Gynecomastia, or male breast enlargement, is an increasingly common reason that male patients schedule consultation in our practice. Gynecomastia may occur on one or both sides of the chest, may be localized primarily behind the nipple and areola or involve the entire pectoral area, and may arise in the teen years or in retirement years. As the manifestations of gynecomastia vary significantly from patient to patient, the surgical treatment must be carefully individualized.
Some enlargement of male breast tissue commonly occurs during puberty, and the incidence of noticeable (transient) pubertal breast enlargement has been reported to be as high as 60%. For most males this hormone-related breast enlargement is temporary, but for a few individuals the breast tissue proliferation will persist and in some cases even continue.
For the majority of patients with gynecomastia, no clear causative factor can be identified. However, because this phenomenon may be associated with endocrine (hormone) disorders, testicular tumors, and the use of some medications/drugs, a careful medical evaluation is an absolute necessity prior to surgical treatment.
Over the past two to three years, I have evaluated and treated a number of male patients who developed gynecomastia after using 'prohormone' and steroid supplements as part of a bodybuilding regimen. These agents are known to increase estrogen activity in some individuals, which may stimulate the proliferation of breast tissue and result in visible breast enlargement. The breast enlargement generally persists after the cessation of supplement use, requiring surgical treatment.
Patient evaluation, treatment planning and surgical management are carried out with complete discretion in my practice. Some gynecomastia breast surgery patients have related that prior to scheduling an appointment, they were concerned about 'feeling awkward' while sitting in a plastic surgeon's waiting room before their consultation. Because my office is a medical spa offering a variety of services, including laser treatments and massage, no client in our office can ever be presumed to be a surgical patient. Discuss privacy concerns with a plastic surgeon practice prior to scheduling a consultation.
