Surgical treatment of gynecomastia
Plastic Surgery – EuroDoctor.ru – 2009
Gynecomastia – a breast enlargement in men, when they become outwardly similar to the female. Translated from the Latin gynecomastia means "feminine breasts."
This disease was first described only in the 14th century, but we know that it occurs in men and in ancient times. For example, gynecomastia was a pharaoh Tutankhamun. This can be seen from the images the size of the breast more clearly "designated" normal limits. What a man feels, who suffers from gynecomastia? Shame, the feeling of inferiority, the feeling that you do not like a man.
According to the American Association of Plastic Surgeons, gynecomastia is more than 65% of all diseases of the mammary gland in men.
Causes of gynecomastia
In most cases, the causes of gynecomastia are unknown. In some cases, the cause of gynecomastia is an imbalance between the sex hormones estrogen and testosterone. We note immediately that both women and men in the body are synthesized by both types of sex hormones (estrogen and testosterone), the only difference in the numbers.
In addition, the cause of gynecomastia may be a genetic predisposition, diseases that include disorders of the endocrine system, cancer and chronic diseases, as well as taking certain medications such as antidepressants, drugs that reduce blood pressure, smoking marijuana and the use of steroid drugs.
Some men and boys may experience folds of fat on the chest, causing it may seem that they have gynecomastia. But this is not gynecomastia, a so-called psevdoginekomastiya. In this case, can help sports, gymnastics, and diet. In contrast to such a state, with gynecomastia diet and exercise do not help get rid of the hypertrophied breast.
Breast augmentation – is not such a serious problem, but at the same time, it may be accompanied by pain. Enlarged breasts can become an object of ridicule, which is especially characteristic for teens.
In our country, this disease occurs less frequently, but here in the U.S., according to the American Association of Plastic Surgeons, nearly 65% of adolescents in the age of 14 suffer from gynecomastia. The reason for this is largely hormonal changes that occur during puberty.
In 75% of teens breast augmentation is for two years on their own without any treatment, and within three years – 90% of them.
According to the magazine The New England Journal of Medicine the use of products containing tea tree oil and lavender during puberty may suspend the development of gynecomastia. However, at the termination of the use of these products effect gradually disappears.
Gynecomastia also can occur in newborns. Yes, you heard right, and it's not a typo. This is due to the fact that, while in the womb, the baby receives its blood and its hormones. This gynecomastia usually resolves in two to three weeks after birth.
In older men, gynecomastia is often the result of lower levels of testosterone in the body. In addition, with age in the male adipose tissue accumulates, which is a result of increasing levels of female hormones than male.
Drugs and substances, the reception of which can cause gynecomastia:
- Anti-androgenic drugs that are used for prostate cancer or benign prostatic hyperplasia, as well as for treating other diseases.
- Drugs used in AIDS.
- Tricyclic antidepressants.
- Drugs for treatment of ulcers.
- Preparations for the treatment of cancer.
- Drugs for treatment of heart disease.
- Anabolic steroids and androgens.
- Smoking marijuana.
Diseases for which there may be gynecomastia:
- Any condition that interferes with the formation of testosterone in the body.
- Some tumors such as testicular tumors, adrenal or pituitary gland.
- Hyperthyroidism (when the thyroid gland synthesizes a large amount of hormones).
- Renal failure.
- Liver failure and cirrhosis.
- Eating disorders.
Surgical treatment of gynecomastia
Surgical treatment of gynecomastia is to perform plastic surgery breast reduction, liposuction, or a combination of both methods.
Most often resort to plastic surgery, the reasons for which the two: first, the purpose of the operation – removal of excess breast tissue and the formation of its normal form, and secondly – the study of excised tissue for possible changes in cancer. Typically, breast augmentation with gynecomastia appears on both sides. If you find a seal in the enlarged breasts, without delay, consult a physician (surgeon or oncologist) to ensure that as soon as possible to exclude tumor pathology.
The first step in treatment is to consult with a plastic surgeon to figure out, but if you need surgery, and how you are suitable for surgical treatment. A candidate for surgery for gynecomastia should have a relatively normal weight, did not have a chronic disease of the heart, lungs or kidneys. Going to need surgery if breast augmentation is really bothering you. Ideally, you should be firm and elastic skin that can change the shape of the breast and re-create a normal appearance.
Surgery in adolescents is applied if the gynecomastia is strongly expressed, or if it persists for more than two years. In some cases, may require a secondary operation, and if the breast continues to evolve.
The operation is not recommended for obesity, or unsuccessful attempts at surgical interventions for obesity. In addition, it is necessary to consult with your doctor about the drugs you are taking because they can also cause gynecomastia. But do not stop taking medication on their own!
Preparation for surgery
Before surgery, a doctor conducts a complete examination. To do so, made common blood and urine tests, biochemical blood tests, a blood clotting. The doctor will ask you about whether you have an allergy to something, as well as the previously transferred diseases and surgical interventions, especially in the chest. Be sure the cage is held chest radiography and, if necessary, and ultrasound. Are blood tests for hormones, in order to determine the level of sex hormones. Before surgery, the doctor will make pictures of your chest, so that after surgery you can assess treatment outcome. Before the operation is strongly advised to stop smoking, as it negatively affects the healing of surgical wounds. It is generally recommended to stop smoking a month before surgery and within a month after it.
Methods of surgery for gynecomastia
If the enlarged breast is composed mainly of fatty tissue, the doctor may offer you liposkatsiyu – a procedure in which using a special apparatus is drawn off excess fat. If excess glandular tissue is excised with a scalpel. Excision of glandular tissue can also be combined with liposkatsiey.
The incision during surgery is usually done either on the edge of the areola, or in the underarm area. After skin incision the surgeon excised the excess breast tissue, fat tissue and skin around the areola and the lower chest. After that, the skin incisions are stitched together. In the case of a combination of surgery with liposuction, a tube system, through which the fat is suctioned, injected directly through the incision. Further, this tube is connected to the apparatus and the fat is suctioned.
If only liposuction, the doctor makes a small incision (about 1 cm) through which the chest tube is introduced. In addition, the incision for the tube may be held in the armpit area. You can feel with some vibration, but the pain does not happen. In place of the cuts are set rubber drains that do not accumulate in the tissue fluid. Once the wounds are sewn, glued them to the sterile dressings.
Usually, surgery for gynecomastia lasts half an hour. The operation is performed under general anesthesia, but may under local anesthesia.
Possible complications of surgery: scarring, swelling, bruising, bleeding, blood clots, infectious complications, poor wound healing, temporary or permanent loss of sensation in the nipples and breast skin, complications of anesthesia, a violation of the symmetry of the breasts, skin discoloration, permanent changes in skin pigmentation , damage to nerves, blood vessels, muscles and lungs, allergic reactions to the surgical materials of fat necrosis in the deep breast tissue, fluid retention, deep vein thrombosis, complications from heart and lung pain.
Possible complications of liposuction: the rough contours of the breast, skin wrinkling, irregular pigmentation, excessive fluid accumulation, infectious complications, pulmonary embolism, hematoma (accumulation of blood in the tissues), temporary numbness and discoloration in the incision area, asymmetry, rippling, wrinkling, and uneven in the chest, reaction to anesthesia, swelling, burns (using ultrasonic liposuction).
PLASTIC SURGERY in Germany – Plastic Surgery Clinic OPTIMA
BEAUTY CLINIC IN MOSCOW – UNICLINIC
Department of Plastic Surgery CB 6 RZD – MOSCOW
PLASTIC SURGERY IN MOSCOW – Professor S. GAGARIN
Examination and treatment in GERMANY – Institute "DIAGNOSTIX"
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