Gynecomastia

What exactly is gynaecomastia?

Gynecomastia is the benign enlargement of the mammary glands in men. It involves the proliferation or growth of the mammary gland itself – that is, the mammary gland tissue in men – and is not merely a build-up of fat. It can occur on one side or both sides and is often caused by a hormonal imbalance.

Distinguishing it from pseudogynecomastia (lipomastia)

It is important to distinguish this from pseudogynecomastia. In this case, there is no enlargement of the mammary gland, but rather an increased accumulation of fatty tissue in the male chest area, often associated with obesity (excess weight). The treatment varies. A mixed form is also often present. A specialist can determine which form is present through diagnostic tests.

Common causes of gynaecomastia

The Causes of gynaecomastia are varied. The Pathophysiology is usually caused by an imbalance in the Hormone levels (Oestrogen-androgen ratio):

• Physiological gynaecomastia:
• Neonatal gynaecomastia: Through maternal hormones.
• Adolescent gynaecomastia: Very common in boys; it usually resolves spontaneously.
• Age-related gynaecomastia: caused by hormonal changes associated with ageing.
• Pathological gynaecomastia:
• Hormonal imbalances: Hypogonadism, tumours.
• Drug-induced: Numerous medicines can cause side effects Breast growth promote.
• Diseases: Chronic liver diseases (e.g. Cirrhosis of the liver), kidney disease, thyroid disorders.
• Drugs/Alcohol: Excessive consumption.
• Malnutrition: Paradoxical response following periods of starvation.
• Factors such as insulin-like growth factor 1 (IGF-1) may also play a role, but the exact mechanisms are complex.
• Idiopathic gynaecomastia: No clear Cause of the condition can be found.

Symptoms: How can you recognise gynaecomastia?

Symptoms and signs of gynaecomastia:

• Visible/tangible Breast augmentation.
• Palpable, often firm glandular tissue beneath the nipple.
• Tightness, tenderness, pain.
• Enlargement of the areola.
• Sometimes Swelling as far as the armpit.
• Rare: secretion.

In pseudogynecomastia, the tissue is usually softer (pure Fat deposition).

Diagnosis: How does a doctor diagnose gynaecomastia?

Diagnosis in cases of suspected gynaecomastia is important in order to determine the cause and rule out serious conditions:

1. Medical history Symptoms, medication, etc.
2. Physical examination Palpation of the breast (glandular tissue vs. fat), testicles.
3. Imaging Ultrasound is the standard method for distinguishing between glandular and fatty tissue. Mammography is rarely used, and only when malignancy is suspected. Computed tomography (CT) is used in exceptional cases for further investigation.
4. Blood test Determination of the Hormone levels (testosterone, oestrogen, etc.), liver and kidney function tests.

Treatment options for gynaecomastia

Treatment depends on the cause, severity and level of distress:

Wait and see

This is often sufficient in cases of pubertal gynaecomastia, as spontaneous resolution is common.

Medication for gynaecomastia

Rare; only in specific cases (e.g. early, painful forms) by specialists. Discontinuation of the triggering Medicines.

Surgical treatment (gynecomastia surgery)

The most effective treatment for persistent, troublesome gynaecomastia. Carried out by specialists in Plastic and Aesthetic Surgery (or Reconstructive and Cosmetic Surgery).

• Liposuction: Liposuction using fine cannula, often in cases of pseudogynecomastia or mixed forms.
• Removal of glandular tissue (excision): Removal of the actual breast glandular tissue via a small incision. Necessary in cases of true gynaecomastia.
• Combination/streamlining: Often necessary to achieve the best possible aesthetic result.

The operation is usually carried out on an outpatient basis or with a short hospital stay. Initial Bruises and swelling are normal. It is important to wear a compression girdle. The final Results of a gynaecomastia operation becomes visible after a few months.

How much does gynaecomastia surgery cost?

Budget: Approx. 2,500 – 6,000 euros in Germany.

Takeover of a cash register: Only in cases of strict medical necessity (pain, hormonal imbalance, proven significant psychological distress). An application must be submitted.

What can you do yourself? Alternatives to surgery

Steps you can take yourself:

• Weight loss: At Obesity and pseudogynecomastia are essential.
• Checking medication: Consult your doctor.
• Healthy lifestyle: Sufficient exercise and a healthy diet.
• Training: Strengthens the pectoral muscle, but does not break down glandular tissue.

Important: No creams or tablets without proven efficacy! Medical Diagnostics is always the first step.

When should you see a doctor?

If you experience any new enlargement of the male breast, pain, lumps, discharge or significant distress, it is advisable to seek medical advice.