Gynaecomastia is a condition by which males develop breast tissue due to an imbalanced ratio of oestrogen and androgen activity. It is a common condition with at least a third of men experiencing gynaecomastia in their lifetime. This can cause considerable embarrassment and there can be a concern to the patient for the potential of breast cancer developing although this is a rare occurrence.
Physiological gynaecomastia most commonly occurs in adolescence as delayed testosterone surges at puberty relative to oestrogen. It is less common in the older population secondary to decreasing testosterone levels with increasing age.
Pathological gynaecomastia results from changes in the oestrogen/androgen activity ratio and underlying mechanisms such as:
- Lack of testosterone: Causes include Klinefelter’s syndrome, androgen insensitivity, testicular atrophy or renal disease
- Increased oestrogen levels: Causes include liver disease, hyperthyroidism, obesity, adrenal rumours, or certain testicular subtypes.
- Some types of medication can cause this such as digoxin, metronidazole, chemotherapy, anti-psychotics or anabolic steroids.
- It is important to differentiate between Gynaecomastia and adipose tissue in the breast region due to being overweight and therefore in this case surgery should not be carried out. Investigations are only necessary if the cause of Gynaecomastia is unknown.
Gynaecomastia surgery is carried out to reduce the appearance of a man having “breasts”. By removing excess glandular and fatty tissue from the area flattens it resulting in a more muscular appearance to the chest area. This result can restore self-confidence and boost self-esteem.
Mr Ferrando is a very experience Plastic surgeon and has carried out numerous Gynaecomastia removal procedures.