Human beings have always been conscious about their body image at subconscious level, but rarely expressed their desire for improvement as either the means were not available or it was not accepted by society as normal. With the modernization of India the social norms have also changed. There is a spurt in outdoor activities which has exposed our body to people. Everyone wants to put his or her best feet forward, appear always young and fit to outdo others in the present competitive world.
Gynaecomastia, an enlargement of male breast, was although well recognized as a clinical entity for long, it is now more and more recognized by young males having this problem.
Gynaecomastia is the most common breast problem in men characterized by benign enlargement of breasts. Usually both breasts are symmetrically involved but sometimes there may be enlargement of only one breast. Breast growth usually starts at puberty and is a physiological response to the changes in hormonal milieu at that age. Any physiological change or pathological interference with this balance can result in gynaecomastia. This slight hypertrophy normally subsides spontaneously but occasionally persists. Persisting gynaecomastia in young manhood requires an evaluation to exclude the possibility of abnormal endocrine secretion. Most of the patients who come for treatment have no underlying cause of gynaecomastia.
The treatment of gynaecomastia in adolescents is expectant ,as the process usually resolves within 2 years. If the enlargement is excessive or lasts over 2 years, operative treatment is considered.This condition needs to be treated as persistent enlargement of the male breast can become a source of embarrassment and distress in the adolescent or adult male. The treatment for gynaecomastia is surgical by means of liposuction by a very small incision at the margin of areola(dark pigmented skin around the nipple).There are no visible scars after surgery. Patient is given pressure garments for six weeks to prevent hematoma formation and allow the loose skin after liposuction to shape nicely over pectoral muscles.
In some cases gynaecomastia may be so large and longstanding that skin becomes redundant. In such cases excess skin may need to be excised in such a way that the scar is hidden at the margin of areola.
Surgery can be performed under local anaesthesia as a day care procedure. The patient can walk back home in the evening after discharge from hospital. There are no recurrences. The patient can resume his normal activities a day or two after surgery.
Complications of surgery include hematoma, asymmetry, seroma, nipple slough and infection. But with proper technique and adequate precautions such complications are rarely seen in practice.
Posted By: Dr. Manoj Bansal
MS (General Surgery) Mch (Plastic Surgery).
Cosmetic and Plastic Surgeon in East Delhi, Krishna Nagar
Cosmetic and Plastic Surgeon in Vaishali, Ghaziabad (Pushpanjali Crosslay Hospital).