Male breast overgrowth, commonly known as Gynecomastia, is usually the result of circulating hormones, certain medications, obesity, and excessive use of marijuana. On rare occasions it could be due to breast tumors. Medications known to cause gynecomastia include some anti-inflammatory drugs such as Ibuprofen, mood altering drugs such as Effexor, and acid reducers such as Tagamet, Zantac, and Pepcid. Steroids, commonly used by many athletes, are also known to cause gynecomastia. Occasionally, gynecomastia occurs with no identifiable cause.
In overweight patients, the enlarged breast is composed mainly of fat tissue while gynecomastia in a lean person is predominately glandular enlargement. Often gynecomastia is a combination of overgrown breast gland and fatty deposits. Gynecomastia could be confined to the area just under the nipple and areola, producing a small, localized protrusion or it could cover a larger area of the chest causing generalized breast enlargement. Sometimes male breast enlargement can be quite excessive approaching a size C cup.
During puberty, the incidence of breast enlargement, consisting usually of a small, firm, rubbery nodule is quite high. It occurs most often between 14 and 15 years of age and ordinarily regresses completely within 18 months of its initial appearance.
In order to avoid insensitive remarks and stares by others, men with gynecomastia try to hide their enlarged breasts by not appearing bare-chested in public and avoiding participation in athletic activities. Gynecomastia causes some degree of self-consciousness and low self esteem because enlarged breasts are perceived as a female feature by society.
After a general physical examination and appropriate blood tests performed by the patient’s family physician, men who suffer from gynecomastia may become candidates for surgery. Treatment for gynecomastia depends on the composition of tissues within the breasts. Fatty gynecomastia can be effectively treated with liposuction. Glandular gynecomastia, on the other hand, is best treated by excision of the enlarged breast gland. Often patients will require glandular excision and liposuction to correct both components of the enlarged breasts. When excision is planned, incisions are placed along the junction of the lower areola and the breast skin. For liposuction treatment, two small stab wounds is all that is needed. The wound generally heals with inconspicuous scarring. When breasts are very large, techniques similar to female breast reduction may be utilized. Surgical correction of gynecomastia is usually performed under general anesthesia. All suturing is performed beneath the skin; therefore there are no stitches to be removed. Recovery time is 7 days. The best time for excision of gynecomastia is when the condition appears to bother the patient, which is usually during adolescence. Post-operative discomfort is easily controlled with prescribed pain medication.
Nipple Hypertrophy (Enlarged male nipples)
Occasionally, males with normal breasts have abnormally enlarged nipples, which show through clothing causing self-consciousness and anxiety. Patients with enlarged nipples often do not expose their chest in public and avoid athletic activities. To reduce the size of a large nipple, I prefer to use a very effective plastic surgical technique originating in Brazil. Nipple size reduction is performed under local anesthesia and the recovery time is only 7 days. A very small incision is placed at the base of the nipple; scars after healing are inconspicuous. Post-operative pain is minimal and easily controlled with prescription pain medication.
- Ivan Thomas M.D., F.A.C.S.
2080 Century Park E. Suite 501
Los Angeles, CA 90067