Gynecomastia

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Gynecomastia

 

Gynecomastia ( women Breast)

Gynecomastia is development of breast tissue in Men.

Gynecomastia in young male is analogous to a breast deformity in the teenage female. Occurrence of an abnormality in a secondary sex characteristic at this critical emotional period in life, when the self image plays a major role, may produce significant psychological problem if not corrected. This results in low feeling in them particularly when they go to gym or swimming pool. Correction of gynecomastia restores a lot of confidence in them. Gynecomastia is mainly bilateral but sometimes it can be unilateral.

1.      A soft, diffuse mass with no palpable glandular disc is fat and will respond to liposuction

2.    A firm, discrete mass in a thin adolescent boy is composed of pure glandular material. It cannot be removed by liposuction and should be excised through an areola incision.

3.    If on examination the breast mass suggest mixed glandular and fatty components, It should be treated with liposuction followed by direct excision.

Operation is mainly done as an o.p.d. procedure.

 

Simon Classification of Gynecomastia

 

Grade Enlargement Skin Excess

I small Absent

IIA Moderate Absent

IIB Moderate Present

III Large Present

 

Causes:

Congenital & Acquired

Idiopathic 25% most common

      Neonatal: Exposure to high maternal oestrogen concentration in utero leads to the development of breast tissue in neonates.the proces resolves within few weeks of birth as the estrogen level returns to normal

      Pubertal: Estradiol-to-testosterone ratio is elevated in some boys, leading to gynecomastia in upto 65% of patients. Most instances resolve by the end of puberty (12 yrs to 16 yrs)

      Senile: Peripheral conversion of testosterone to estrogen by aromatase remain intact in the peripheral fat even as systemic production declines, causing elevation of the estrogen-to-testosterone ratio and including breast developement.

 

Treatment:

The initial approach to gynecomastia in adolescents should be conservative. Increased breast size is normal and usually transient, lasting no more than 2 years. If gynecomastia is excessive and lasts more than 2 years, a full evaluation of patient for possible etiology is indicated, to be followed by appropriate treatment.

Gynecomastia in young male is analogus to a breast deformity in the teenage female.occurance of an abnormality in a secondary sex characteristic at this critical emotional period in life, when the self image plays a major role, may produce significant psychological problem if not corrected.

 

Treatment Plan

      A soft, diffuse mass with no palpable glandular disc is fat and will respond to liposuction

      A firm, discrete mass in a thin adolescent boy is composed of pure glandular material. It cannot be removed by liposuction and should be excised through an inferior periareola incision.

      If on examination the breast mass suggest mixed glandular and fatty components, It should be treated with liposuction followed by direct excision.

Operation is mainly done as an o.p.d. procedure.

 

 

Dr. Manojkumar Manwani

Gynecomastia Surgery Centre

Criticare Hospital,

Main Gulmohar Road, J.V.P.D.S.,

Andheri (W), Mumbai-49, INDIA

 

 

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Gynecomastia Mumbai India