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What is Gynecomastia? How Much Does Gynecomastia Surgery Cost?

The endocrine system carries out the regulation and control of the functioning of all tissues in the human body. Gynecomastia is one of the problems that occur due to disruptions in the endocrine system.

Gynecomastia, also seen in infancy and old age, is most common during adolescence. According to a study, the prevalence of gynecomastia in adolescent males in our country is 34.6%. In other words, gynecomastia is seen in one out of three adolescents. Medical and surgical intervention is required for gynecomastia that persists for a long time, it cannot regress spontaneously.

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Gynecomastia is the benign growth of breast tissue due to an imbalance in estrogen and testosterone hormones, especially in adolescent males. Gynecomastia is the physiological growth of the part of the breast that is specialized for milk production, that is, the development of female-type breast tissue in men. In some cases, this may affect only one breast tissue and in some cases both breast tissues. In the case of obesity, the growth in the breast that occurs due to increased adipose tissue is called pseudo-gynecomastia.

Male and female breasts are structurally identical. However, since men do not secrete enough estrogen, the male breast does not grow as much as the female breast.

It does not seem possible for gynecomastia to heal spontaneously. It is a problem that can be treated with medication or surgical intervention.  It causes pain and soreness in some patients, but health is not harmed.

Since gynecomastia in men is especially common among young men, it can cause social isolation in this group of men. It can lead to the inability to enter the sea or pool, hesitation to undress among friends, loss of self-confidence, introversion, inability to wear the clothes they want, and physical posture disorders.

Breast reduction surgery for gynecomastia in men is one of the most preferred aesthetic surgeries. It has very satisfying and permanent results.

What are the causes of gynecomastia?

In 85% of cases, gynecomastia is idiopathic, which means no apparent cause. 15% of cases are caused by different reasons such as cancer, endocrine and metabolic diseases, stress, obesity, trauma, viral infections, certain medications, or familial predisposition. Hormone levels may increase or decrease due to natural or environmental causes.

The cause of gynecomastia is an irregularity or imbalance in the hormones estrogen and testosterone. In other words, gynecomastia can occur due to a decrease in the amount of testosterone in the body or an increase in the amount of estrogen. Fluctuations in the level of the hormone testosterone often result in gynecomastia. In men, abnormally high production of estrogen, or estrogen production that is out of balance with testosterone levels, can cause gynecomastia. These hormonal changes can occur naturally or other causes.

1. Natural hormone changes:

Testosterone and estrogen control sex characteristics in humans. Men also synthesize small amounts of the hormone estrogen. When the testosterone/estrogen balance in men shifts in the direction of estrogen, gynecomastia can occur.

Gynecomastia in infants:

They are born with gynecomastia due to the estrogen hormone passed to them by their mothers. The enlarged breast tissue disappears spontaneously within two to three weeks after birth.

Gynecomastia during puberty:

It is a common condition. In 90% of cases, the breast tissue returns spontaneously within six months to two years.

Gynecomastia in adults:

The incidence rate increases in adults between the ages of 50-69. One in 4 men in this age group experience this problem.

2. Medications:

Side effects or misuse of many medications can cause gynecomastia. These medicines are;

• Anti-androgen drugs (flutamide, finasteride) that inhibit prostate growth or are used in the treatment of prostate cancer,
• Anabolic steroids and androgens,
• Some antiretroviral drugs used to treat AIDS,
• Some anxiety medications (diazepam)
• Antidepressants belonging to the tricyclic group,
• Cirrhosis medicines,
• Ulcer medicines (proton pump inhibitors),
• Some heart medications (Spironolactone, digoxin, amiodarone, ACE inhibitors captopril, enalapril, calcium channel blockers),
• Amphetamines (medicines used to treat attention deficit or hyperactivity disorder),
• Medicines for fungal infections (ketoconazole),
• Medicines used for bacterial infections (Metronidazole),
• Medicines used to treat infertility (human chorionic gonadotropin hormone),
• Chemotherapeutic drugs (Alkalizing agents, Methotrexate, Vinca alkaloids),
• Some antibiotics (Ethionamide, isoniazid),

3. Drugs, smoking, and alcohol:

• Excessive alcohol consumption,
• Smoking,
• Marijuana,
• Heroin,
• Cannabis,
• Substances like methadone,

4. Health Problems:

Tumors:

Tumors in organs such as the testes, adrenal glands, and pituitary gland.

