision, this helps to drain away excess fluids within the surgical area. If your gynecomastia consists primarily of excessive fatty tissue, your surgeon will likely use liposuction to remove the excess fat. A small incision, 3-4 mm in length, is made around the edge of the areola or underarm area. A slim hollow tube called a cannula which is attached to a vacuum pump, is then inserted into the incision. Using strong, deliberate strokes, the surgeon moves the cannula through the layers beneath the skin, breaking up the fat and suctioning it out. Major reductions that involve the removal of a significant amount of tissue and skin may require larger incisions that result in more conspicuous scars. In these cases, excess skin may have to be removed to allow the removing skin to firmly adjust to the new breast contour.

Gynecomastia surgery is usually done in the hospital where you will be under the general or local anesthesia. This procedure normally takes 45 minutes to 1,5 hours to be completed but may be longer if it becomes more detailed or complicated. Discomfort will be noticeable, especially during the first few days, but your doctor will prescribe medications to help alleviate the pain afterwards. Bruising and swelling of the surgical area and around is normal after surgery. You will have to wear a garment for pressure made out of elastic material for 1-4 weeks continuously and after the two weeks you will have to wear it only at night for a few more weeks to sleep in. This will help in your recovery process. Your sutures will not be removed, because they will resolve spontanously.

Gynecomastia surgery can enhance your appearance and self-confidence. The results of the procedure are significant and permanent.

Op. Dr. H. Nazmi BAYÇIN