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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.
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Dr.
Manojkumar Manwani Gynecomastia Surgery Centre Criticare
Hospital, Main Gulmohar Road,
J.V.P.D.S., Andheri (W), Mumbai-49, INDIA Email: For appointment call +919820167509 +918169622775 |
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Gynecomastia
Mumbai India |
