Gynaecomastia means a condition in which the male chest tissues enlarge, more than its regular size. It is also sometimes referred as Man Boobs. It is caused by an increase in ductal tissue, stroma and/or fat in the male breast. Depending on Pathology 3 types can be described. 1) Florid type – increase in ductal tissue and vascularity. Variable amount of fat is mixed with the ductal tissue 2) Fibrous type--has more stromal fibrosis and a few ducts. 3) Intermediate type – is a mixture of the two.
Causes of Gynaecomastia are multiple. Most common cause of Gynaecomastia can be described as idiopathic ie no definite causes, can be found out. The type of Gynaecomastia usually seen around time of birth, in adolescent boys and in older men more than 65 years of age, usually occurs due to change of hormone level. Gynaecomastia may also manifest itself as side effect of some medications; or Disease of Liver, Thyroid, Adrenal. It may also be due to tumours of - Pituitary, Lung, Adrenal, Testis. Although the before mentioned factors are very rare causes of Gynaecomastia, but a thorough examination with needed investigations play a very important role in diagnosing and treatment of Gynaecomastia.
Clinical Classification - SIMON divided into Gynaecomastia into 4 grades == Grade1: Small enlargement and no skin excess. Grade 2a: Moderate enlargement, no skin excess .Grade 2b: Moderate enlargement, with extra skin. Grade 3: Marked enlargement with extra skin.
Observation – If a patient has Gynaecomastia for less than 1 year, and a normal history and physical examination, observation is indicated. If some definite cause or other systemic abnormalities is found in the work up of the patient, the underlying condition should be treated, and if the Gynaecomastia persists beyond 1 year, Gynaecomastia Surgery should be considered.
Gynaecomastia Surgery -- Depending on the composition of the tissues, the Surgery considered may be Liposuction, Excision of glandular tissue or combination of both(with or without excess skin excision). The incision for the surgery is always placed by the Cosmetic surgeon in such a way, that after healing it is not easily visible. For example in surgical excision of gynaecomastia tissues, the skin incision is placed at the junction of the areola and skin, so after healing the final scar is inconspicuous. Afterwards all patients are instructed to wear compression garments for one month.
Gynaecomastia Surgery Cost may vary depending on the type of Anaesthesia used (Local / Sedation/ General Anaesthesia) and also on the factors such as , if the patient was treated as a daycare case or as Indoor Admission.
Complications of Gynaecomastia surgery like – Haematoma, Underresecton or Overresection of tissues; are very rare and can be minimised with taking adequate precautions during the surgery.