Gynecomastia Treatment in Iran
Best Gynecomastia (Men enlarged breast) Treatment in Iran at the best price performed by board-certified Iranian plastic surgeons
GOALS
- To reduce the size of the breast through liposuction or excision approach or both
GYNECOMASTIA IN IRAN: ALL YOU NEED TO KNOW
Gynecomastia is defined as the enlargement of the breasts in men due to the pathologic proliferation of breast glands in males. This condition may occur due to physiological or pathological reasons. It can affect one or both breasts. Clinically, the presence of a firm mass extending from the nipples defines gynecomastia. Gynecomastia is different from lipomastia (psodugynecomastia) which is the accumulation of fat tissue without granular proliferation.
Gynecomastia is not considered as a serious issue. However, it may cause pain and swelling in the breast and the feeling of embarrassment.
One of the therapeutical approaches of persistent gynecomastia is breast reduction surgery. In this operation, the excess glands, fat tissue, and skin are removed.
What are the causes of gynecomastia?
Gynecomastia originates from physiological or pathological reasons. The natural imbalance between estrogen and testosterone is the most common physiological reason for gynecomastia, especially in puberty. Estrogen is the responsible hormone for manifesting female characteristics and respectively testosterone is the hormone that controls male characteristics. Some people suppose that estrogen is exclusive to females. However, males also produce estrogen in small amounts.
Pathological reasons affecting the hormonal balance and causing gynecomastia are as follows:
Other medical conditions may include:
• Obesity
• Hypogonadism: conditions such as insufficiency hormone release from pituitary and Klinefelter syndrome can interfere with the level of testosterone.
• Tumors: tumors in testes, adrenal glands, and pituitary glands can affect the balance between male-female hormones.
• Hyperthyroidism: over-production of thyroxine hormone alters the production of sex hormones.
• Kidney insufficiency: gynecomastia happens in around 50% of men undergoing dialysis.
• Liver dysfunction and cirrhosis: the imbalance can happen due to hormonal changes in liver hormones or prescribed medications for liver failure.
• Malnutrition: deprivation of proper amount of nutritional substances may cause limited testosterone discharge while estrogen levels are stable.
Some medications may cause gynecomastia including:
• Anabolic steroids and androgens prescribed for certain medical conditions or used illegally for building muscles and improved athletic performance
• Estrogens
• Anti-androgens such as finasteride (Proscar®, Propecia®), flutamide and spironolactone (Aldactone, Carospir) for treating enlarged prostate or prostate cancer
• Medications for controlling hypertension and heart conditions such as Spironolactone (Aldactone®), digoxin (Lanoxin®), amiodarone (Cordarone®), and calcium channel blockers
• Ulcer over-the-counter medications for treating heartburn such as Cimetidine (Tagamet®) and proton pump inhibitors
• Medications such as diazepam (Valium®) for controlling anxiety
• Anti-fungal medications such as Ketoconazole (Nizoral®)
• Anti-biotic medications such as Metronidazole (Flagyl®)
• Human chorionic gonadotropin for fertility problems
• Tricyclic anti-depressant medications
• HIV medications such as Efavirenz (Sustiva) used in antiretroviral therapy
• Medications used to empty the stomach such as metoclopramide (Reglan)
• Lavender, tea tree and other herbs with estrogenic activity used in shampoos and lotions
Drugs and alcohol also make men prone to gynecomastia:
• Marijuana, heroin (“street drugs”)
• Alcohol
• Amphetamines, illegal use or prescribed to treat attention-deficit/hyperactivity disorder
• Marijuana
• Heroin
• Methadone (Methadose, Dolophine)
What are the preparations for male breast reduction operation?
The following terms are required to be eligible for gynecomastia:
• Your skin should have proper elasticity to adjust to breast reduction. It should have enough elasticity.
• General physical health is required
• Your weight should be stable (if not, try physician-supervised diets and exercise to lose weight)
• Smoking and marijuana are disallowed
• Anabolic steroids are forbidden
Before the operation, your doctor may ask you to:
• Get medical diagnostic evaluations and lab tests (mammography, breast ultrasound and hormones concentration in the blood)
• Take prescribed medications and stop taking blood thinners such as aspirin, anti-inflammatory medications, and herbal supplements which increase the bleeding.
Arrange someone to be with you at least until the first night after the surgery.
What are the risks of gynecomastia treatment?
Breast reduction surgery may have some potential risks just like any other surgery they may include:
• Adverse reactions to anesthetics and materials used for closing the incisions.