Hypogonadism:

Impaired testosterone production as a result of Klinefelter syndrome or pituitary gland failure.

Hyperthyroidism:

Excess secretion of thyroid hormone.

Kidney failure

Hemodialysis patients

Liver failure and cirrhosis:

Liver problems cause hormone dysregulation. Gynecomastia occurs in 67% of cirrhosis patients. Androstenedione is converted into estrogen. High doses of spironolactone used in the treatment of cirrhosis also cause gynecomastia.

Hermaphroditism

Hermaphroditism is when an individual has both female and male reproductive organs. Estrogen secreted in these people causes gynecomastia.

Aging:

Testosterone production in the testicles decreases.

Obesity:

Testosterone levels may decrease as a result of an uncontrolled increase in body fat.

Starvation:

Due to excessive hunger in the body, testosterone levels decrease and estrogen production continues.

5. Herbal products:

The amount of estrogen contained in shampoos, soaps or lotions, Dong Quai, tea tree oil, and lavender.

What are the advantages of gynecomastia surgery?

The advantages of gynecomastia surgery can be listed as follows:

1. Correction of aesthetic appearance:

Gynecomastia causes abnormal growth of breast tissue in men, which often results in an uncomfortable aesthetic appearance. Gynecomastia surgery solves this problem by removing or reducing breast tissue and providing a more aesthetic appearance.

2. Increased self-confidence:

After gynecomastia surgery, men feel more confident and this can help increase their self-esteem.

3. Return to physical activity:

Gynecomastia can cause pain or tenderness in the breast area in some men, which can limit physical activity. Once the post-operative healing process is complete, men can usually return to their normal activities.

4. Psychological recovery:

Gynecomastia surgery not only provides physical benefits but can also have a healing effect psychologically. Men who have decreased self-confidence due to gynecomastia may feel better after surgery.

5. Reduced risk of recurrence:

Gynecomastia surgery solves the problem through complete removal or reduction of breast tissue, often reducing the risk of recurrence.

What are the types of gynecomastia?

There are two types of classification;

1. According to the structure of the growing tissue;

Glandular Type:

Mostly milk glands are enlarged.

Fatty Type:

There is a considerable increase in fat tissue. There is no increase in mammary gland tissue. It occurs as a result of excessive weight gain and loss.

Mixed Type:

There is an increase in both milk glands and adipose tissue.

2. According to the size of the breast and the condition of the skin;

Type 1:

The skin of the breast is ideal, with only some hardness under the nipple.

Type 2A:

No excess skin in the breast, and the breast is moderately enlarged.

Type 2B:

There is some excess skin in the breast, the breast is moderately enlarged. The skin may shrink and return to normal spontaneously after surgery.

Type 3:

The breast is large like a woman’s breast and there is excess skin. The skin is removed with additional surgery.

Who is at risk of gynecomastia?

People in the following group are at risk of gynecomastia;

• The elderly,
• Adolescents,
• People with thyroid disease,
• People with kidney disease,
• Klinefelter syndrome,
• People with liver disease,
• Users of anabolic steroids and androgens (those who want to improve athletic performance)

They are at risk of gynecomastia.

What is the incidence of gynecomastia?

In newborn childs, gynecomastia caused by estrogen passing from the mother returns to normal in a few weeks. In a study conducted in our country, gynecomastia was observed in 34.6% of adolescent males. At later ages, the rate of gynecomastia will increase due to the decrease in the testosterone hormone.

Although gynecomastia is generally seen in both breasts, it may be slightly more on one side.

What are the symptoms of gynecomastia?

