Gynecomastia is a common benign condition in which one or both of a males’ breasts become over-developed.
It can occur in newborns, adolescent men, or older men. In newborns, there may be influence from maternal hormones. In adolescent males, there may be hormonal changes during puberty. In adolescents, the enlarged breasts are sometimes referred to as “man boobs.” In older males, there is usually an increase in estrogen and a decrease in testosterone. There also may be side effects of medicines that may lead to enlarged breasts. During the history and physical examination, the factors which may contribute to gynecomastia can be determined. From this, a plan can be developed to treat the condition.
In most newborns and adolescents, the condition is often temporary and no treatment is necessary. If the condition does not resolve within a reasonable period of time (What is considered as a reasonable period of time??), then surgical correction can be under taken. Some young men may experience anxiety due to the over-developed breasts. In older patients, gynecomastia can be the result of a side effect of medications. Some of these medicines include cimetidine, ketoconazole, human growth hormone, spironolactone and others.
If gynecomastia persists beyond puberty or in older men who correct the medical causes of the condition, then surgical correction may be appropriate.
The classification of the disease is helpful in understanding the various treatment options. The patient can have minor enlargement and no excess skin, moderate enlargement and no excess skin, moderate enlargement with excess skin, or, marked enlargement with excess skin. The treatment that is suited for a patient with any of these conditions is best determined by the treating physician and which type of surgical intervention to use is determined by the treating plastic surgeon.