• Hematoma (bleeding in the breast tissue or seroma or fluid accumulation)
• Blood clot formation and deep vein thrombosis leading to cardiac and pulmonary complications
• Irregularities in breast shape and its evenness
• Temporary or permanent alteration in nipple sensation and persistent pain
• Temporary or permanent damage to deeper structures including blood vessels, lungs, and nervous and muscular tissues
• Necrosis of breast fat cells
• Infection at incision sites
• Poor wound healing consisting of thick scar tissue formation and permanent changes in pigment cells.
What to expect from a gynecomastia treatment?
Gynecomastia can be treated by medications or surgery. The doctor’s approach depends on the cause, severity, and duration of the condition.
For adolescents (12 to 14 years old) the doctor observes the condition without any treatment to see if it goes away on its own. In severe cases when the condition is causing pain and tenderness, medications are used to block the effects of estrogen. If the symptoms persist for more than 2 years and the boy is passed puberty, surgery is performed. There is a chance of breast tissue regrowth if the surgery is done before puberty is completed.
In adult men, gynecomastia is usually the result of using drugs or an underlying condition. Treating the underlying condition or quitting the drug often resolves the problem.
Sometimes, radiation therapy (1 to 3 sessions) before antiandrogen (tamoxifen or raloxifene) treatment can reduce the size of the breasts and pain.
Usually, surgery is recommended in these situations:
• You have lost a lot of weight and need to correct the sagging of the breast tissue. This surgery includes the removal of glandular and fat tissue along with the excess skin.
• Gynecomastia has lasted for over 2 years.
• The condition hasn’t responded to medications or you can’t tolerate medications.
• It’s causing significant emotional and physical pain
Breast reduction surgery in males comprises these steps:
• Anesthesia: for your comfort during the procedure, medications are administered. Intravenous sedation with local anesthesia and general anesthesia are the two options in this surgery.
• Liposuction: in lipomastia and gynecomastia with excess fatty tissue liposuction is used. First, several small incisions are made to insert the cannula (thin hollow tube). Then the surgeon moves the cannula back and forth to loosen the fat tissue to be suctioned by vacuum.
• Excision: To remove the glandular tissue, an incision is made around the nipple. Then the excess tissue is removed using a scalpel. If a lot of tissue is removed, the excess skin is cut and the nipple is repositioned to a more natural male contour. To provide a male contour, the crease created by excess fat and tissue is eliminated and instead of rounded breasts, a normal masculine chest is created.
• Combination: Sometimes the surgeon uses a combination of two above mentioned procedures.
The whole operation takes around one hour and a half to complete. You may be needed to stay in the hospital overnight. The improvement in the shape and contour of the breasts is noticeable immediately after the surgery. You will be fully recovered after several weeks, and the bruising and swelling will be removed gradually during this time. In the first two weeks after surgery, you may be advised to wear compression garments to support the healing. After the wound healing is completed, the sutures will be removed in case they are not dissolvable. You can go back to your daily activities and strenuous exercise after 6 weeks. After around 6 months, you can see the final result of your surgery. Patients have reported enhanced self-confidence and being comfortable shirtless after years of embarrassment and a feeling of self-consciousness.
Gynecomastia FAQs
1. Can weight loss substitute breast reduction surgery for gynecomastia?
In overweight men, losing weight can improve the appearance of the chests via loss of fat tissues. However, gynecomastia is the proliferation of granular tissues, which cannot be treated by dieting. Furthermore, the excess skin also needs excision and the loose skin appearance have to be corrected.
2. Can young boys undergo this surgery?
They can undergo this surgery nonetheless It is recommended to wait until your 18 years old. In special circumstances, through counseling with your plastic surgeon, earlier surgery is possible.
3. Are the results permanent?
The results are often remain permanent. Accordingly, keeping a healthy lifestyle helps you to avoid the return of the condition. A healthy lifestyle involves avoiding steroids, “street” drugs, gaining weight and having a healthy diet.
4. Will I have pain after surgery?
The level of pain is often minimal. However, your doctor will prescribe pain-killers so you will be comfortable.
5. Will my scars be obvious?
Sometimes, very small scars will remain at liposuction sites under the armpits and chest that aren’t significant. In excision procedure, a scar at the size of 1 inch is formed at the periareolar site. In this area, the scar will be hidden and inconspicuous. Some more extensive surgeries include incisions under the breast and a vertical cut on the breast. These scars are minor but aren’t in hidden areas.
6. Does the surgeon drainage the operated site?
Usually, there is no need for drainage after surgery. However, in the case of heavy bleedings, a drain is necessary. Several days following surgery the drain will be removed.
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