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Gynecomasty/Big Breast in Male

In puberty, the growth of the breast in male caused by hormonal factors, sensitivity and fullness is natural. If this temporary case turns into a permanent one caused by various factors, it is called as gynecomastia. It may effect the young's activities and clothes in a bad way and it may become a social problem.( wearing loose clothes, posture disorders and avoidance of swimming etc...)

Although, Gynecomastia is seen mostly in a way that are mentioned above, sometimes unilateral or bilateral gynecomastia can be seen caused by hormonal, tumoral reasons or drug use. In order to diagnose the reason, a detailed history, visualization techniques (ultrasound and MR) and hormonal analyses may be needed. While Classical Gynecomastia/ Big Breast in Male starts in puberty and continues, the gynecomastias caused by other reasons may appear at later ages and the possibility of having unilateral gynecomastia is high.

With a distinctive diagnosis the reason of the gynecomastia is understood and then treatment planning starts. Gynecomastia is divided into 3 groups according to the structure of the excessively grown breast tissue. At the first level, the growth of the breast tissues is limited and looseness and sag in the skin are not seen. At the second level, It is like a largish woman breast and there is no skin sag. .At the third level, sagging skin requires treatment additionally. The level of the gynecomastia is important in planning the treatment. If the patient has got the gynecomastia at the first level which is caused by the fatty tissue mainly, gynecomastia is treated by vacuum application. If the breast structure is consisted of mammary gland except for the fatty tissues, this tissue is removed with the help of a slight incision entered from the nipple and it can be sent to pathology. It can be said that almost the same treatment techniques are used at the second level as well. In the gynecomastias at the third level, If the sag in the skin is advanced, some certain surgical planning may be thought in order to remove the excess skin.

Situations in which the skin has excess elasticity can bee seen and in this case skin problem is removed by the vacuum or the surgical operations from the round of the nipple. But semi lunar surgical interventions on the nipple may be required at older ages and in the cases that the skin has much sagging. No matter which technique is used, the patient must not take aspirin for 10 days before the operation and certain laboratory investigations must be done. In addition to this, important illnesses gone through in the past and permanently used medicines (if they are used) must be stated to the doctor. If one of the open surgical interventions is chosen for the operation, a drain must be used. The aim of the drain is to prevent the accumulation of the blood and serum in an effort to minimize the possibility of complications. Drain is removed between 24-48 hours generally.

Another application that is used in almost every case is wearing a special corset in order to compress the operation area. The usage of this corset is very simple. Since there is an open part that leaves the space between the thighs open, it is possible to go to the toilet easily without taking it out. This corset must be worn for the first week continuously. After the first week, in the morning while doing heavy activities especially, it is profitable to wear this corset. This length of time is approximately 5 weeks. On the fist days, edema, sensitivity, pain and even bruises may appear on the operation zone. These problems start to disappears after the first 2-3 days gradually. The sensitivity may last for weeks. Sometimes, even if they do not effect the daily life in a bad way, numbnesses, stings, paresthesias can be seen. After the second week, the patient is allowed to swim in the pool or in the sea and factors that can cause edemas such as; steam bath, sauna, solarium must be avoided for 6 weeks. Doing active and risky sports in which there is possibility of receiving a blow to the breast area must be avoided for 6 week accordingly.

The method of the anesthesia used for the operation can be changed. General anesthesia is preferred and local anesthesia with sedation that help letup and anesthetizing the operation area can be applied as well. The General anesthesia solely is not suggested most of the time.


The Complications that May Occur in Postoperative Period:

Early Period: 

* Bleeding: It can be minimized with the help of a drain. This situation is taken into consideration mostly for the people who take aspirin or who are disposed to massive bleeding.

* Infection: it is not seen generally.
Late period:

* Disorders that are seen rarely.

* Significant and bad scars that may be seen on the operation area.

* Sometimes, long lasting numbness  and the changes in the color can be seen in the gynecomasty operations carried out with liposuction. Generally, these problems disappear in time. 



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