Sep 28

Written by: Hande Hospital
9/28/2012 11:02 AM

Gynaecomastia is a condition in which males develop enlargement of the mammary glands. This is quite common in adolescents and is often first noted at the onset of puberty. Most of these cases are due to changes in the hormonal secretion with temporary excess of estrogen like substances or relative deficiencies of testosterone like substances. This imbalance can lead to temporary increases in the amount of ductal tissue present on one or both sides. The majority of cases show enlargement on both sides. The degree of enlargement varies widely. The milder cases usually resolve in 3 months to a year. By the late teens most of these patients will have normal appearing glands without any form of treatment. For some the problem persists. Because young boys are reluctant to discuss their concerns they are likely to hide their abnormal appearance with clothing. They may try to avoid gym classes, athletic activities, and swimming or beach activities and this may affect their behavior too.

Apart from Gynaecomastia seen in adolescence, which is by far the commonest cause, there are other rarer causes for this problem. It could be due to endocrine gland malfunction and tumors. Some types of liver disease and cancers of several types can produce gynaecomastia. However these are extremely rare instances. Some cases are due to congenital syndromes and others may be related to drug use such as steroids or marijuana. Prolonged use of certain prescription drugs may also cause gynaecomastia as a side effect. There is a second peak in incidence late in life and here the risk of ductal carcinoma must be a stronger consideration so that biopsy  may be necessary.


When gynaecomastia is severe; when it is the cause of abnormal behavior and loss of body image; when it persists, and in those cases where there is a suspicion of malignancy surgical treatment is indicated. The incision for this operation is placed just inside the areolar border (dark area of the breast) where it is less likely to be conspicuous. The glandular tissue must be removed. At Hande Hospital we always use liposuction to remove the fatty tissue, which surrounds the ductal tissue. Without liposuction, patients would have a “doughnut” or a “volcano” shaped defect after removal of the ductal tissue and the patients are unhappy with the inferior results. Liposuction is a procedure where fat is sucked out from under the skin with a blunt needle. Between three and four liters of fat can be sucked out in one sitting. Liposuction of the abdomen and hips may also be performed simultaneously along with correction of gynaecomastia. Several of our patients have opted for this.

Stay in hospital is usually for a period of about three days. A drainage tube is placed to prevent any haematoma (collection of blood) under the skin, which is removed at the end of three days. The patient after discharge can perform light work straight away. Strenuous exercise and going to gym etc may have to wait for a period of up to fifteen days.

 The vast majority of patients undergoing this operation are very pleased and adopt a more normal life with regard to exposure of the chest in normal social situations. As said earlier, adding liposuction to conventional surgery has greatly enhanced patient satisfaction.