Getting Rid of Gynecomastia
You’re a 15-year-old high school sophomore male. You feel shy about taking off your shirt. You have breasts. You have gynecomastia.
Gynecomastia is a combination of two Greek words that translate roughly as “female-like breasts.” All males have breasts; anatomically speaking, the term refers to the front portion of the chest. Boys often develop at least some excess breast tissue when they reach puberty. The condition usually disappears within a few months or years, though that may as well be an eternity for a young man who must tolerate catcalls from his classmates. But some young males never outgrow the problem.
Gynecomastia also can arise in adulthood, particularly among older males. It affects between 50 to 65 percent of boys and men worldwide. Men who seek medical attention do so for one of three reasons. Some are worried that they have breast cancer. Others experience pain and tenderness, which can be a symptom of gynecomastia. The rest don’t like having prominent breasts and want to do something about it.
After ruling out breast cancer (which rarely resembles gynecomastia), a doctor will determine whether the breast enlargement is caused by too much flab. The more weight you gain, the more fat you get behind the breasts.
True gynecomastia, however, is caused by the overgrowth of breast tissue, which can occur if a man’s body has too little testosterone or too much of the female hormone, estrogen. This hormonal imbalance can be induced by a variety of medical conditions (e.g. liver function or an overactive thyroid) and medications (e.g. anabolic steroids or tricyclic antidepressants). For example, men born with a genetic disorder called Klinefelter’s syndrome often develop gynecomastia, as do men with adrenal tumors and liver disease.
Many drugs also can disrupt hormone levels and lead to breast growth. Some experts say smoking marijuana can cause gynecomastia, though the evidence for that claim is unclear. Overweight men are doubly at risk for gynecomastia because fat tissue produces enzymes that convert testosterone to estrogen.
Many physicians treat gynecomastia by lowering a man’s estrogen levels with the drug tamoxifen, which is known as a treatment and preventative therapy for breast cancer. In fact, some studies of gynecomastia patients respond well to tamoxifen has shown extremely positive results with few side effects.
Men now account for 40 percent of all breast reduction surgeries in 2015. The procedure used to be performed with a scalpel and left large scars, which meant men were reluctant to go without their shirts. Today, surgeons use smaller instruments which require tiny incisions.
The most commonly used surgical procedure for treating gynecomastia is ultrasound-assisted liposuction. Surgeons use ultrasound tools to melt the fat and breast tissue, which are then removed with a liposuction device. For those who may not wish or unable to undergo this procedure, there is surgery similar to a mastectomy that can remove excess skin and reshape the chest.
In most cases, the liposuction technique is performed on an outpatient basis, though a man must wear a compression vest for a month while his chest heals. Male breast reduction usually isn’t covered by insurance and can cost anywhere from $3,500 to $6,000. Before having the surgery, a man should examine his reasons for this procedure.
Don’t be afraid to reach out to others for support. Whether it be counseling, talking with family and friends, connecting with others who have gynecomastia, be sure to tap into a groundswell of support.
