Typically, gynecomastia is not permanent. It usually progresses through several phases and then goes away. First, there's an inflammatory phase in which most men experience some breast tenderness. After about six to 12 months, the inflammation subsides, leaving only scar tissue behind.
In most cases, little or no treatment is needed. If gynecomastia is caused by an underlying medical condition, such as a pituitary gland disorder or a liver condition known as cirrhosis, that condition may need treatment. If you're taking medications that can cause gynecomastia, your doctor may recommend stopping them or substituting another medication.
If the excess breast tissue is persistent and associated with pain or discomfort, treatment may include a short course of an estrogen-blocking agent commonly used in the treatment of breast cancer, such as tamoxifen. If significant symptomatic breast enlargement continues despite other treatment, surgery may be an option to remove the excess breast gland tissue. If you have questions or concerns about gynecomastia, or if you have other risk factors for male breast cancer, talk to your doctor to ensure that your treatment plan and follow-up schedule are appropriate to your needs.
By Shawn Bishop. Answer: Gynecomastia — enlarged male breast tissue — may slightly increase your risk of breast cancer. Special for WBRC. It can happen in one or both breasts. Sometimes a small, rubbery lump can be felt under the nipple. The breast area might feel sore, especially in the months after gynecomastia begins.
Puberty is the main cause of gynecomastia in adolescent boys. Hormones are chemical messengers. The ones involved in puberty can get out of balance and lead to gynecomastia. Some medicines, drugs including alcohol, marijuana, amphetamines, and heroin , anabolic steroids taken to build muscle and improve strength , and other medicines also can cause gynecomastia. The herbal supplements tea tree oil and lavender oil may also lead to gynecomastia.
Rarely, gynecomastia can be a sign of other medical conditions. There's also something called pseudogynecomastia or false gynecomastia. This has nothing to do with puberty or hormones. It's when some guys have extra fat in the chest area that makes it look like they have breasts. Remove enough to treat the problem but not too much to create contour irregularities.
Treatment depends on the cause. The easiest treatment is when only the central portion of the breast tissue is removed and leaves a central crater. In this case, proper breast tissue removal and beveling the margins provides good results. Finally, a common cause of cratering is due to low nipple placement.
Typically, this means that you were not a type 1 gynecomastia. Some type of precise skin excision is necessary to achieve optimal results. However, it is possible that skin re-draping can redistribute the skin and make it appear flatter. Making the same analogy — It is like trying to fit a 10 foot rug into an 8 foot room — no matter what you do there will always be some bumpiness.
Patients will always assume that this laxity is breast tissue. See the image of the skin cutaway showing how this occurs. With type 1, there is not as much breast tissue but enough to frustrate a body builder or someone really trying for chest definition. Sub-optimal incisions widen from the constant stretching movement of the shoulder. However, when performed strategically, tension is reduced and the incisions fade extremely well.
Areola incisions routinely heal fantastic as early as 3 months. Skin incisions, however, take longer. While it may be shorter, Dr. Cruise tells his patients that it will take at least a year to fade to the point that they can comfortably take their shirt off in public. Therefore, waiting a year is not an issue. The up side is that even during the waiting period you will be able to where any shirt you could possibly dream of.
Even the dreaded tight white T-shirt. To many, this does not even seem possible and has sent goose bumps down your spine. With body builders it is the holy grail of physique. Virtual Consultations Available! Start Your Journey Today.
Most common age group: Puffy nipple is caused by swelling of this excess breast tissue. Cruise Classification System A classification system is only useful if it outlines a treatment plan.
The purpose of the Cruise Classification System is: Easily identifies what type you are Defines the goals of surgery Describes the critical steps in achieving optimal results Cruise Classification System — 6 Types of Gynecomastia Notice the progressive increase in skin laxity.
