MEDICAL SECOND OPINION

Enlargement of breasts in men - Gynecomastia

Overview

In some men and young adolescents, one or both breasts enlarge, resulting in a huge breast. This condition is called gynecomastia.
The enlargement of breasts in men occurs at adolescence in fifty to seventy percent of all gynecomastia cases. The underlying reason is natural primarily changes in estrogen and testosterone. A short-lasting gynecomastia can be observed in infants.

This condition occurs when the maternal estrogen hormone persists in the blood for a while. Middle-aged and older men face a similar condition. Aging (resulting in changes in hormone levels) or below-listed medications cause enlargement of breast(s) in men.

Causes

Natural changes in the hormonal balance of the body usually cause gynecomastia. Therefore, gynecomastia is most commonly diagnosed in adolescents. Abnormally high estrogen – the hormone that regulates female sex characteristics – and unusually low testosterone – the hormone that regulates male sex characteristics – leads to abnormal enlargement of breasts in men.

In addition, below listed medications and substances may cause gynecomastia:

•    Antibiotics
•    Heart medicines
•    Anti-anxietic agents
•    AIDS medications
•    Tricyclic antidepressants
•    Chemotherapy
•    Drugs used in treatment of peptic ulceration
•    Marihuana and heroin
•    Amphetamines and steroid agents

Finally, medical conditions that influence blood level of testosterone, aging, heavy alcohol consumption and liver, kidney and thyroid diseases are among factors that lead to gynecomastia.

Diagnosis

The definite cause of gynecomastia may not be always determined.
Determination of the underlying cause and final diagnosis requires a detailed examination by an endocrinologist and general surgeon.

The detailed physical examination is usually followed by an analysis of hormone levels in blood and imaging studies (mammography, computed tomography, magnetic resonance imaging) to visualize the abnormal enlargement of breast(s).

After all those tests and studies are completed, the underlying cause is determined, and the final diagnosis of gynecomastia is made. Still, it is possible to decide on no etiological factor.

Treatment

Gynecomastia usually does not cause a symptom, excluding enlargement of the breast and varying degrees of tenderness. In some advanced-stage cases, pain and discharge from the nipple of one or both breasts can be seen.

As the condition may spontaneously regress over time without the need for treatment, your endocrinologist or general surgeon may first consider treatment of the underlying cause or follow-up for a particular period if no etiological factor can be found.

Inability to determine a causative factor, absence of spontaneous regression, occurrence or aggravation of pain, discharge, tenderness, and social reasons may point to surgical treatment of gynecomastia.

Gynecomastia arising out of breast cancer is extremely rare in men. However, if your doctor has concerns about a tumor, it is necessary to verify or rule out cancer by mammography and biopsy. If you want surgical gynecomastia treatment, please consult our plastic surgeons for techniques, expectations, and potential risks.
It would help if you discussed the aim with our plastic surgeons and endocrinologists in order to get the most realistic and satisfactory outcomes before deciding on surgical treatment of gynecomastia.

Created at 15.06.2024 04:03
Updated at 15.06.2024 04:03

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