Gynecomastia is defined as benign breast growth due to various reasons in men. According to researchers carried out in our country, gynecomastia is seen in one in 3 men. Gynecomastia is not a disease, but a disorder of appearance. Although it is usually seen in adolescence, it can also occur in infancy and old age. The problem of gynecomastia in adolescence can pass by itself. If this problem is seen for a long time, it requires treatment. Although gynecomastia is not a health problem, it causes a lack of self-confidence in men, various psychological problems and a alienation from the social environment.

Causes of gynecomastia;
The problem of breast enlargement can be seen due to irregular or unbalanced hormones called estrogen and testosterone in the body of men. Breast enlargement occurs as a result of the increase in estrogen, the female hormone, in the body of men. There may be more than one reason for the change in the hormonal balance, and there may be other underlying causes of gynecomastia other than hormone imbalances. These reasons can be explained as follows;

• Breast size can be seen in male babies from birth due to the excess of estrogen passed from the mother. This gynecomastia condition is passable and usually disappears 2-3 weeks after delivery.

• The cause of gynecomastia during adolescence is due to the increased hormone estrogen. During this period, the problem of breast growth lasting between 6 months and 2 years can be observed.

• Gynecomastia in adults is seen with the deterioration of hormonal balance due to aging. This gynecomastia problem occurs after the age of 60.

• The problem of breast growth can also be caused by prostate cancer drugs, prostate treatment drugs, some drugs used to treat AIDS, the use of steroids and andogens, some of the antidepressants, ulcers and some antibiotic drugs, chemotherapy treatment and some heart medications.

• Drugs and alcohol use can also cause gynecomastia by disrupting the body’s hormone balance.

• Some tumors in the body, cirrhosis, liver failure, hyperthyroidism and kidney failure can also lead to the end of breast growth.

• Substances such as lavender oil or tea tree extract found in some herbal shampoos, soaps or lotions contain low estrogen, and their prolonged use is thought to cause gynecomastia in men.

What are the symptoms of Giomasti?
Symptoms of gynecomastia in men are tenderness in the breasts, pain, excessive swelling and fluid coming from one or two nipples.

How to diagnose gynecomastia?
Physical examination is performed first for the diagnosis of the problem of breast growth. During the physical examination, the doctor makes a manual diagnosis. During the examination, a mass comes to the hand from the nipple. After this initial diagnosis, USG is performed and gynecomastia is fully diagnosed.

How is gynecomastia treated?
Gynecomastia problem is often expected to pass by itself. If there is a problem of breast size that does not pass after 3 years, then the underlying cause should be investigated. When the underlying is detected and treated, the problem of breast growth is mostly eliminated. Multiple options are available for the treatment of gynecomastia.

Treatment with medication;
It is applied for gynecomastia that has not yet progressed, that is, it is at the initial stage. With the use of drugs that correct the hormonal imbalance, the problem of breast enlargement, which is diagnosed in the early period, can be effectively treated. Medicines called testosterone replacement can also be used for gynecomastia. These drugs usually eliminate the problem of breast enlargement for older men, but are effective for those with low testosterone hormone levels in their body. Drug treatment called SERM is applied for severe or painful gynecomastia. These drugs help reduce breast tissue.

Surgical treatment;
Surgical intervention is required to definitively resolve the gynecomastia problem. Surgical treatment varies according to the type of gynecomastia. Types of gynecomastia can be examined in four groups as both hard breast tissue that develops due to excess hard breast tissue, develops due to excess fat tissue, and breast enlargement that develops due to excess skin on the breast.

• If there is a gynecomastia problem caused by hard breast tissue, open surgery is preferred by doctors.

• If there is only gynecomastia caused by adipose tissue, treatment is provided by liposuction (fat removal).

• If there is a problem of breast enlargement due to both hard breast tissue and adipose tissue, open surgery and fat removal operations are applied together.

• If there is gynecomastia caused by excess skin, surgical intervention will be performed again.

• Although the duration of the operation varies according to the method to be applied and the causes of breast enlargement, it takes an average of 2 hours. In open surgery, tiny incisions are made in the lower part of the patient’s chest area and excess skin and breast tissue are removed. Then the incisions are closed with sutures and the surgery is completed. In the liposuction method, laser or vaser method is used and the excess fat tissue in the breast is removed with the help of thin cannulas. After both methods, the patients will be sutured, albeit a little. The surgeries are usually performed under local anesthesia, but sometimes general anesthesia can be applied in open surgery.

Patients undergoing general anesthesia should stay in the hospital for one day immediately after the operation. In surgeries performed with local anesthesia, patients are discharged to their homes on the same day.

What is the process after gynecomastia surgery?

• Patients do not feel pain after gynecomastia surgery.

• It is recommended that patients rest for the first 2-3 days after the surgery. Patients are able to walk after the surgery, but resting is important for accelerating the healing process.

• In the first few days after the surgery, solid foods should not be taken to avoid strain on the stitches.

• After the surgery, patients should wear a corset for 3 weeks. After removing this corset with the permission of the doctor, it should be used for 6 weeks during the daytime and during sports, that is, during heavy activities.

• Patients should wait a week after the surgery to return to their daily lives. At the end of this one week, light exercises and walks can be done, but patients should avoid movements that will force them.

• Patients generally need to protect the surgical site from sunlight for the first three months.

• It is considered normal to have edema and swelling after the operation. These will go away on their own within a week.

• On the 3rd day of the operation, patients can take a shower, provided that they do not stay in the bathroom for a long time.

The gynecomastia problem disappears completely with surgery and usually does not reoccur. However, there is a possibility that patients gain too much weight and reoccur only due to lubrication.


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