Nipple position At or above pectoralis muscle border Skin excess Tight skin — straight chest fold no rounding Type 2 Breast tissue Extends over pectoralis muscle border Nipple position At or above pectoralis border Skin excess Tight skin — rounded chest fold Type 3 Breast tissue Extends over pectoralis muscle border Nipple position 0 to 2 cm.
Type 1 Gynecomastia Visualized Type 1 Appearance. What is going on underneath? Optimal Results for Type 1 Unfortunately, the clinical definition for optimal results for gynecomastia is virtually non-existent; even in plastic surgery literature. Nipple position Ideally, the nipple should be cm above the pec.
Areola size, projection and shape The areola is the dark, pigmented skin around the nipple. Chest shape Overall, a masculine chest is full and powerful. Arm pit Should have sculpted appearance with a well define hollow at its apex. Three Fat pockets — pre-axillary, axillary and breast roll Ideally, there should not be any fat pockets.
Breast rolls Should not be present. Back rolls Should not be present. Optimal results — Insights from Dr. Cruise Accurate classification and accurate assessment of patient goals This is, by far, the most important pieces of information you absolutely need to know. Men with perfect skin and no chest hair.
Surgical treatment options Pros and Cons of each: Incision visibility is less of an issue with type 1 gynecomastia compared to the other types.
Type 1 Incision Options Inferior crescent excision Superior crescent excision Inferior linear incision Inferior crescent — most common type 1 incision with Dr. This does several good things beyond tightening the chest skin. More importantly, it pulls the areola tight similar to getting the wrinkles out of a bed sheet. This little maneuver has a large impact in getting rid of excess skin that has been stretched over time.
It also flattens the lower chest skin mildly so that it better wraps around the pec. The incision is located low on the areola where it is very hard to see even early on. Crescent incisions, however, create skin margins that do not line up exactly. The side toward the areola will always be shorter than its counterpart. When sutured together this length mismatch will create mild bunching that takes a little longer to fade away than a linear incision.
However, it is certainly worth it. Superior crescent — useful when the nipple is near the pec. The downside is that superior incisions are always more visible and widen more than inferior. Superior incisions pull the nipple upward slightly.
While this is a good thing from a position standpoint, the slight additional tension means it will take longer to fade. Overall, it is a good way to go for low hanging type 1 nipples. However, young body builders with flawless, darker toned skin and no chest hair should avoid this incision if possible. Inferior linear — most common type 1 incision world-wide. Because there is no skin removal at all, the incision lines up exactly and fades away the quickest.
However, it does not tighten the areola which means that the areola must tighten on it own. If it is unable to tighten it may puff out which is a major reason for the surgery in the first place.
Recovery — Everything you need to know Type 1 — Puffy nipple View timeline Before and Afters Sub-optimal results Perhaps, the best way to demonstrate what are the most important concerns to focus on with type 1 is to give an overview of its most common complications.
Persistent puffy nipple Undoubtedly, the most prominent concern we see in revision type 1 cases is persistent puffy nipple. Incorrect classification will often lead to incorrect treatment. Your type 1 may actually be a type 2 or type 3. This will cause the nipple to drop below the pec. Remove virtually all breast tissue. Type 1 glandular breast tissue acts very different than in other gynecomastia types. It is incredibly tenacious. It invades directly into the dermis of the areola like tentacles.
Removing precisely the correct amount requires experience. This is not as easy as it may seem. Even small amounts of residual breast tissue can swell significantly causing the nipple to continue to be puffy and patients to be upset. Optimal treatment is a balancing act. Tighten the areola skin Often, with puffy nipple the areola has been so stretched out that it simply has too much skin to completely snap back.
This excess areola skin makes the nipple look puffy even if all the breast tissue has been removed. It is similar to trying to put a 10 foot rug into and 8 foot room — you will never get it to lay flat. Tightening the areola is critical and is the reason Dr. Cruise strongly prefers the crescent excision compared to the traditional linear incision. This scar tissue will look puffy — which is very upsetting.
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