Abnormal growth and development of male breast tissue manifests itself with some symptoms. We can list the symptoms that may occur in gynecomastia as follows:

• Size difference between the two breasts,
• Feeling of a lump under the nipple,
• Swollen axillary lymph nodes,
• Increase in breast size and volume,
• Tenderness or pain in the breast tissue,
• Discharge, milk secretion or blood from the nipple,
• Breast tissue swelling,

Symptoms such as gynecomastia are symptoms of gynecomastia.

However, it should not be forgotten that breast cancer can also occur in men. Men can develop breast cancer without gynecomastia. The symptoms listed above can also appear with breast cancer.

How is gynecomastia diagnosed?

For the diagnosis of gynecomastia, physical examination is performed first. Information about the health history of the patient and his/her family is collected. In addition to physical examination, some tests are performed to distinguish other diseases and conditions. These are

• Blood tests,
• Computed tomography scan,
• MRI scan,
• Breast USG,
• Testicular ultrasound,
• Tissue biopsy,
• Mammogram,
• Liver function tests,
• Urine tests.

As with gynecomastia, there are several similar conditions with breast swelling. One of these is breast adiposity caused by obesity. Breast cancer should be considered in the presence of a single breast size or a hard mass in the breast. Breast abscess is similar to gynecomastia in terms of breast enlargement.

What is Pseudo Gynecomastia?

False gynecomastia is also called pseudo gynecomastia, adipomastia, or fatty breast. In this case, there is excessive fat accumulation in the breast and it is usually seen in obese individuals. In these patients, there is fat accumulation in other parts of the body along with the breast. In gynecomastia, there is an increase in the milk glands.

In a physical examination by hand; in gynecomastia, enlarged milk glands come to the hand as a rubber hard mass. In false gynecomastia, there is no such mass. A homogeneous, diffuse, and soft tissue is felt on palpation. Increased fat tissue is detected by breast ultrasonography.

The most effective treatment method for false gynecomastia is “liposuction”. With the help of a cannula, the accumulated excess fat is removed.

Is gynecomastia a disease?

Male breast enlargement is a benign condition that is not cancer. It is related to changes in female or male hormone levels. In most cases, no specific cause can be identified. It is not necessarily a condition that needs to be treated. In some cases, it can also occur as a symptom of an underlying disease.

 Every man with breast enlargement should be thoroughly examined by a specialist in endocrinology and metabolic diseases. If no disease is detected here, it may be considered an aesthetic problem.

How is gynecomastia diagnosed?

The diagnosis is usually based on the patient’s history and physical examination. In cases where a full diagnosis cannot be made, imaging options such as ultrasound, mammography, and blood tests are used. Conditions such as false gynecomastia, breast cancer, and breast abscess are ruled out by determining the fat content in the breast tissue.

In patients diagnosed with gynecomastia, an important part of the process is the diagnosis of diseases that may cause gynecomastia. For this purpose, blood tests, computed tomography or MRI imaging, ultrasonography of the testicular tissue, and tissue biopsy are performed when necessary.

Frequently Asked Questions

How much is the price of gynecomastia surgery?

Gynecomastia’s price varies according to the technique of the surgery and the material to be used. You, our valued patients, can contact our surgeons in our clinic for your gynecomastia problem that does not go away on its own. An examination is essential to determine the price of gynecomastia surgery.

You can contact us to get information about our current prices. (CONTACT INFORMATION WILL BE GIVEN HERE)

Is there pain after gynecomastia surgery?

It is normal to feel mild pain or discomfort after gynecomastia surgery. However, this pain usually starts to decrease in the first few days after surgery and can be controlled with prescribed painkillers.

Postoperative pain may vary depending on the level of gynecomastia experienced, the type of surgical procedure performed, and the patient’s pain tolerance. Some patients may experience only mild discomfort, while others may experience a more intense pain sensation.

Postoperative pain is usually mild in the first few days. During the healing process, the pain continues to decrease and patients can usually return to their normal activities in a week or less.