Plastic Surgery

1. Physiological- this happens to the hormonal changes in adolescence. The rapid rise in male hormone levels and their subsequent conversion to oestrogen in fatty tissue leads to enlarged breast size. This type of Gynaecomastia resolved with time and usually doesn’t require treatment.
2. Pathological – This can have a number of causes like-
   • Hormonal deficiency
   • Old age
   • Chronic liver disease
   • Chronic kidney failure
   • Alcohol abuse
   • Drugs

The most common symptom of gynaecomastia is an enlargement of one or both breasts which presents as a swelling. There may be associated pain and tenderness in some cases and it may be felt as a hard nodule below the nipple and areola.

Gynaecomastia is detected by a combination of clinical examination and some investigations. An ultrasound scan is usually sensitive enough to pick up the problem and it can be confirmed by needle biopsy which will show abnormal glandular development in the male breast.

The treatment of gynaecomastia is required when it is large, unslightly and causing significant cosmetic embarrassment to the patient. In case of physiological or pubertal gynaecomastia, watchful waiting is recommended as it usually subsides over a few years.  Gynaecomastia caused due to systemic diseases and drugs require treatment of the particular condition and or stoppage of drugs which usually leads to resolution of the problem. 

The treatment of gynaecomastia is through surgical removal of the excess fatty and glandular tissue of the breast. This is done through a periareolar cosmetically placed incision to give a aesthetic  appearing scar after the procedure.