Frequently Asked Questions About Gynecomastia and Its Treatments

Gynecomastia refers to the benign enlargement of male breast tissue, often resulting from a hormonal imbalance. It occurs when there is a disproportionate increase in estrogen (the female hormone) compared to testosterone (the male hormone). This condition is characterized by the growth of glandular tissue in the breast, not just excess fat.

According to the National Institutes of Health (NIH), gynecomastia affects up to 65% of adolescent males and 30% of adult men during their lifetime (NIH, 2018). The condition can occur during puberty, as hormonal fluctuations lead to temporary breast tissue growth, or in older men, when testosterone levels decrease and estrogen levels remain the same or rise.

The causes of gynecomastia can be complex, and several factors may contribute to the development of this condition:

1. Hormonal Imbalances: This is the primary cause of gynecomastia. During puberty and aging, fluctuations in estrogen and testosterone levels can lead to breast tissue enlargement. A study published in the Journal of Clinical Endocrinology & Metabolism found that 50-60% of adolescents experience temporary gynecomastia during puberty (Katz et al., 2015).
2. Medications: Certain medications, including anti-androgens, steroids, antidepressants, and heart medications, can alter hormone levels and promote gynecomastia. According to the American Society of Plastic Surgeons (ASPS), medication-induced gynecomastia is a significant contributing factor in adult males.
3. Medical Conditions: Underlying health issues such as liver disease, kidney failure, thyroid disorders, and testicular cancer can lead to gynecomastia. According to the Endocrine Society, men with cirrhosis or chronic kidney disease are at higher risk for developing the condition.
4. Substance Use: The use of substances like alcohol, marijuana, and anabolic steroids can disrupt hormonal balance and cause gynecomastia. A study in the American Journal of Men's Health noted that marijuana use was linked to an increased risk of gynecomastia due to its effects on the endocannabinoid system.
5. Aging: As men age, testosterone levels naturally decline, leading to a higher likelihood of developing gynecomastia. Testosterone production decreases by about 1% annually after the age of 30, increasing the risk of hormonal imbalances.

Yes, gynecomastia surgery generally offers permanent results. Once excess glandular tissue is surgically removed, it does not typically regenerate. Liposuction or glandular excision can provide a more contoured chest, with most patients seeing long-term improvements.

However, certain factors could trigger a recurrence of gynecomastia:

• Weight gain: Significant fluctuations in weight can lead to the accumulation of fat in the chest area.
• Medications or drug use: The use of anabolic steroids, marijuana, or other substances can induce hormonal changes that lead to gynecomastia.
• Aging: If testosterone levels continue to decrease with age, some men may experience a recurrence.

Dr. Shteynberg will guide you through post-surgery instructions to maintain long-term results, such as staying at a healthy weight and avoiding substances that can disrupt your hormones.

You may want to consider gynecomastia surgery if:

• The condition causes physical discomfort, such as tenderness or pain in the chest area.
• The condition negatively impacts self-esteem or leads to emotional distress.
• You have tried non-surgical treatments (such as weight loss or medication changes) without improvement.

According to the American Society of Plastic Surgeons (ASPS), cosmetic surgery to correct gynecomastia can lead to improvements in self-esteem and quality of life for many patients, with over 95% of patients reporting satisfaction with their results.

A consultation with Dr. Shteynberg will help determine if surgery is right for you. He will perform a thorough assessment, review your medical history, and explain the best surgical options tailored to your needs.

The two primary types of gynecomastia surgery are:

• Liposuction: This is ideal for pseudogynecomastia (fat accumulation in the chest) or cases where the condition is more fat than glandular tissue. Liposuction involves the use of a small cannula inserted through tiny incisions to remove excess fat.
• Excision Surgery: This is recommended for cases where glandular tissue is present. Excision involves making incisions around the areola or in the natural folds of the chest to remove the glandular tissue. This technique can also be used to correct significant sagging or skin excess.

In many cases, Dr. Shteynberg combines both liposuction and excision techniques to ensure optimal results for patients with mixed gynecomastia (both fat and glandular tissue).

Most patients experience minimal discomfort after surgery, with swelling and bruising being common for the first few days. Recovery can vary depending on the extent of the surgery, but here’s what you can typically expect:

• Compression Garment: Patients are advised to wear a compression garment for about 4-6 weeks to help reduce swelling and support the chest during healing.
• Return to Normal Activities: Light activities can typically resume within 1-2 weeks. Most patients can return to work after 5-7 days, but strenuous activities, including lifting or heavy exercise, should be avoided for 4-6 weeks.
• Final Results: It can take anywhere from 3-6 months to see the final results of the surgery as swelling subsides and the chest contour becomes fully defined.

Dr. Shteynberg will provide you with detailed post-surgery instructions to ensure a smooth recovery.

All surgical procedures come with some risk of scarring. However, Dr. Shteynberg takes great care to minimize visible scarring. For liposuction, small incisions are used, resulting in minimal scarring. In the case of excision surgery, scars are usually placed around the areola or in natural chest folds, which helps them remain inconspicuous.

According to a study in the Aesthetic Surgery Journal, 95% of gynecomastia patients report that the scars are well-hidden and not noticeable after full recovery.

To help prevent recurrence, consider the following:

• Maintain a stable weight: Weight gain can lead to fat accumulation in the chest area.
• Avoid drugs and steroids: Anabolic steroids and recreational drugs can disrupt hormones and cause gynecomastia.
• Follow Dr. Shteynberg’s guidelines: Adhering to post-surgery instructions and maintaining a healthy lifestyle can significantly reduce the chances of recurrence.

You can generally resume light activities like walking after 1-2 weeks. However, more strenuous activities and heavy lifting should be avoided for 4-6 weeks after surgery. Full recovery from surgery takes 3-6 months, but your chest will be well on its way to its final shape after just a few months.