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Breast - Mens

Gynecomastia means the development of breasts in men. Learn why this happens. The term gynecomastia, the Greek "female breast" refers to benign enlargement, temporary or permanent, of the male breast due to the development of the mammary gland. Both the female breast and male breast is formed by the mammary gland and adipose tissue (fat). However, in men there is the hormonal stimulus for growth of the mammary gland, which occurs in women during adolescence. Thus, normal male breast said fat tissue is formed and an incipient mammary gland. However, in a considerable portion of the male population, there is the development of the mammary gland. The estimated occurrence of gynecomastia is between 32% and 36%, in adolescence (64%) and elderly (40-60%).

Gynecomastia can result from an increase in the mammary gland alone or associated with an increased adipose tissue, called mixed gynecomastia. The breast enlargement only is consequent to the accumulation of adipose tissue is classified as pseudogynecomastia (false gynecomastia). Gynecomastia is related to physiological causes, pathological (associated with other diseases), pharmacological (drug or drugs) or idiopathic (unknown cause). However, in all cases there is an increase of female hormones and / or reduction of male hormones in the blood stream. Due to the wide range of causes, the medical patient should be comprehensive in order to guide the investigation and to propose the best treatment. Laboratory tests are rarely needed.

The physiological cause of gynecomastia is divided into neonatal, pubertal and andropause (the male form of menopause). In gynecomastia neonatal maternal female hormones are transferred through the placenta to the fetus. The breast enlargement is transient, lasting for a week to a few months. Thus, treatment is seldom needed. Adolescents, in 65% of cases have some degree of gynecomastia, which usually resolves spontaneously in a few months to years. Only 7.7% of patients remain with breast enlargement after 17 years of age. Therefore, surgery is only indicated in this age group after years of observation or when the patient is emotionally affected. Andropause in men has a frequency of 40 to 60% with gynecomastia, because of reductions in blood levels of testosterone and the increase of the female hormone.

In pathological gynecomastias, the simple treatment of associated diseases and discontinuation of medication or illicit drug use respectively, can be sufficient for reducing the size of the breast. However, chances of recession are significantly reduced where gynecomastia has developed for more than one year. Physical examination shows an increase in volume due to the growth of the breast gland, which is palpation of a discoidal shape, located behind the areola, which is movable and firm and elastic. It can occur in both breasts or just one and only 10-20% of people report pain with palpation. People with gynecomastia do not seem to be at increased risk of developing breast cancer. Thus, treatment is recommended when gynecomastia causes discomfort, or the aesthetic point of view to the patient.

Some authors advocate medical treatment of gynecomastia, especially when onset is recent and is symptomatic, i.e. pain. However, none of the various drugs are 100% efficiency, with no sign of gynecomastia after taking the medication. Surgical treatment remains the leading choice for gynecomastia.

The surgical procedure will depend on the size of breast size and the presence or absence of excess skin. The larger the volume of the breast and the greater the excess skin, the greater the scars will be left by surgery. But in most cases they will be located in areolas and be discreet. Because much of gynecomastias are either mixed or psedoginecomastia (fat source), the use of liposuction it is often necessary in the affected site so we can achieve a good cosmetic result. The surgical time generally ranges from two to three hours, so there is no need of hospitalization and the patient can return to normal activities within a week. The postoperative period is usually very calm and with little pain. However when there is mild to moderate pain it can be controlled with common analgesics. Dr. Peixoto Peixoto uses the most modern suture techniques that exist, with absorbable wires, which as its name states does not need to be removed because they are absorbed by the body spontaneously with time.
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